Written by: Miriam Gauci Bongiovanni, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
An aching back? Pain while typing, sitting or exercising? If you’re an adult in the US, there’s a 20% chance that you’ll develop chronic pain, according to the 2019 National Health Interview Survey. And sadly, 7.4% of sufferers have to frequently limit life or work activities as a result. [1]
We might think of this as a normal fact of life that some of us have to live with ‒ but in reality, chronic symptoms are far from normal; they are an indicator that the body has adopted some kind of negative pattern. And this can happen due to various reasons.
The main reason why chronic pain persists is that both medical professionals and individuals do not identify the factors that are causing it in the first place ‒ and some of these factors could surprise you!
It’s just like a crime novel where the villain hasn’t been found yet, and as a result more crimes continue to be committed ‒ but it doesn’t mean that this villain doesn’t exist!
With chronic pain, the contributing factors often have to do with incorrect beliefs and treatments, which lead to behaviours that actually worsen chronic symptoms in the long term.
And so, based on my experience as a Chronic Pain Coach and MindBody Practitioner, I’d like to make people aware of some of the most common beliefs and behaviours that can actually make chronic symptoms worse (even though we believe that we’ve adopted them for our own good!):
5 behaviours that actually cause chronic symptoms to persist:
1. You’re blaming the pain on an old injury ‒ although old injuries may cause scars or imperfections in the body, very few (if any) injuries lead to chronic pain that lasts over 6 months.
The majority of chronic pain symptoms fluctuate in intensity or tend to shift location. Sometimes they flare-up ‘for no apparent reason’. This is not how real injuries behave.
The only reason why we may keep feeling the pain long after an injury has healed is due to a process called conditioning. This process involves a learned association between specific activities and symptoms, leading the brain to memorise specific pain pathways. [2]
What can you do about this? Make sure that any serious injury has healed by having the appropriate tests with a medical professional. Then look for exceptions to the pain, and assess whether the painful areas actually correlate to the location of your past injury. Most often, people find that their chronic pain doesn’t make structural sense!
2. You’re avoiding activities that usually trigger the pain ‒ this is a huge one! Although we may avoid movements or activities which we believe will make our pain worse, each time we do this, we are actually strengthening the conditioning process!
This is because each time we shrink away from something due to the fear of pain, we are essentially ‘confirming’ to ourselves that the activity in question is dangerous ‒ and pain is none other than one of the danger signals that the body has at its disposal!
What can you do about this? To unlearn this conditioning, people often need to re-engage in certain activities, in a paced and safe manner ‒ so that slowly, the brain will learn that harmless activities like sitting, walking or even running and more intense workouts need not cause pain!
3. You use phrases like ‘it always hurts when…’, ‘I can’t do X and Y’ or ‘ it’s impossible’ ‒ in short, you talk about pain as if it was a permanent condition. By using such statements, you are setting very concrete expectations. Given that expectations play a role in chronic pain, you could be literally talking yourself into pain!
What can you do about this? Think about symptoms as being present-moment sensations. If possible, think of any exceptions to the pattern, when the pain was minimal or just about gone, or when you were engaged in an activity and it still didn’t hurt. Never use words like ‘always’ or ‘impossible’ in relation to your symptoms.
4. You’re constantly on the ‘lookout’ for pain ‒ in short, you engage in hypervigilant behaviour. Maybe you wake up and wonder how your pain levels are going to be like. Or you start scanning your body for the first signs of pain after exercise. You may even press the area or move it to check for pain.
All of these behaviours and thought patterns actually bring the memory of pain to life, and are often coexistent with a feeling of fear and dread ‒ the very feelings that increase pain perception and overall tightness in the body! Several studies have already linked pain hypervigilance to increased pain levels. [3]
What can you do about this? Notice how often you think about pain, or how often you find yourself expecting it. Think about reducing this behaviour by thinking of more positive scenarios instead, and stop yourself from constantly touching or examining the pain area!
5. You are constantly judging your symptoms harshly and wishing them away. As the popular dictum says, ‘what you resist persists’.
This couldn’t be more true than in the case of chronic pain. The more negative we feel about it, and the more desperate we are for it to go away, the more likely it is to persist.
What can you do about this? mindfulness practices can be very beneficial for chronic pain sufferers. Such practices may help you cultivate more acceptance with whatever sensations you are feeling in the present moment.
It all starts by thinking ‘outside the box’.
If you’re new to the concept of mindbody pain, then you may find the above reasons a tad conflicting with your current perspective and beliefs. Don’t worry, the majority of chronic pain sufferers think that the above doesn’t apply to their specific situation when they first hear about this.
But once you start to understand the dynamics of how chronic pain develops and persists, things will fall into place. And no matter what you’ve been told about your pain, if there’s no underlying serious condition (like cancer or infection), there is much more hope than you think.
My aim is always to make things easier to understand for the average person, and it’s for this reason that I founded my blog and coaching venture, PainOutsidetheBox.
I literally help people think outside the box when it comes to the origin and persistence of their symptoms. Because if nothing has worked so far, it means that they need to be doing something radically different. And who knows, it may be your own turn for a breakthrough!
Miriam Gauci Bongiovanni, Executive Contributor Brainz Magazine
Miriam is a certified Holistic Life Coach and MindBody Practitioner specializing in chronic pain recovery. After having overcome debilitating symptoms herself by working with the mind-body connection, she continued to study the psychology of chronic pain and pain neuroscience. Miriam founded her coaching and educational venture, PainOutsidetheBox, as part of her vision to educate people on the connection between chronic pain and the brain. Miriam now coaches clients internationally, empowering them to eliminate pain, resume physical activity and reclaim their lives. She is also the author of an internationally-accredited MindBody Syndrome Practitioner Course delivered by the MindBodyFood Institute and runs a self-paced Pain Recovery Program for chronic pain sufferers on her website, www.painoutsidethebox.com.
References:
[1] CDC, National Center for Health Statistics, Chronic Pain and High-impact Chronic Pain Among U.S. Adults, 2019’ (Nov 2020).
[2] Paul Ingraham, ‘Chronic Pain as a Conditioned Behaviour’, PainScience.com.
[3] Catherine J Vossen1 et. al, ‘Pain Hypervigilance Influences Cortical Processingand Habituation to Painful Stimuli in Healthy Subjects: A Cross Sectional Pain ERP Study’, Journal of Anaesthesia and Intensive Care Medicine, 2019.
Additional Resources by the author:
‘Acute vs Chronic Pain’, PainOutsidetheBox
Neuroplasticity and Chronic Pain ‒ a new angle on psychosomatic symptoms’, PainOutsidetheBox
