Why chronic pain persists, and what to do about it

Are you one of the 1 in 4 adults in the UK who live with chronic pain? And in this shockingly high number, women are even more disproportionately affected. Perhaps you have unexplained fatigue, or other mysterious symptoms. It’s frustrating, confusing, scary, disheartening and exhausting, isn’t it? Perhaps you’ve tried everything- the supplements, herbs, medications, scans, chiropractors, thinking positive, doing more exercise, meditation- and none of it has worked for long. Or maybe you’ve been told that there’s nothing more the doctors can do, and been sent home with antidepressants and painkillers.

The thing is, the entire medical profession, and many of the bodyworkers out there, are looking for answers in the wrong places. They are coming from a biomedical and biomechanical approach, when pain is a biopsychosocial phenomenon. What this means is that there are many factors influencing your perception of pain, and tissue damage is only one of them. Tissue damage actually has a surprisingly weak correlation to pain. In fact, most chronic pain (lasting 3 months or longer) isn’t caused by structural damage at all- it’s due to changes in the way your brain interprets signals from your body.

That said, all pain is real! If you have been told “it’s in your head” then this is your signal not to listen to that person again! Once you have expanded your understanding of what pain is, how it perpetuates, and what you can do about it, you’ll be in a much better position to feel hopeful, empowered, and like you have agency and choice over your situation-  and this essay aims to provide you with just that. So, read on!

By the end of this article, you’ll have a deeper understanding of the following facts-

• Chronic pain is often driven by nervous system sensitivity rather than ongoing tissue damage.
• Stress, trauma, inflammation and life load can sensitise the nervous system over time.
• This process is called central sensitisation.
• When the nervous system feels unsafe, it produces protective symptoms such as pain, fatigue and tension.
• Understanding how pain works can reduce fear and help retrain the nervous system.

So- if pain is not simply a sign of damage, then what is it?

Pain Is a Protective Output

Pain is a protective output. It is your nervous system’s best guess at how much danger you are in, based on the information available. Think of it like a guard dog. A well- trained guard dog barks when there is a genuine threat, and settles when the threat has passed. But if that dog has been repeatedly startled, stressed or confused, it may begin barking at everything- the wind, a passing shadow, a harmless visitor. The barking is real. The alarm is loud. The doggy thinks he’s doing a good job. But the danger is not always proportional.

Your nervous system is the same. It’s not broken- it’s doing its job, too well.

What Is Central Sensitisation?

Chronic pain is often the result of an inner guard dog that has become overprotective. Over time, stress, injury, trauma, inflammation, hormonal shifts, a harsh inner critic, lack of sleep, blood sugar swings, adverse childhood experiences, and repeated periods of overload can all sensitise your nervous system. This is where central sensitisation comes in- a state in which the nervous system becomes more responsive, more vigilant, and quicker to interpret sensation as threat. The threshold lowers. The volume turns up.

And once your nervous system has learned this pattern, it doesn’t simply switch off because you want it to. Many of these responses operate below conscious awareness. They are shaped by memory, by subconscious associations, by neural networks strengthened over time, by previous experiences of danger or overwhelm. Which means that trying to “think positively” your way out of chronic pain is a bit like asking the barking guard dog to read a self- help book.

When we talk about central sensitisation, we are describing a nervous system that has become too efficient at producing pain. Neural pathways get stronger with repetition. The more often a protective response is activated, the easier it becomes to trigger. This does not mean the pain is imagined. It means the system has adapted- just not in a way that feels helpful.

The Biopsychosocial Model of Chronic Pain

This is where an understanding of the biopsychosocial model becomes important. Pain is influenced not only by tissues, but by stress chemistry, immune activity, past experiences, how much support you have, beliefs, context, and whether the nervous system feels safe. The hypothalamic-pituitary-adrenal (HPA) axis (your stress response system) plays a central role here. Prolonged stress can alter cortisol rhythms, disrupt sleep, increase inflammation, and amplify pain sensitivity. Add hormonal shifts during perimenopause or menopause, and the system may become even more reactive.

You might recognise this in yourself. Perhaps your pain or symptoms flare when you are stressed, overwhelmed or haven’t slept enough. Perhaps they worsen before a difficult conversation, during hormonal shifts, or after pushing yourself too hard for too long. Maybe scans have shown nothing significant, yet the pain is very real. These patterns are clues. They tell us that the nervous system is involved. If you’d like structured, personalised support to work through this in depth, you can read more about 1:1 support here.

Some researchers describe a related concept called the “cell danger response.” In simple terms, when the body perceives threat- whether physical, infectious, inflammatory or emotional- cells shift into a defensive mode. Resources are diverted toward protection rather than repair. If that protective state becomes chronic, symptoms can persist even when the original trigger has resolved. Again, this is not dysfunction. It is protection that has not yet received the message that it is safe to stand down.

The Bathtub Analogy

You may not feel consciously stressed. In fact, many of the women I work with are competent, capable, used to coping. But the body keeps score of cumulative load- deadlines, parenting, caregiving, childhood adversity, illness, relational strain, internal pressure to hold everything together. Like a bath with the tap still running, eventually it overflows- and the overflow can look like pain, fatigue, migraines, gut symptoms, in fact any symptoms (skin complaints, dizziness, brain fog to mention a few), or persisting anxiety.

(Many of the same mechanisms that drive chronic pain also underlie anxiety symptoms- you can read more about that here.)

The important thing to understand is that it isn’t just the steady drip drip drip of daily stress that causes the overflow. That drip is to be expected; after all, we can’t get through life with zero stress. (And nor would we want to- some stress is a good thing.) It’s everything that was already in the bath to begin with. Old injuries. Unprocessed experiences. Unexpressed emotions. Hormonal shifts. Years of pushing through. Patterns learned in childhood about staying vigilant, staying responsible, staying strong. The water level may have been high long before the most recent stressor arrived.

And this is where many approaches go wrong. They focus only on turning off the tap- reducing stress, thinking differently, managing workload. That can help. But if the bath is already near the brim, even a small additional drip will cause overflow. Sustainable change comes from gradually emptying what has accumulated and, at the same time, increasing the capacity of the bath itself- expanding what is called your Window of Tolerance. In nervous system terms, this means building flexibility, so that the same inputs no longer trigger the same protective output.

What Is the Window of Tolerance?

The “Window of Tolerance” is a term used to describe the range within which your nervous system can respond to life without becoming overwhelmed or shutting down. When you are within your window, you can think clearly, feel your emotions without being consumed by them, and respond rather than react. When you are outside of it, your nervous system shifts into survival mode- fight, flight, fawn, freeze, or collapse. Pain often intensifies in those states because the body is on high alert.

For some people, that window is naturally wider. For others, especially those who have experienced repeated stress or early adversity, it can be narrower. Research into Adverse Childhood Experiences (ACEs) has shown a strong association between early chronic stress and later health challenges, including persistent pain. This does not mean that your past determines your future. It means that the nervous system is shaped by experience- and can also be reshaped by experience.

How Subconscious Patterns Influence Chronic Pain

Many of these adaptations happen below conscious awareness. If you grew up needing to stay vigilant, to anticipate other people’s moods, to be responsible beyond your years, your nervous system may have learned that the world is unpredictable. That learning does not disappear just because you are now an adult with insight and intelligence. It becomes encoded in patterns under the surface- in muscle tone, posture, breath patterns, stress chemistry, expectation, and subconscious associations.

This is where the role of the subconscious becomes important. Alarm pathways are influenced not only by structural input, but by prediction. The brain is constantly asking: “Is this safe?” (This spidey sense is called neuroception.) If past experiences have taught it that certain sensations, movements, contexts or emotions are dangerous, it may generate pain in anticipation. Not as punishment, or weakness. As protection.

If pain is influenced by prediction, it also means it is influenced by learning. The nervous system is not just reacting in the moment. It is constantly drawing on past experience to anticipate what might happen next. If bending once led to injury, if stress once coincided with a pain flare, if a particular time of the month has repeatedly been difficult, the brain begins to prepare in advance.

This is called predictive processing. We don’t get to choose this, and its not a flaw- its an inbuilt shortcut in the human brain. That unconscious preparation can include increasing muscle tension, amplifying sensitivity, and, sometimes, producing pain itself.

You may have noticed this in subtle ways. The ache that begins before you even start a task you expect to aggravate it. The flare that arrives the night before an important event. The migraine that appears at the end of a long period of coping. These patterns are not imagined. They are learned associations- protective shortcuts the nervous system has built over time.

And here is the hopeful part: what is learned can be unlearned. Your inner guard dog can be retrained and soothed.

Neural pathways strengthen with repetition, but they also weaken when new experiences are introduced. When the system repeatedly encounters the same movement, sensation or emotion and discovers that it is safe, prediction begins to shift. The guard dog learns that not every sound requires barking. The bath slowly drains. The window widens.

This is not about forcing yourself to push through pain. It is about creating enough safety- physiologically and psychologically- that your system no longer needs to shout.

And this is why understanding pain changes your experience of pain.

When you begin to see symptoms as protective rather than catastrophic, you no longer need to be scared of your symptoms. When fear reduces, you can work on sending safety signals to your nervous system. When safety increases, sensitivity can begin to lower. Education is not just information- it is a practical intervention that can lead to positive results.

Why Chronic Pain Can Worsen During Perimenopause

And let’s talk about hormones for a minute. Hormones can play a significant role in how pain is experienced. Oestrogen, for example, influences pain sensitivity, inflammation, sleep regulation and mood. During perimenopause and menopause, fluctuating oestrogen levels can lower pain thresholds and increase nervous system reactivity. Many women notice that old injuries resurface, migraines become more frequent, or new aches appear without clear cause.

If this has happened to you, it does not mean your body is deteriorating. It means the buffering systems that once helped regulate stress and inflammation are shifting. When hormonal change coincides with accumulated stress load, previous adversity, sleep disruption or long- standing overextension, the nervous system can become more vigilant. The guard dog was already alert; now it is quicker to bark.

Immune signalling adds another layer. Inflammation is not inherently harmful- it is part of the body’s protective response. Short- term inflammation is a good thing. But chronic low- grade inflammation, often driven by stress, poor sleep, blood sugar instability or unresolved threat patterns, can amplify pain sensitivity. The system becomes primed. Signals are interpreted through a lens of caution.

Again, this is not dysfunction. It is protection layered upon protection.

When you step back and view chronic pain through this wider lens- nervous system learning, stress physiology, immune activity, hormonal shifts, subconscious prediction-  the experience often begins to feel less random. It may still be uncomfortable, frustrating and annoying. But it is no longer mysterious, or something to be feared.

And when something is no longer mysterious, or feared, it becomes workable.

This is where many women experience their first real sense of relief- not because the pain has magically vanished overnight, but because the story has changed. Instead of “my body is broken,” the narrative becomes “my system has been protecting me.”

And making that shift matters.

What You Can Do About It

Because if chronic pain is an overprotective response, then the work is not about fighting the body. It is about retraining it.

That retraining happens on multiple levels.

First, education reduces the feeling of threat. When the brain understands that pain does not automatically equal damage, the alarm system can begin to soften. Research consistently shows that pain neuroscience education alone can reduce fear, catastrophising and sensitivity. Knowledge, when properly integrated, changes physiology.

Second, the nervous system needs repeated experiences of safety. This is not forced exposure or pushing through symptoms. It is gradual, intelligent reintroduction of movement, sensation and emotion within a regulated window. Each safe experience slightly updates prediction. Each moment of tolerable challenge expands capacity. This can take time, and be a non-linear process, but given the right inputs, the outputs will naturally change. And safety is one of the most important inputs.

Breath patterns also deserve a mention here. Often, improper breathing is the missing link. Chronic over-breathing or erratic breathing can maintain sympathetic arousal (fight/flight) and amplify sensitivity. Chest breathing keeps shoulder, chest and neck muscles tight, and tells the body that there is imminent danger- even when there isn’t. Breath re-education, including the Buteyko method, improves carbon dioxide tolerance (a good thing), improves autonomic balance and flexibility (meaning you can relax more easily) and stabilises the stress response. When breathing becomes steadier, the system receives a powerful message- we are safe enough to slow down.

Somatic awareness also plays a role. The body often holds patterns of tension that reflect long-standing vigilance. Learning to notice and gently shift these patterns increases flexibility. Trauma-informed approaches such as TRE and impulse completion can help complete stress cycles and complete gestures that were never fully resolved. The goal is not dramatic release. It is gradual recalibration.

Subconscious work is equally important. If pain has become associated with specific movements, environments or emotions, those associations need updating. Cognitive Hypnotherapy allows us to work directly with predictive patterns held below conscious awareness. In a safe, structured state of focused yet relaxed attention, the brain can begin to rewrite outdated threat responses.

Over time, these layers combine. Education reduces fear. Breath stabilises physiology. Somatic work restores flexibility. Subconscious patterns update prediction. Lifestyle factors- sleep, blood sugar stability, pacing, relational boundaries- support the system as a whole.

What this means is: the bath drains. The guard dog settles. The window widens.

This is not an overnight process. But it is a reliable one. Change the inputs, and the outputs change. This is a long-term solution- going upstream to address the root causes, rather than just treating the symptoms.

I have witnessed women who felt trapped by persistent pain begin to move more freely, sleep more deeply, and trust their bodies again. Not because they forced symptoms away, but because we addressed the protective patterns underneath them.

If you recognise yourself in this article- the frustration, the confusion, the sense that something deeper is driving your symptoms- then you are not alone. And I’d like to reassure you that you are not broken.

Chronic pain is complex. It deserves a framework that is equally nuanced. I’m here to make it simple, and workable.

When you are ready, working together means approaching your symptoms with curiosity rather than fear, intelligence rather than force, and compassion rather than criticism. We build capacity. We expand tolerance. We restore flexibility. If you have questions about how this work happens in practice, you may find the answers to these common questions helpful.

And from there, positive change becomes not only possible- but sustainable.

If this resonates with you and you’d like personalised support, you’re welcome to book a free clarity call here.

“Why do I hurt, even though nothing is wrong?”- The link between Adverse Childhood Experiences and chronic pain

Enduring a tough childhood can seem like a double whammy of unfairness- having to go through the original trauma of abuse/ neglect/ unmet needs, and then also having to deal with the repercussions in later life. However, understanding how your early experiences have created the conditions for your present suffering can be illuminating and empowering, and the good news is that your body and brain have a remarkable capacity to heal, given the right inputs.

Lets explore the links and shed some light on how your difficult childhood may have influenced you on a cellular level- and what you can do about it.

Adverse Childhood Experiences (ACEs) are sadly incredibly common, and are endured by all types of children, regardless of race, education and economic background. They have been classified as a list of 10 experiences, characterised by abuse, neglect and dysfunction, ranging from having a parent in prison (less common) to parental separation (most common) and the more ACEs you have, the higher the likelihood of mental and physical health problems, including addiction, personality disorders, PTSD and chronic pain. (If you’d like to discover how many ACEs you have, please head to the ‘resources’ section on my website, where you will find the definitive list of them there.)

There are several distinct biological responses to ACEs- I’ll break them down into sections here.

HPA Axis Dysregulation

The hypothalamic-pituitary-adrenal (HPA) axis is the body’s main stress-response system. Childhood trauma can lead to hyper- or hypo-reactivity of the HPA axis (too much or too little activation)

This is characterised by:

• Altered cortisol rhythms (blunted morning peaks or chronic elevation of this stress hormone)

• Heightened sensitivity to stress
  
  - Which leads to persistent low-grade inflammation, immune activation, and greater sensitivity to pain signals.

Central Sensitization

Central sensitization is a state where the central nervous system (CNS) becomes hypersensitive to pain. Trauma primes the brain and spinal cord to:

• Overreact to pain (hyperalgesia)

• Misinterpret non-painful input as pain (allodynia)

• Keep firing pain signals even without injury
  

  - This means you experience chronic widespread pain, fatigue, or "mystery symptoms" — often without a clear medical cause.

Gut-Brain Axis and Dysbiosis

The microbiome plays a key role in mood, immunity, and inflammation. ACEs can alter gut flora and intestinal integrity, causing:

• Leaky gut (increased intestinal permeability)

• Chronic inflammation and neuroinflammation (inflammation in the brain and spinal cord)

• Greater risk of IBS, fibromyalgia, fatigue, and depression

• Overactivation of immune cells and inflammatory cytokines

• These cytokines sensitize nerves and reduce tolerance to pain

• Gut microbes also regulate calming neurotransmitters like serotonin and GABA, effecting pain modulation
  

  - Resulting in a feedback loop between gut inflammation and heightened pain perception.

  Epigenetics & Nervous System Imprinting

• ACEs can alter gene expression through methylation—especially genes linked to stress, inflammation, and immune function

• Trauma “imprints” a pattern of heightened vigilance and dysregulation into the autonomic nervous system

  - This results in a nervous system that misreads safety cues and overreacts to minor triggers, creating a negative feedback loop of '‘pain- stress- more pain- more stress’

The Cell Danger Response (CDR)

The CDR model explains how cells under threat (from toxins, trauma, infection) shift into a defensive, energy-conserving state.

• This state disrupts mitochondrial function, impairs cellular healing, and sustains inflammation.

• Trauma in early life may lock the body into a chronic CDR, impairing tissue repair and keeping the body in "threat mode."
  
  - Which can lead to exhaustion, chemical sensitivity, slow recovery, and persistent pain.

Emotional Suppression and Alexithymia

• Many people with ACEs develop emotional numbness or difficulty identifying feelings- this is called Alexithymia

• This dissociation from internal states can manifest somatically—as pain

  - Then pain becomes a proxy for unexpressed or unprocessed emotions- if you can’t feel it emotionally, you will feel it physically instead.

Impaired Vagal Tone

• Trauma decreases vagal tone, impairing the ability to shift into rest-and-digest- the natural state for healing and growth

• This hinders digestion, repair, immune function, and pain resolution

  - Meaning you are more likely to stay in sympathetic overdrive (fight, flight, freeze, fawn) or dorsal vagal shutdown (collapse, exhaustion, burnout)

Neuroplasticity and “Wired for Survival” Patterns

• Childhood trauma shapes brain development.

• The brain becomes hypervigilant, wiring neural pathways for threat detection and pain.

• Without intervention, this wiring reinforces suffering and can maintain a chronic pain state even when original injuries have healed.

- Leading to your brain picking up on alarm signals more easily, which gets translated into pain.

As well as these biological responses, enduring childhood trauma also leads to several unconscious defences- beliefs and behaviour that once kept you safe, but are now keeping you suffering.

These are things such as-

Not feeling able to ask for help

If you asked for support when you were younger, and got ignored, ridiculed, shamed or otherwise punished for it, you will have learnt not to bother- internalising the message that ‘I’m safest when I rely only on myself’.

But now, not asking for help- being hyperindependent- can mean you don’t reach out when you need support. This keeps the body in an alarm state and can lead to overwhelm or burnout.

Not meeting your own needs = self-abandonment & exhaustion

When basic needs (comfort, safety, soothing) were ignored or shamed, you internalise the following belief-

“My needs are too much. To be loved, I must ignore them.”

This can result in chronic overgiving and depletion, disconnection from hunger, fatigue, or pain signals, and pushing through pain - causing alarm in the body, worsening symptoms and leading to burnout.

Not trusting your intuition = anxiety, shame & disconnection

If caregivers gaslit or ignored your reality, you will have learned:

“My instincts are wrong. I must defer to others.”

The impact of this is second-guessing bodily sensations, distrusting your own inner guidance, and relying on others to validate your experience- which limits your self agency to heal.

Ignoring body signals = disembodiment, dissociation & pain escalation

In unsafe environments, it may have felt necessary to “leave the body” to survive.

This can lead to the internalised belief that “It’s safer not to feel” and a tendency to dissociate.

The consequences can be a disconnection from subtle warning signs (tightness, fatigue, inflammation) which leads to pushing past thresholds until pain becomes severe, which increases stress and anxiety, further ruling the body’s internal sense of alarm- which leads to physical pain.

Perfectionism & people-pleasing = chronic stress & muscle guarding

Origin: If love or safety were conditional when you were younger, you likely grew up with the belief

“If I’m perfect or useful, I’ll be safe.”

This tends to lead to an inability to relax, and an inability to let your guard down- causing chronic bracing, muscle tension, jaw clenching and habitual shallow breathing. It can also be the root cause of overworking, and putting everyone else’s needs before your own. Chronic tension is exhausting, because your muscles don’t fully relax, leading to tiredness, hypoxia (low cellular oxygen levels, poor blood flow) and pain flares.

Toxic inner critic = low self-worth & nervous system dysregulation

If you were regularly criticised by your caregivers, their voice becomes your default, leading to a harsh and toxic inner critic. Maybe the following beliefs ring true for you?

“I’m not enough. I’m weak if I rest. I need to be productive to be worthy. I don’t deserve it. I need to keep small. I must do more”

This inner pressure maintains a chronic stress state, and shaming yourself for being in pain or needing to rest will increase your sympathetic activation- the fight/ flight/ fawn/ freeze response. Self-criticism is the equivalent to being constantly chased by a tiger- except the threat is inside your own head- this activates pain centres in the brain.

Fear of vulnerability = emotional suppression & somatic pain

If it was unsafe for you to express your vulnerability as a child, this can lead to the belief that “If I’m seen or feel too much, I’ll get hurt.”

The outcome of this is that emotional pain gets stored somatically. When you are unable to express and process your emotions, they can increase the levels of inflammation in your body. And the things you need to do the most- crying, connection with others, and tuning into your emotions to feel them, are resisted.

The Pain-Protection Loop

These psychological patterns maintain a loop of chronic pain:

1. Early trauma sensitizes the nervous system.

2. Subconscious rules lead to self-neglect and overextension.

3. Pain flares when needs are ignored or body is pushed too far.

4. Shame, mistrust, and emotional suppression block healing.

5. The cycle repeats—until new patterns are built.

So lets talk about the new patterns! Because your past does not have to define you. The following practices are evidence based ways that can help you overcome past trauma, step away from chronic pain, and start to thrive.

I use them all regularly with my clients, with great success-

• Changing your inner critic with Cognitive Hypnotherapy, using inner child work and parts work, to soothe, soften and release the voices that are making you feel unsafe.

• Embodiment practices such as TRE, breath work, progressive muscle relaxation and other healthy movement patterns to rebuild trust and communication with your body’s signals.

• Nervous system regulation to shift you out of survival mode and into a state of safety, balance and flexibility.

• Compassionately witnessing your suffering, to work through, release, and come out the other side of your emotions, and meet your own needs without shame.

• Rewiring attachment wounds with building safe and trusting relationships.

• Psychoeducation around the nervous system, subconscious survival tactics, and chronic pain, to expand your understanding, reduce fear and shame, and leave you feeling empowered with knowledge.

• Learning how to recognise shifting emotional states with observing your thoughts and physical cues, and working with them to consciously create new, happier and more positive thoughts and emotions- leading to greater comfort and ease.

• Visualising your desired outcome with clarity, to create a roadmap for your subconscious to work towards- a future full of health, hope, connection and purpose.

I hope you have found this blog to be helpful, either for yourself or perhaps someone you know. Finding out the links between the past and your present reality can be overwhelming as well as illuminating- but you don’t have to solve it all on your own. If you need support, reach out- I’m here to help you navigate through difficult life experiences, and come out the other side- into the most healthy, happy and healed version of you.

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