How does chronic pain start…and how do we get out of it?

When I pause to review the last 12 months, what I see if that I have gained far more clarity than ever before, about a lot of things…but perhaps more than anything about the path of chronic pain that has been the journey of my life to date. I realise that the sense of having found my way onto a new path is well underway and that it makes me want to share a few pointers in this start of the year summary-post, in case it helps anyone else to get themselves onto a new trajectory for 2022.

So, in short, I feel I want to outline a very typical way that chronic pain gets started in the first place. How or why do some people get into this situation when so many don’t, and is there a way out of it? Well, first off, let me say that increased understanding of how you got onto such a path is the very first step to freedom from it. So, in summary, here are the steps that, very-typically lead to chronic pain.

Challenging childhood experience can be the first step, teaching the brain to go into protective mode more quickly than is usual, thus increasing sensitivity. Some people are born far more sensitive than others (as I’ve spoken about many times, some of us are born as Highly Sensitive People, or HSPs and this can be determined via the self-assessment provided by Elaine Aron) yet life can exacerbate this trait, flipping it from being a fairly benign or even highly-creative tendency towards being a problem.

Coping strategies such as people pleasing and perfectionism can add ongoing tension and high vigilance to this situation, as I have recounted from my childhood experiences before. If the child has any further reason to feel “odd one out” such as undiagnosed autism, high sensitivity or being an introvert in a situation that overwhelms or excludes them because extroversion is valued more highly, or of they are left feeling devoid of appropriate adult support systems (for a variety of reasons), this effect can be quite profound as they now feel they have to project to the world that they are coping and being helpful, all of the time, in order to deflect unwanted attention and thus survive. I can relate to all of the above but even one of these scenarios can be enough to set the chronic pain pathway in motion.

Any additional health or other scares, to self or family members (for instance, my father almost died when I was very young and then had so many health issues that I became acutely aware of his symptom patterns and the associated fear in our household) can lead to catastrophising, triggering the amygdala part of the brain (associated with fight, flight or freeze responses) even further.

As the child matures, so-called everyday stresses, such as exam pressures, entering the “adult world” of work, money issues and so on can combine with this over-protective nervous system to produce physical symptoms. The more bewildering or abitrary those symptoms are (leading to feeling disbelieved, abandoned and afraid or being put through invasive treatments and wrong medications) the more the nervous system gets further provoked, as happened to me throughout my 20s. “Coping mechanisms” such as smoking or drinking and other distractionary addictions only worsen the situation.

Major life events such as trauma, loss, changed of circumstance etc. tend to coincide with a worsening of symptoms. For instance, sexual abuse, bereavement and loss of livelihood happened to me in very quick succession in my mid 20s, coinciding with significant worsening of my pain levels.

Other tipping points such as physical injury or emotional breakdown add to the likelihood of pain exacerbation. In my case, a back injury, a divorce and a flu vaccination given at the exact wrong point in my stress pattern (when my nervous system was already teetering on the brink) were major trigger points. Certain medications and vaccinations can provoke a significant worsening response if the nervous system is already highly-triggered because the body interprets them as a further threat and/or they may suddenly deplete various nutrients, such as vitamin B1, that are essential for nervous system equilibrium (more on that in a future post).

When stress and pain itself become chronic, brain changes occur because the brain itself becomes hyper-protective, triggering a pain response even when no real danger is present. In effect, the brain gets caught up in a catch-22 where pain is causing it to trigger even more pain responses, even when around fairly minor threats. From now on, even subtle environmental factors, ingredients in food or slight changes in a person’s feeling of safety can be quite enough to tip the balance towards severe pain, for longer and ever-more impactful periods of time, requiring more lengthy recovery periods. This is when the body has truly arrived in a state of chronic pain and the effect can feel as devastating as it is unfathomable and, apparently, without remedy or appropriate support from most of the conventional medical profession.

Lack of feeling heard or understood by other people only adds to the array of provocative situations now dreaded or avoided by the highly over-stimulated nervous system. The western medical professions pride themselves on having answers and remedies for everything, thus unfathomable illnesses bring out the worst in their bedside manner. Wrong diagnoses, jump-to-it conclusions about mental health and prescriptions that only make things worse significantly add to the minefield of chronic pain and/or those with it decide to cut themselves off from conventional medical assistance, only adding to their sense of isolation and thus the chronic, all-enveloping state of pain.

This new chronic state means that learned neural pathways start to develop in the body and the more the nervous system uses these, the easier it becomes to activate pain all over again. As such, the pain and associated fatigue and other physiological symptoms start to mushroom.

Pain itself has now become a major stressor, becoming a primary reason the body is feeling so triggered, all of the time. As every minutest life-choice or exposure feels like the potential cause of more pain, the nervous system learns to behave in a more and more activated fashion, all of the time; never knowing when or how to switch off. Life itself takes on a very different form as so many different activities and exposures have to be reconsidered or avoided altogether, having a severely detrimental effect upon overall health and happiness and, typically, resulting in an increased withdrawal from social engagement.

Ironically, the very activities that trigger “happy” endorphins become restricted by this behaviour, while fear and heightened vigilance continue to increase.

The key to this gridlock is to notice all of this has happened and become self-aware of the impact it is having upon your overall health and future prospects. Once a wake-up call has occurred (as first happened to me in 2011), a giant stride can be made towards reversing the chronic pain process and finding your way out of the maze.

Learning how pain works is a big part of the process. Coming to understand that the brain and nervous system have become wired for more pain is important, from which point there are many techniques that can be used to retrain the brain into a better way of being. There are just so many resources I could refer you to at this point, made far more accessible than ever before (considerably so, compared to ten of fifteen years ago when I began to look for them!) but the best of them, in my opinion, is The Gupta Program as it covers so many approaches to retraining the brain and nervous system under one easily-accessible umbrella process. This can then serve as a gateway to further developing some of its recommended practices, if you so desire, such as experimenting with a deeper meditation practice and other mindfulness approaches as part of an ongoing, quality of life enhancing, routine…in fact, you may never look back!

Once you learn how pain occurs, the fear is removed from it, which means the fear of symptoms themselves is lessened. You can now see the light at the end of the tunnel.

Sorting out the wood from the trees is also a key stage, as is coming to realise the super-power of self-love. Realising and appreciating, for instance, that maybe you were already a highly sensitive child and that this was not seen or appropriately nurtured by your carers, that you had childhood trauma, or unrecognised/unsupported autism or other kind of neurodiversity, or perhaps that you were introverted in a world geared solely for extroverted behaviours, etc, and then loving yourself back from the brink by offering yourself all the profound understanding and compassion that was missing from those childhood experiences, can be a HUGE step towards healing the root of your pain.

Eliminating all trace of self-blame from the picture is a very key component to reclaiming your health. Additionally, reaching the point (and you can get there) where you can see that this has ALL been a gift and that your journey through pain led directly to you becoming the highly-aware, compassionate and appreciative human being that you are today is the cherry on the cake!

Understanding how to support neural pathways with activities proven to provide pain-relief and sustained periods of pain distraction, such as gentle physical activity, time spent in nature, self-expression through unspoken means such art or dance, daily mindfulness and gratitude or a meditation practice can be a massive step along the road.

Coming to understand ways that the body can be further supported in its healing process, for instance by providing an appropriately balanced diet (suitable for you, as no two individuals have the exact same requirements!), certain supplements to aid healing of the body and especially the nervous system, or replacing any chronically depleted vitamins or nutrients such as vitamin B1 (on which topic I have more to share soon) can provide just the nudge your body needs to really start to repair any damaged pathways to assist you onto a more positive trajectory, leading towards an increasingly pain-free life.

Its important to set appropriate expectations and to accept that no healing is instanteous, and certainly not when applied to a chronic state. I am not out of the woods of significant pain, by a long stretch, and yet, what is different is, I choose not to dwell there…even when I can feel the cast of pain’s shadow over my days. I acknowledge it yet I stay, as far as possible, out of fear…and old, unconscious,responses such as cutting myself off from all engagement or feeling, or indulging in addictive or overly intense/repetitious distractions that only make me feel worse in the long run (you can see how the addition of self-awareness is so critical to the process). When I notice myself slipping into my old ways, I gently realign my path with what I know to be more supportive of my ultimate objective, which is to retrain the brain and nervous system out of its old state of repeat behaviours, sense of helplessness and feelings of abject overwhelm.

Redirecting the attention towards a more positive focus is so critical for the path of progress, which is not to deny pain but to remain as neutral as possible around it…and generally focus somewhere else, unless it needs your direct attention for some practical reason (such as requiring a particular remedy or action in that very moment). What you find is that, as you retrain your reponses to pain, you also evolve yourself because of all the increased mindfulness that comes with the daily practice of your less than straighforward existence!

The more consistently you hold to the belief that you can heal whilst routinely supporting that intention with all those useful practices you have so-diligently gathered to entrain your body to really feel that way too (for instance, those moments of experiencing neutrality or even total absence of pain, even bliss, during meditation really start to add up!), the more quickly and robustly you step into that new potential, until one day you realise you are spending more of your time out of pain (or pain awareness) than in it, and so it begins. Every journey, even the most epic, begins (as they say) with a single step and before we know it, we find ourselves in a very different place to where we were before; which has been my last decade but mostly my last 12 months, continuing, and I wish for all of you that today is another such step.

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