Pain and the Brain
Updated: Oct 28, 2021
Post #1 in the series "Reprocessing Chronic Pain"
When I was in my 20s, recovering from a spinal surgery that had failed to relieve two years of back pain, my mother gave me a book by a Dr. John Sarno. The title was Mind Over Back Pain. I was enraged. I assumed she was suggesting it was "all in my head." As any sane person with chronic pain would, I threw the book across the room. But the idea that my thoughts and feelings could affect pain stuck with me.
It wasn't until about 20 years later that I revisited the idea, still experiencing pain after three additional surgeries. I began working with a Somatic Experiencing practitioner. She helped me learn to listen to and respect the messages my body was sending me, rather than deny, hide, and override them, as I had done for two decades. I worked with several different integrative medicine doctors who viewed chronic pain more holistically. I had believed that the problem was in my back and therefore the solution had to come from fixing my back. But physiological approaches - surgery, physical therapy, exercise, chiropractic and massage therapy had not helped. In many cases they made it worse. My energy level was unusually low for an otherwise healthy woman in her mid-40s. And I had developed GI symptoms which were diagnosed as IBS when nothing showed up on any tests. Those symptoms too resisted all conventional medical treatment, as well as every conceivable diet and lifestyle change.
In those years I also became a health coach. I was naturally drawn to working with clients with chronic pain and illness. I threw myself into the research on the stress response, the inflammatory response, the autonomic nervous system, and the gut brain axis. And, I developed a Buddhist meditation practice. When I was able to calm my mind, it helped to calm my body.
All roads led to the same conclusion, namely that the whole body, mind, and spirit are involved in conditions like chronic pain and illness. (The fact that conventional medicine doesn't incorporate this understanding is a tragedy of epic proportions, but that's a story for another day).
The broader understanding and the new tools I've acquired, have radically changed my relationship with my body and improved my life dramatically. I've worked though past traumas and crafted a much less stressful life. I am more compassionate with myself and have deeper and more meaningful relationships with others. I live more authentically and with greater acceptance of what is.
And, the pain and other symptoms persist. They flare and they ease - sometimes they briefly disappear. But then they come back. Some days that feels like a failure. With all my knowledge and good work, why haven't I been able to "fix" this by now?
There is yet another layer of healing to be done.
This week I learned about a new protocol for healing chronic pain and related symptoms called Pain Reprocessing Therapy (PRT). A newly published, ground-breaking study of 50 chronic back pain sufferers (who'd been in pain for 9 years, on average) found that 98% of participants improved, and two-thirds were pain-free or nearly pain-free after four weeks of PRT. And most maintained relief for one year. The findings were confirmed by Functional MRI imaging of the brain, conducted at the beginning and end of the 4-week study period. The scans showed a significant reduction in the intensity of brain activity in one of the "pain centers" of the brain, when pain was induced in the patients.
The PRT protocol is outlined in a new book by Alan Gordon called The Way Out. It's based on neuroplasticity - the understanding that the brain and nervous system can be rewired and retrained at any age.
Reading the book, I realized that a conceptual understanding of the mind-body connection was not enough for me. The inner work I have done has been powerful and life-changing but there's a missing piece. I haven't broken the "pain-fear cycle" that keeps chronic pain going. There's fear of the symptoms. There's fear of what will happen because of them. If they abate, there's fear they will return. If they flare, there's fear that they will get worse and never end. There is a nearly constant warning signal blaring in the primitive part of my brain, the part that processes fear and triggers fight, flight, and freeze responses.
And it's not just fear that keeps the brain on high alert. I'm frustrated, irritated, discouraged, and self-critical. Those feelings also reinforce the brain's perception that symptoms are dangerous, that I am not safe. And so it keeps sounding the alarm, creating stronger and stronger pain and distress signals. Though there's a lot more ease in my life than there was a decade ago, I still put a lot of pressure on myself. That too sends danger signals to the brain, amplifying pain. Pain also becomes habituated. After 30 years I have powerful, hard-wired associations between certain activities (like sitting or bending) and pain. It's classic conditioning - like a dog learning to sit when she gets a treat. I anticipate that something will trigger a flare and that makes it more likely that it will.
All of that can be changed through the miracle of neuroplasticity. But it requires structured practice and dedication. So I've decided to follow the Pain Reprocessing Therapy protocol used in the back pain study. The hope is to rewire my brain and nervous system to break the mind-body pain cycle. I am not sure where this will lead, but for the first time since my fusion surgery in 2012, I have hope that I could live a pain and symptom-free life.
And I can teach the protocol to my clients!
I will be chronicling this journey here, with you. I'm excited, I'm apprehensive, I'm hopeful. If this works, it will literally change everything.
To follow along with me, please subscribe to the blog. If you want to learn more about the protocol, please contact me or set up a time for a free Zoom chat.
And please share this with others dealing with chronic pain and chronic illness.