Chronic pain is often something that the people around us cannot see or understand. The emotional burden that comes with the pain is invisible, heavy, and often outweighs the physical pain itself. As a chronic migraine sufferer, I understand the toll of being in pain, both physically and emotionally. As a therapist and someone who loves psychology and neuroscience, I've studied how to emotionally cope with the burden of pain.
Imagine that one time someone grabs your arm and gives a little squeeze, then they keep squeezing, keep squeezing, until your arm is bruised, tender, and screaming with pain. The next time someone goes to grab your arm, you would flinch away. You might screech "ow!! Stop!!" The pain isn't there yet, but you know what's coming. Your anxiety skyrockets and you think "not again!" This is often the process that people with chronic pain are going through. The second the inkling of pain begins, we flinch away, we become fearful, we try to stop the thing that we suspect is coming: pain.
Our brains are made up of neural pathways. The pathways we use most often are prioritized in the brain, becoming faster and more automatic than other, less used pathways. Our thoughts travel through these pathways and trigger various emotions and physiological responses, such as fear, sadness, loneliness, excitement, etc. When we start to experience pain, especially for people with chronic pain, a cascade of neural networks start firing. The thoughts might go something like "oh gosh, I think I'm getting a migraine", and then "where did this come from? Is it because I went to bed late last night?" and then "I guess I should take some medicine. Do I take X? Or Y?" which then might trigger thoughts around pros and cons of each medication, thoughts of long-term consequences of each, thoughts of insurance and how much certain medications cost. We also might start feeling angry or upset about the pain. "C'mon! Why do I have to deal with this. This isn't fair!". The pain might intensify, along with our anxiety about the pain. "Is this going to ruin my day again? Should I go ahead and cancel my plans tonight?" It might, eventually, cause sadness, despair, and loneliness: "my friends don't understand what this is like. My partner is tired of hearing about it. I have to carry this pain alone".
The onslaught of thoughts, emotions, decisions, and sensations, might all stem from one, tiny trigger. They might come from a feeling that isn't necessarily painful–yet–and the knowledge that it might very well turn into pain. The thoughts might also come from something that is already painful, a feeling that never quite goes away, a hurt that goes up and down in intensity but never fully weakens to a point of relief.
Being in pain is, of course, painful, but it's also exhausting, isolating, and mentally taxing. So many decisions have to be made when one is in pain. "Do I push through, or rest?", "Do I take this medicine, or that one?", "Do I prioritize this thing, or that one?", "Will this make me feel better, or worse?". Then, of course, there's the ever-present task of trying to schedule doctor's appointments, deal with insurance, pick up prescriptions, etc. People with chronic pain are holding more in their brains than people without pain could ever imagine. Often people with pain worry that they're burdening the people around them because truly, the pain feels like such an intense burden to themselves.
The medical system in the US certainly doesn't help, with insurance refusing to cover medications that might help, having to wait months to see a specialist, getting conflicting advice and information from various sources. The financial stress can contribute to the pain itself, as our minds don't differentiate from physical and emotional pain. The emotional pain we feel contributes to the physical pain we experience, and vice versa. Pain is pain.
How can therapy help break through this broken system, these feelings that are physical in nature? How could talking about it possibly reduce the pain?
One goal that's often present in therapy is re-wiring the pathways in our brains so that we can be happier. Instead of going to "danger!" when something neutral, like getting a phone call, happens, we purposefully and mindfully try to shift mindsets. No, that's not dangerous. Take a deep breath. This is okay. With time and compassionate practice, we can train our brains to not be triggered by certain stimuli. In treating chronic pain, the goal is the same. Notice the sensation. Don't panic. Don't ignore or push it away, but instead greet it like an old friend. "Oh hi, you. I notice the sensation you're bringing. Do you need something from me?" Learning to treat the pain with neutrality doesn't necessarily make the pain go away, but it lessens the emotional pain, which ends up lessening the physical pain, too.
Therapy is also beneficial in that it can give you a space where you can share the worries circling your mind without feeling like a burden. You can be heard, understood, and validated without someone saying "oh, you should try ____!" or "you just need to stay more hydrated!" or whatever (well intended) advice that many people try to give. I'm not going to try to "fix" your pain. What I will do is hold space with compassion and try to help you feel less alone.
If any of this resonates with you, please reach out to schedule a consultation today.