Today, people often talk about the connection between the mind and the body, and there can be a perception that this concept is something new. However, the understanding that our minds and our bodies are essentially one-and-the-same thing has been around for a long time. The ancient Roman poet Ovid, for example, wrote, “When the mind is ill at ease, the body suffers.”
In the modern world physical ailments such as chronic pain, metabolic diseases, and cardiovascular disease are often viewed only through a medical model. Often they’re seen as the result of purely physical causes; unhealthy eating, sedentary behaviour, substance use, or simply physical injury. But what if things are more complex than this?
What some people may not be aware of is that many of these kinds of behaviours are actually ways in which we are trying to manage uncomfortable emotions, calm ourselves, and stabilise our sense of self. In the case of chronic pain (that is pain that continues to occur for more than three months after a physical injury), it can be helpful to gain an understanding of what happens in our brains as time progresses.
What brain imaging studies have shown us is that when we experience acute pain, such as when we injure ourselves physically, this is processed primarily in the sensory cortex – that is, our brains are trying to understand the sensations and sensory information we’re receiving from our bodies. If this initial physical injury then heals without difficulty and pain ceases, then the activity levels of the sensory cortex gradually return to normal. However, if an individual goes on to develop chronic pain after an injury has healed physically, brain imaging studies have shown a shift in which brain areas become involved. Instead of the sensory cortex trying to make sense of incoming information, we see other areas of the brain being recruited. These include the amygdala (understood as an emotional centre of the brain), the hippocampus (a region of the brain crucial to memory), and the nucleus accumbens (part of the “reward system” of the brain).
So what does this tell us, and why might this be important? Put simply, chronic pain becomes an emotional experience which is bound up in our memories and associations, and potentially a sense of relief when we might avoid certain movements or activities. For example, if I’ve strained my back badly, understandably there may be fear about bending or stretching in a particular way, and if I come to associate a particular place or movement with the experience of pain, I’ll probably try to avoid it. When we avoid something painful, generally it feels pretty good; we might experience a rush of relief. This feeling of relief is a very powerful reinforcement, making it more likely that I’ll continue to avoid that place, or movement associated with the experience of pain.
This is where psychological therapy can become helpful, as it provides us with the opportunity to build awareness of our own affective states, learn how to regulate our emotions, and gradually work toward changing our behaviours in meaningful ways for us as individuals. Ultimately this provides the opportunity for us to re-learn how to feel safe in our bodies, and make decisions that are in-line with what we really care about, rather than reacting automatically and becoming stuck in fear, avoiding things we’re scared of. So if you would like support around understanding and managing chronic pain, psychologists provide a safe, confidential space for individuals to put language to their emotions, and become more aware of their own thought processes, feelings, and behaviour with the goal of helping people to move towards living a fulfilled life, engaging in meaningful activities and movement for them.
