Question 1

Is the pain all in my head? It feels so real!

Accepted Answer

Your pain is real, just as all pain is real. You're NOT weak, sick, crazy, imagining this pain, or consciously deciding for it to happen!

We now know that based on medical science that when we experience physical or psychological stress, it  can create real physical symptoms in the body. This is an example of our fight or flight response, which is our body's way of keeping us alive.

All pain is created in the brain, either in the immediate response to a physical injury, or in the case of chronic pain, because of over-active neural circuits in the brain. It is not your fault. In fact, this is human - every human has had a mindbody reaction before (e.g. when you get embarrassed, your cheeks may turn red.)

The great news is that brain-generated pain is learned, which means it can also be unlearned.

Question 2

I was told by my doctor that I have a structural problem.

Accepted Answer

So was I, and so were almost all of my clients. This is a common thing that doctors tell people, but the science tells a different story.

While it’s important to get a physical examination to rule out fractures, tumors, infections, etc., blaming chronic pain on a structural abnormality is often like blaming migraines on grey hairs.

In fact, in a recent study (https://www.sciencedirect.com/science/article/abs/pii/S1526590023005448)of back pain sufferers, 98% had a spinal 'abnormality' on their MRI, but in only 12% of cases were these abnormalities actually causing pain! The other 88% of sufferers had pain caused by neural circuits.

Consider also that 30% of 20-somethings without any back pain have herniated discs. 84% of 80-somethings without any back pain have herniated discs!

The same goes for pain in the neck,(https://www.painpsychologycenter.com/miraclesofmindbody.pdf) knee,(https://pubmed.ncbi.nlm.nih.gov/12110735/) ankle,(https://pubmed.ncbi.nlm.nih.gov/15827919/) and other areas. These findings are normal, and occur with age, but are rarely the cause of pain. More and more doctors are figuring this out.

Question 3

I know a lot of people with stressful lives who don't have this much pain.

Accepted Answer

It's true that everyone has stress, some worse than others. But science shows that how we interpret stress has a bigger effect on our health than the amount of stress we have.

And it turns out that how you interpret stress changes your body’s response to stress.(https://www.youtube.com/watch?si=goJBKqdS3OJHHu2W&v=RcGyVTAoXEU&feature=youtu.be) People who experience a large amount of stress - but do not perceive it as harmful - have better health outcomes than those who experience little stress!

We don't entirely know why stress can create pain in one person, and not another. But it does have a lot to do with your interpretation of stress, and what you've been through in life.

But we do know that everyone suffers from stress-related symptoms from time-to-time, some more severely than others. Fortunately, we also know that chronic pain is often generated from a stress response in the brain, which means that it's reversible.

Question 4

Could my symptoms be genetic?

Accepted Answer

We know that genetics can play an (often small) role in certain chronic pain conditions. However, these are predisposing factors - they do not cause the symptom onset.

Symptom onset occurs when those genes are activated or triggered, generally through fear, anxiety, worry, or injury. It's far more likely for the child of a back pain sufferer to have back pain not because of genetic predisposition, but because the exposure to a trusted figure with pain conditions the child with certain beliefs (e.g. the back is "weak" or certain physical activities are dangerous). This conditioning is 'priming the pump' for pain to occur later in life.

We also know that although genetic evolution can take thousands of years, we can alter gene expression in a short amount of time. For example, studies (https://pubmed.ncbi.nlm.nih.gov/23650531/#:~:text=Relaxation%20response%20induces%20temporal%20transcriptome,insulin%20secretion%20and%20inflammatory%20pathways)show that meditation can alter your gene expression in a positive way in a very short amount of time.

This means that genes that are activated can be deactivated. And chronic pain symptoms are often reversible because the neural-circuits causing pain can be deactivated.

Question 5

I had a bad accident many years ago. I think that is still causing my pain.

Accepted Answer

Accidents and injuries occur. However, the human body has an incredible ability to heal - from broken bones, ligament tears, etc. Consider that the biggest bone in the body, the femur, can heal - and actually become stronger than before the fracture - in just 8 weeks!

What often happens is an injury can transition from being 'acute' to 'chronic' through fear, worry, and the activation of neural circuits.

If we took a fMRI of your brain right after your accident, it would show pain in the brain regions associated with bodily feeling.

However, after a certain number of weeks, when pain persists, other brain regions light up - ones associated with emotions, learning, and memory! The pain then becomes learned - like a bad habit.

Consider also that despite an average number of car accidents, whiplash doesn't exist in Lithuania,(https://pubmed.ncbi.nlm.nih.gov/10084524/ - The Whiplash Debate) and that whiplash can be generated by a fake car accident.(https://www.painpsychologycenter.com/miraclesofmindbody.pdf)

Pain is often not due to ongoing injury from an accident that happened years ago, but neural circuits driven by fear, anxiety, and worry. And these neural circuits can be turned off, no matter how long you've been in pain.

Question 6

My muscles feel tight around my area of pain - how can that be caused by my brain?

Accepted Answer

This is very common. In the case of chronic pain, these areas of muscle tension are generally caused by the brain. They are a symptom of pain, rather than the cause of pain. As the nervous system is calmed through neural circuit retraining, these areas of muscle tightness go away, along with the pain.

Question 7

I get pain when I make a certain movement. How can that be my brain?

Accepted Answer

This is very common. Many people have pain or symptoms that are generated by movement, activity, weather, heat, cold, light, sound, certain people, foods, or pressures. In each case, these are triggers not causes of pain.

Like Pavlov,(https://www.simplypsychology.org/pavlov.html) who taught his dogs to salivate by ringing a bell without food, your brain learns to associate symptoms with these activities. This is  a conditioned response.

In the same way that we can learn to ride a bike or learn an instrument, we can 'learn' pain, too.

These triggers also generate symptoms outside of our conscious awareness.

Research (https://eagleman.com/books/the-brain/)shows that most decisions are made subconsciously, and we make subconscious associations all the time. Consider that you are more likely to rate someone's behavior as disagreeable if you are subsequently exposed to a strong smell, and you're more likely to say someone is likable if you're holding a warm cup of liquid.

In the same way, you don't need to be consciously aware of these triggers (e.g. that the weather has changed) in order to have symptoms arise.

Question 8

Why do I need to believe in the treatment in order for it to work?

Accepted Answer

We have learned of the immense power of the brain to create pain and to resolve it. If you believe you're broken or damaged, you will have fear, which will perpetuate the pain cycle.

There is no trickery involved here - we're getting to the truth that you're not broken, not damaged, and your very real pain is coming from neural circuits in the brain, not a structural problem.

This is why healing from chronic pain using a mindbody approach is not like taking an antibiotic, which will work whether or not you believe in it. This approach requires the client to take an active role in healing.

When you believe - and know - that you're not broken, your fear level goes down. This is a key factor to stopping the pain/fear/pain cycle.

Question 9

I've been in therapy for years. I don't think I need to resolve anything.

Accepted Answer

If you are in chronic pain, there is still a 'threat' that is being perceived.

While emotional processing is a key to recovery, there is also education, breaking conditioned responses, and unwinding harmful personality traits. Each of these may need to be addressed in order to become pain free.

The good news is that the inner work you've already done will be a massive help in your healing journey.

Question 10

I had a perfect childhood - I don't have trauma

Accepted Answer

Not all chronic pain patients have had a difficult childhood. Issues can stem from adulthood, how we treat ourselves, or conditioned responses.

In fact, there are new studies (https://pubmed.ncbi.nlm.nih.gov/40020402/)that show that stressors in adulthood can have a greater impact on chronic pain in adulthood than childhood trauma.

But no matter how great someone's childhood was, how much love we've received, we do not come out without some scarring.

It may not be big traumatic events. Sometimes personality traits and emotional turmoil can result from the equivalent of small paper cuts, or from things that didn't happen versus what did.

Parents who are therapists will tell you this; they'll say it's about 'minimizing' adverse impacts on children instead of preventing them outright.

Chronic Pain / Tension Myositis Syndrome FAQs