What is pain?

What is pain? This simple question has a seemingly obvious answer- pain is anything that hurts!

But asking ourselves that question can lead to some surprises, which bring empowering solutions.

The latest clinical definition of pain as described by the IASP (The International Association of the Study of Pain, of which I am a member) is as follows-

“Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”

There are a few categories of pain- generally speaking, acute pain means recent, and chronic pain is defined as anything persisting for 3 months or more. (I prefer the term ‘persisting’ as ‘chronic’ sounds like its implying there will never be an end- which is entirely untrue- but I will use the word ‘chronic’ as its how the literature generally refers to this type.)

There are subgroups of chronic pain- secondary pain is is due to underlying disease such as cancer, and primary pain is arguably a disease in its own right, because its the sole symptom and complaint.

(I work with people experiencing chronic pain, who have ruled out underlying tissue damage, because I’m a therapist not a nurse or medic, and I will always make sure people have had appropriate medical treatment first.)

There are also 4 broad types of pain, which can overlap and cross over- nociceptive (caused by tissue damage) inflammatory (caused by inflammation) neuropathic (caused by nerves) and neuroplastic (caused by changes in the brain.)

All this sounds quite depressing and well, painful! But- there is hope, and lots of it- so please read on!

Chronic pain, lasting 3 months or longer, generally will have an element of neuroplasticity to it. (Neuroplasticity = your brain’s ability to change).

This is GOOD NEWS! Because it means if your brain has changed to be a certain way, it can change back again, given the right inputs. I’ll go into some of those inputs soon. But first I’d like to go back to the official definition of pain.

“Pain is an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”

Let’s unpack that a little bit here. The first part is- its unpleasant. That much is clear. Pain is a warning that something needs to change. In this respect, its an excellent protective mechanism.

Some people are born without the ability to feel pain- they sadly usually don’t live very long. There is nothing to prevent them from injuring themselves over and over again. So actually, its appropriate to be thankful for the ability to feel pain, as weird as that sounds.

The next part of that sentence to highlight is that its a ‘sensory and emotional experience’. So the most scientifically proven and up to date definition of pain recognises that it ALWAYS has an emotional component. This is important- because if we change our emotions associated with pain, we change our experience.

This change can come in many forms- creating new neural pathways by having hypnotherapy for anxiety or hypnotherapy for trauma for example, or making positive new brain connections by expanding our knowledge with Pain Neuroscience Education. I also find that Buteyko Breathing is super helpful for letting go of stress held in the body, as is TRE (Trauma and Tension Release Exercises).

Whichever way you address it, understanding your emotional response and finding ways to soften fear and anxiety around the pain is a vital part of releasing pain.

Lets look at another part of that official definition- ‘actual or potential tissue damage’. Basically what this acknowledges is that there doesn’t need to be actual damage for pain to be present.

This is where the neuroplastic element comes in.

One way of saying this is that PERCEPTION IS YOUR INTERPRETATION OF SENSATION.

The way that you interpret incoming sensations- on a spectrum from ‘safe’, through ‘neutral’, to ‘dangerous’ - will inform how you perceive that sensation. Change the interpretation, and your perception changes.

In fact there is only a weak correlation between perceived pain and tissue damage.

This is demonstrated through the peculiar and well documented case of a man who showed up at a hospital in unbearable agony, having accidentally shot a nail gun through his work boot. Because thats going to hurt, right?

But when the doctors cut his boot off, everybody was surprised to see that the nail had merely gone between his toes, causing zero damage to his foot. And yet the pain that the man had experienced was very, very real.

His brain had made a mistake in its calculations- by expecting there to be a nail penetrating his foot, it had predicted tissue damage which warranted extreme pain, and therefore created the alarm signals that needed to happen to protect his foot from further ‘damage’- which was to cause pain. But his foot was 100% fine!

He had interpreted a neutral sensation as dangerous, causing pain perception.

Another way of saying this is that PAIN IS YOUR BRAIN’S ASSESSMENT OF HOW MUCH DANGER YOU ARE IN.

And your brain, helpful though it may be trying to be, can get that assessment wrong. In fact, its protectiveness may be the problem- because in the absence of tissue damage, that protectiveness is misplaced. Its a bit like a dog who bites the postman’s hand- the dog thinks he’s helping, but now the postman is considering suing you- creating a big problem that wouldn’t be there if the dog wasn’t so overprotective. He thinks he’s doing his job, but is driven by fear.

And so the brain can get stuck in a feedback loop, called the pain/fear cycle. Pain triggers feelings of fear. The fear puts the brain on high alert, with increases pain perception. This leads to more fear. Which leads to more pain. Its a downward spiral.

So what can we do?

In fact, there are many, many things we can do.

• Soothe the inner guard dog, for a start.

• Break the pain/ fear cycle.

• Change the interpretation of sensation.

• Identify and challenge limiting beliefs around pain with the intention to update them.

• Increase safety cues so that there is no need for alarm.

• Dial down the stress hormones cortisol and adrenaline that ramp up pain perception.

• Utilise the body’s own painkilling hormones and neurotransmitters- endorphins and endocannabinoids- to bring the body back to ease.

• Create new neural pathways with hypnotherapy for pain relief.

• Use visualisations to bring to mind a different way of relation to your body.

• Learning about pain is in itself a treatment for pain. We have learnt more about pain in the last 15 years than in all of the preceding history of recorded time- and this new knowledge is empowering!

And this is just addressing the psychological aspect! The other aspects involved- biological and social- well thats a whole other blog post.

As you can probably tell, I’m a little bit excited to help people out of persisting pain. Because I know, with the right inputs, your perception of pain can change. Its my job, but not just my job- its my passion, to find those inputs and share them with you.

If you need help with putting pain behind you there are a few ways I can help-

• Sign up to my monthly newsletter to receive valuable cutting edge insights into the psychology and reversal of chronic pain

• Take the Persistent Pain beliefs evaluation questionnaire attached to the link on my contact page or IG to find out how much of your pain is being driven by your thoughts

• Follow me on IG for regular pain busting tools and techniques

• Get on the list for my next group program Releasing Chronic Pain, a 6 week course combining Pain Neuroscience Education, Cognitive Hypnotherapy, Trauma Release Exercises and Buteyko Breathing to help you put pain in the past. These are conducted via zoom, and are small groups, to heal in community. Email me for more info

• Book a free, no obligation 30 minute phone call to find out more about working 1 to 1 with me, either online or in my therapy room in Hastings

• Check out the resources page on my website for free hypnotherapy recordings, and book recommendations.

Until then, I hope you have found this interesting and helpful.  To your good health,

Ella

Relationships- Attachment Styles, the Therapeutic Paradox, and Repetition Compulsion.

Have you ever had a friend that you’ve spent years consoling over various failed relationships, each time watching them choose people who hurt, belittle, confuse or abuse them? 

Or perhaps you have been in a similar situation yourself. And maybe you have asked yourself why? Why would they do that? Why do I do that?

This seemingly illogical behaviour isn’t done on purpose, and instead of heaping judgement on it, (and them, and ourselves) if we understand the root cause, we can start to change those habits and patterns that keep us from finding happiness in ourselves-  and if we choose to be partnered, to find someone who is going to love and cherish us and help us feel safe.

Continually seeking people out who are emotionally unavailable/ untrustworthy/ unsafe is one of these self defeating behaviours, and is usually caused by the subconscious drive to repeat the unresolved issues of the past (the relationship we had with our parents) in order to prove to ourselves that we can ‘fix’ people who remind us on some level of our early caregivers- this is known as Repetition Compulsion. 

An example of this would be the woman who constantly seeks out unavailable, flaky men who are cheating on their partners, because this is how she witnessed her dad behaving towards her mum.

The Therapeutic Paradox is a phenomenon where due to negative behaviour driven by faulty beliefs, we inadvertently create the very situation we were trying to avoid. 

In relationships this can look like- someone so jealous or clingy that they drive away the person they love with their constant acting out/ questioning/ demands/ suspicion… their insecurity forcing the loved one to leave, unable to cope with the excessive demands and accusations.

Or it could manifest as someone who is so terrified of being hurt that they always push their loved one away first, keeping people at arms length and ultimately ending up alone.

The first is indicative of an Anxious attachment style, the second an example of an Avoidant attachment style. 

Both these Attachment styles can be confusing for everyone involved, and they often attract each other- the Anxious person naturally gravitating towards the Avoidant and vice versa. This push pull dynamic is ultimately unhealthy no matter how seemingly well suited each partner is- because each partner will continuously activate the other’s core wounds.

The reason people wind up in these unsatisfactory relationships is due to their family of origin. Classic studies done in the 70’s by John Bowlby showed that the relationship dynamics your parents bought you up in have long lasting implications for your later, adult romantic relationships. If you had a mother who was less than attentive and attuned, who didn’t meet your needs and was self absorbed, your relationship with adult partners later in life will reflect this. 

If you think back to your childhood, can you remember being hugged, held, and told you were loved? Were you appreciated for just being yourself? 

If so, congratulations- you are one of the lucky 50% of the population who have been bought up as Securely attached. 

Did you only get praise when you got top marks at school/ won the race? Did you have to work to earn affection? Did you feel there wasn’t enough attention to go round?

Or could you do nothing right in the eyes of your parents? Were you ever hit, shouted at for minor mistakes, ignored, left to fend for yourself?

If the answer is yes to anything in the last 2 paragraphs, these parenting fails have probably left an imprint on the way you relate to yourself and others- leading to an Anxious, Avoidant or Disorganised attachment (Disorganised attachment is a combination of Anxious and Avoidant and is caused by unsafe, violent and abusive parenting. This can make navigating adult relationships even more challenging than either Anxious or Avoidant) These trickier attachment styles make up 50% of the population combined.

But, hope is not lost- it’s entirely possible to change the Attachment style you were bought up with. If the people around you, especially your partner, have a Secure attachment style, you can become what’s known as ‘earned Secure’ - their way or relating and sense of safety and trust in others can be passed on to you.

Or with the help of a trusted therapist, as you learn about your patterns, triggers, limiting beliefs and unconscious drives, you can step away from these harmful behaviours and towards more healthy and realistic beliefs and behaviours.

Ultimately we all deserve to feel happy and secure, in ourselves and in our relationships. Undoing the damage a less than great childhood has had on someone isn’t easy, but it is possible. Understanding  why you behave the way you do is the first step. And the work is so worth doing. 

Growing free of self defeating thoughts and drives leaves space to develop safe, nurturing and trusting relationships- with yourself, and with those around you. If you’d like support to navigate your relational style, Cognitive Hypnotherapy can help you yo understand yourself- ultimately leading to feeling safer in the world.

Why I’m here.

This is my first blog, so I thought I’d start from the beginning, by explaining why I do what I do.

Apart from my own experiences with chronic pain, and finding pain relief without the need for drugs or surgery, a lot of my motivation to help people has come from my experience of caring for my mum.

She already had Chronic Obstructive Pulmonary Disease when she was diagnosed with stage 4 Peritoneal cancer 8 years ago. (COPD is an umbrella term to describe chronic lung conditions including Emphysema, Asthma, and Bronchitis. She had late stage Emphysema and chronic Asthma caused by a lifetime of smoking)

But with my help and A LOT of determination, she had 2 periods of remission lasting 5 years, (3.5 years of no cancer in total) before finally succumbing 3 years ago.

Having to deal with the medical system, the endless days in hospital having chemo, the countless emergency trips, having to wait hours and hours in various corridors and waiting rooms, dealing with well meaning but harried nurses, the awful food on offer in places where you are supposed to be getting well, the unhelpful throwaway remarks by doctors that planted seeds of fear and despair in my poor mum’s mind (called a nocebo- the opposite of placebo)- I could go on- I have seen first hand how the system doesn’t work, how years of underfunding and mismanagement have stripped the ‘health’ and the ‘care’ from healthcare.

I also saw first hand how devastating smoking is. My mum found it so hard to stop, even with COPD and cancer, that she kept going back to it even when she was ill.

I learned how so much can be different when we take matters into our own hands. By empowering my mum to look for other sources of health, and using complementary medicine for her anxiety relief and pain relief, I helped her feel in control of her health despite the gloomy prognosis.

Her empowerment led her to make different choices, which enabled her outlive the doctor’s expectations by 5 years!

At the time, I didn’t even know about how hypnotherapy for anxiety was so effective, or hypnotherapy for pain relief. I had no idea what breath work was, let alone how helpful Buteyko Breathing for anxiety was. I had no idea that Butekyo Breathing could improve and even eliminate the symptoms of breathlessness associated with COPD.

I didn’t know chronic pain could be reversed. I had never seen people give up smoking with Hypnotherapy before. There was so much I didn’t know, but just the willingness I had to show up and do my best to help her live longer, live happier and ultimately die better, was enough at that time to keep me going, and to give her as much pain and anxiety relief as possible.

Knowing what I now know, following years of experience of helping my mum and countless others who came to me after her initial success, and after my extensive training in Cognitive Hypnotherapy, Buteyko Breathing, Pain Neuroscience Education and Trauma Release Exercises, I am delighted to be able to offer a bespoke, holistic approach to dealing with chronic illness, chronic pain, anxiety relief, stress relief, smoking cessation, overcoming trauma and more.

Being able to help others find relief from difficult conditions, and all types of pain including physical pain, mental pain and emotional pain, gives my life more purpose and meaning than I had ever imagined possible.

So, much as dealing with my mum’s terminal illness was exhausting, terrifying, painful and difficult, it was also a period of transformation in my life that has ultimately led me to where I am today. It was awful- but also deeply revelatory, and empowering. And maybe my life experiences and subsequent training can in turn, help you to change your life for the better.