Safety First

Post #4 in the series "Reprocessing Chronic Pain"

I have now had two full weeks mostly pain free. I have felt it coming on several times but it hasn't escalated into an actual pain experience. I hasn't upset or frustrated me. It hasn't derailed my day or stopped me from doing anything. I'm able to reassure myself that there is no danger in my body. I can feel the sensations and remind myself that they aren't harmful, that they aren't anything to worry about, and that I am going to be ok. And then they fade. I still use my tried and true soothing strategies -- heat, ice, rest and some OTC pain meds. But I used to grab for them like lifelines, with a felt sense of fear, discouragement, and resignation. I HAD to have them to protect myself from more pain and distress. Now I use them to support the feeling that I am safe -- that I am taking really good care of my body so my brain doesn't have to freak out. I feel comforted, calmed, and empowered using the same tools. It's like the difference between grasping for a life preserver when you are nearly drowning, or choosing to use a swim noodle when you jump into deep water.

When it comes to psychophysiologic disorders (PPD),* healing depends on and starts with increasing a person's felt-sense of safety. The perception of safety or danger, known as neuroception, happens below the level of conscious thought and awareness. It registers deep in the primitive part of our brain in the amygdala and other related structures. The brain receives messages from inside and outside the body. It references them against past experience. And it assesses the overall state of the organism (sick or healthy, strong or weak, calm or distressed). It pools all of that data to determine how loud an alarm signal it needs to ring. This all happens instantaneously. Thus, though we may not be aware of danger on a conscious level, the nervous system senses it, remembers it, expects it, and associates it with context. The body can go into a stress response in reaction to danger that we are not aware of. And it can get locked into that state if the threat persists. That causes a cascade of biochemical, metabolic, and musculoskeletal changes - to help us fight, flee, or freeze - and symptoms begin to appear.

Feeling safe is multi-faceted, complicated, and highly individual. It relates to the physical body, the emotional self, and the inter-relational or social self. It's important to understand that there is only one fear circuit in the brain. This means that the brain does not make a distinction between physical threat and mental/emotional/social threat. All are considered dangerous and merit an alarm response. And any alarm response can trigger or exacerbate physical symptoms.