When we’re in the throes of chronic pain, it can be difficult to even believe that there could be a way out. We may feel stuck, frustrated, scared, or hopeless. The overwhelming fear of potentially never getting better or – maybe even much worse – is keeping us stuck in a constant state of fight or flight.
But there is hope. Modern pain neuroscience shows that, in many cases, chronic pain tends to be neuroplastic, meaning that the pain is not caused by structural or physical problems but rather by learned neural pathways in the brain. Simply put, by the time the physical/structural cause of the original pain has healed, our brain has gotten really good at producing a pain signal.
The good news is that what can be learned can be unlearned.
There are steps we can take to regulate our nervous system and reduce symptoms:
Ditch catastrophizing: It is extremely important to become aware of when our brain goes into worst-case-scenario projections, aka catastrophizing, so we can gently redirect our thoughts to a more productive, more positive outlook. A really powerful tool we can use is sending ourselves messages of safety. “I am okay.” “This is temporary.” “I am not as fragile as I fear I am.”
Letting go of perfectionism: Being ‘always on’ and ‘always giving 110%’ is a common personality trait among chronic symptom sufferers. Ask yourself if this rings true for you and investigate how you can get to a somewhat softer approach. Could you consider 90% to be an acceptable goal?
Reducing the intensity of approaching our pain: Urgency and intensity are entirely understandable. However, they do increase the internal pressure in our nervous system. Our brain reads this as an increase in threat level and ramps up the pain signal. So, we’re getting exactly the opposite of what we are going for. Whenever we notice a rise in intensity, doing a minute of slow breathing can be a helpful pattern interrupt.
Reappraising our symptoms: Once a structural cause of our symptoms has been ruled out, we can rule in that this might be a neuroplastic condition. Dr. Howard Schubiner’s FIT Criteria Self-Assessment is a great tool. The more questions we can answer with ‘yes’, the more likely it is we are suffering from a mindbody condition. From now on, we can learn to look at our symptoms through a lens of safety because we understand that it’s our brain that’s making a mistake, and we will teach it how to correct this mistake.
Practicing Self-Care: A crucial part of retraining our brain is to learn how to take really good care of ourselves. Chronic pain sufferers are often notoriously good at disregarding the subtle messages our body sends us to alert us to the fact that something needs our attention. Over time, the brain resorts to more drastic messages (aka pain/symptoms) to REALLY get our attention. By showing our brain that we are determined to take better care of ourselves, we can relieve it of its need for constant hypervigilance and allow for some calm in our nervous system.
Establishing and enforcing healthy boundaries: Chronic pain sufferers frequently have people-pleasing tendencies, which means that we say ‘yes’ to others way too often and in situations when we should actually say ‘No.’ This can lead to overexertion and, more importantly, to a lack of time or awareness to attend to our own needs. Establishing healthy boundaries is an important step in our self-care practice. It can be difficult and uncomfortable initially, but it is a crucial waypoint.
Making time for fun: When we are stuck in chronic pain, it’s hard to think about anything else. However, as our nervous system gets more and more regulated by following the previous steps for some time, it is important to reintroduce joy and fun into our days. Nothing says ‘I am safe’ better to our brain than doing something with a big smile on our face. It’s okay to start small, for example by making a list of things that bring joy or that we look forward to doing again.
Living our life: Ultimately, the more we go about living our life, the less time and attention we are giving to the pain. Indirectly, this is yet another powerful signal to the brain that the symptoms don’t seem to bother us that much; ergo, they must not be as dangerous as our brain had previously thought – a crucial step of rewiring our brain!
While these steps are simple, following through isn’t always easy. Let’s not forget that our brain always gravitates to what’s familiar, so it takes commitment, time, and repetition to create new, healthier neural pathways. It also takes a great deal of self-compassion and self-kindness, something that doesn’t always come easy to us and will take some time to cultivate. There will be trial and error, and that’s okay. It can be super frustrating to read about how quickly other people have been able to heal (“I just read the book and my pain was gone.”), so let’s not compare ourselves to others. After all, not two chronic pain journeys are alike!
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