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.
The links between stress, anxiety and chronic pain can hardly be denied these days. As our lives get busier and more demanding, as fear and insecurity may have become part and parcel of our everyday lives, chronic conditions such as back and neck pain, tension headaches, chronic fatigue and multiple others are on the increase.
And very often, no structural explanation is ever found for these conditions – which means that tests come out clear, and people are left grappling with pain or symptoms and wondering what’s causing them. It’s only once they start connecting it to their emotional situation that things will start to make sense, and once they start to embrace the concept of Mindbody Syndrome.
Mindbody Syndrome refers to pain or symptoms that are triggered due to stress, anxiety and a host of negative emotions that are replayed in the long term. These emotional states cause a variety of physical changes within the body, such as increased muscular tension and inflammation, making us more prone to develop symptoms.
But why do some people develop chronic mindbody pain while others don’t, even in the face of similar circumstances?
Research is indicating that it has something to do with personality. Our personality is what shapes our perspective of the world around us. Everything that happens to us is filtered through our brain, based on our beliefs, past experiences and expectations. This is why it’s hardly ever the case that two individuals process the exact same experience in the exact same manner.
The American doctor Dr John Sarno was one of the first to note a strong link between certain personality traits and medically unexplained chronic pain, which he details in his book Healing Back Pain. Sarno was a keen observer, and noted that certain personal tendencies increased the levels of anxiety and rage that a person is likely to experience.
Later on, research in Pain science and Rheumatology has established strong links between such traits and chronic conditions like fibromyalgia and unresolved back pain. So if you suffer from chronic pain, and conventional treatments haven’t worked for you, you might need to do a little bit of introspection to determine whether you are unknowingly contributing to your condition. If you feel up to the task, below are 6 personality traits to look out for, and some tips from myself as a Chronic Pain Coach.
6 Personality Traits to look out for if you have chronic pain:
1. Catastrophic tendencies: People who tend to expect the worst outcomes in life or who are afraid of illness are more prone to experiencing chronic pain. According to a study published in Pain Medicine, “the tendency to catastrophize about pain interferes with the neural processes involved in pain modulation in FM [fibromyalgia], specifically in the dorsolateral prefrontal cortex. Patients who reported greater levels of catastrophizing engaged this region to a greater degree.”[2]
What this means is, that if we tend to think negatively about pain and anticipate future pain, it is more likely for us to continue experiencing pain, because these tendencies affect the process of pain modulation that takes place in the brain.
What can you do if you have this tendency? As a Pain Coach, I always recommend to my clients not to describe their pain at length, using any strong adjectives such as ‘terrible’, ‘agonizing’, etc. Instead, I teach them how to observe pain more objectively and without judgement, in order to decrease the ‘intensity’ of emotions associated with the pain itself. 2. Perfectionism: if you’re a perfectionist, you tend to set very high standards on yourself. This means that you would be more prone to experiencing anxiety and stress if you feel at risk of falling short of expectations. Besides the stress, you are more likely to feel angry at yourself, guilty or ashamed for not being good enough. If such emotions are sustained at length, especially during a stressful or particularly busy period in your life, you would be more likely to experience chronic pain.
“Perfectionists are prone to all-or-nothing thinking and behavior. Because of their high standards, perfectionists tend to see only two options for engaging in any task or project: the right way or not at all.”[3] This tendency is also expressed when it comes to dealing with pain itself. As perfectionists seek recovery, they are more likely to feel dissatisfied with their current pain levels, as they desperately wish to attain a completely pain-free state. This ‘obsession’ with being pain-free can be the very thing that keeps them stuck in pain, due to the link between pain, expectations and negative emotions. What can you do if you have this tendency? First, recognize your perfectionist habits and acknowledge your needs. Are you denying yourself pleasure and relaxation due to your never-ending to-do-list?
Secondly, get comfortable with the idea that as humans, we are bound to commit mistakes and can never be perfect. What would happen if you actually made a mistake in your specific circumstance? Can it be easily remedied? Is there an alternative in case you fail? If yes, then it’s time to be a bit more compassionate towards yourself. 3. People-pleasers (goodism) - Goodism refers to a strong compulsion to be there for others or to do the right thing, and has strong links with our need to be liked and approved of. People who are goodists tend to put others’ needs and wants before their own – every single time! They have difficulty in saying no even when it involves something that they absolutely don’t want to do! The relationship between goodism and chronic pain can be best explained through Freud’s theory of the human psyche. According to Freud, every individual is made up of the ID (the inner child, which is inherently selfish), the ego (which is the adult that learns to make compromises) and the superego (which operates on moral principles). In goodist people, the Superego takes over more than usual, suppressing the inner child’s needs and wants. This Superego even punishes the ID by creating tension and guilt. In short, what happens is that we end up denying our selfish needs in order to maintain a good reputation or self-image. When someone represses his needs and wants to the extreme, it is far more likely for pain to manifest in the body, as a ‘warning signal’. According to Dr Sarno, this happens due to the pent-up rage within the individual, which doesn’t even have an outlet for expression due to the tendency to be nice, positive, and sacrifice his or her needs for others. For this reason, the only remaining outlet would be in the form of pain or chronic conditions that may eventually force us to take time off and finally compel us to see to our own needs. What can you do if you have this tendency? Get super-clear on your needs and desires. Are you regularly engaging in an activity that gives you pleasure or that relaxes you? If not, it’s time to work on a self-care routine that will help strike the right balance between your responsibilities towards others and those toward yourself.
Also make it a habit of asking yourself whether your decisions are based on what others expect of you, or on your own wants and needs. Are you constantly acting in such a way to avoid others’ disapproval? Can you feel the discomfort and tension that’s linked to this way of behaving? 4. Low self-worth. Low self-worth has strong ties with both perfectionism and goodism. When we want to be perfect, we are really scared that the world will see us as incapable or inferior. Also, if we are constantly seeking others’ approval, this means that we are not confident about the worth and validity of our own values and desires. People with low self-worth will tend to feel powerless and are more likely to neglect their dreams and ambitions. For example, such individuals may deny themselves a chance to try out something new, due to their belief that they may not be good enough. This leads to feelings of frustration, despair and inadequacy, which can lead to chronic physical symptoms if they remain unexpressed. What can you do if you have this tendency? Think back to all of the things you’ve achieved so far, and to what you’ve learnt from your mistakes. It may also be helpful to reflect back on your childhood traumas, and on what may have led to your low sense of self-worth. Very often, it’s certain events in our childhood that instill the belief that we’re not good enough, which we then carry around with us in our adult life to prevent ourselves from trying something and failing at it.
5. The victim-mindset - possibly the worst trait to have when it comes to chronic pain, the victim personality involves viewing yourself as a powerless victim to circumstances. This trait evolves over time, as we accumulate certain negative experiences and frequently indulge in replaying such negative memories. The victim mentality can easily be transposed to our reactions to illness and pain[1]. ‘Victims’ tend to feel unlucky and powerless in the face of pain, which makes it likelier for such pain to become chronic. This is because the victim personality makes us more likely to develop depression, and depression has very strong links with mindbody (psychosomatic) pain. In order to recover from mindbody pain, we need to cultivate better-feeling emotions such as hope and empowerment. We need to firmly believe that we can one day heal from pain. Being stuck in the victim mindset will prevent us from doing so. What can you do if you have this tendency? Acknowledge your victim-speak. How many times do you tell yourself and others that ‘you’re unlucky’? How many times do you blame other people, God or the universe, for your misfortunes? If you have chronic pain, do you indulge in thoughts that your body is hopeless, and that maybe, in your case, you might never recover? While it’s true that there have been certain circumstances that we had no control over in our past, we need to acknowledge that there are plenty of decisions and actions that we can take today that may lead to better outcomes. We also need to acknowledge that our tendency to view our health as a ‘hopeless case’ will prevent us from healing, since this perspective blocks out the very emotions that we need to cultivate in order to heal. 6. Legalists - legalists are people who feel that their views are always right. These people are very concerned about making the right choices, and tend to hold grudges towards people with whom they disagree. This may also lead to feelings of self-loathing and low self-worth if they feel that they haven’t lived up to their own standards.
What’s more, legalists tend to be very upset at things that they cannot control – they may be ‘addicted’ to reading the news, and end up criticising all sorts of things that they feel are unfair in this world. Despite their good intentions, this may lead them to cultivate a feeling of powerlessness, frustration and resentment in the face of circumstances that they cannot change. Needless to say, these emotions make it likelier for mindbody pain to manifest in the body. This is because pain is a danger signal; if we constantly feel threatened by the world around us, then it’s more likely for us to experience pain in the body. What can you do if you have this tendency? If you’re a legalist, you need to practise releasing resistance towards all of the things that you cannot control. Instead, focus on small decisions that you can take in order to feel better. Even the simple decision to treat yourself to a walk or coffee on the beach can make you feel more empowered.
You also need to stop yourself from constantly judging others and repeating to yourself how right you are! Trust me, I’m so guilty of this and the torment it has led to wasn’t worth it! If you have chronic pain, you also need to release your resistance towards the pain itself to lower the ‘threat level’ that we associate with pain. Surrender to the fact that right now, there is some pain, and that the pain is not life-threatening (assuming you’ve confirmed this with a doctor). The more you resist it, the more it’s going to torment you, so why not let it in and see what happens? You, your pain, and your responsibility The links established above between specific personality traits and chronic pain highlight the fact that we sometimes need to be accountable for our own wellbeing. If you’ve been treating your pain passively, by relying solely on meds or external help, then you may be overlooking this very important aspect. It may be the very reason why you’re still in pain. As you start taking responsibility and acknowledging your role in the generation of symptoms, you will start building the confidence and empowerment needed to heal. Despite what you’ve been told, if there is no structural cause associated with your chronic pain, then it’s very possible that you’re suffering from psychosomatic pain / mindbody syndrome (TMS). And if you are, the only way to heal is to take action and learn about this fascinating condition, so you can change those emotions and behaviours that are keeping you stuck in the pain cycle. For more information, please check out my website, www.painoutsidethebox.com for free resources and to access my recovery programs.
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 mindbody 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:
Dr John E. Sarno, M.D., Healing Back Pain: The MindBody Connection, Grand Central Life & Style (1991).
Laura D Ellingson, Aaron J Stegner, PhD, Isaac J Schwabacher, Jacob B Lindheimer, Dane B Cook, ‘Catastrophizing Interferes with Cognitive Modulation of Pain in Women with Fibromyalgia’, Pain Medicine, Vol. 19, Is. 12, December 2018, pp. 2408–2422.
Institute for Chronic Pain, ‘The Perfectionist and Chronic Pain: How to Cope with Pain Series’, May 2015.
