A Stoics response to pain

There are more things, Lucilius, that frighten us than injure us, and we suffer more in imagination than in reality. – Seneca

In this, nothing has changed in millennia. Fear of suffering is often worse than suffering itself, and the past 12 months has brought its share of it; yet we all react differently. Some are fearful and have hoarded toilet paper. Others are excited and have started new businesses.  And so it is with pain and injury. The same injury causes different reactions in different people. The same tissue is injured, the same insult inflicted. Yet the reactions are different. It is not that people exaggerate their pain; after all pain is a subjective experience unique to the person suffering it.  It is simply that everyone’s perceptions are unique. This applies equally to physical or mental pain.

‘So, are you saying that the pain is all in my head?’

This is one the most common questions we hear from people dealing with longstanding pain. The answer is yes. Because everything we perceive is in our mind. Pain is in our head, along with perceptions such as hunger or anxiety. The brain is the final destination for processing.

When you touch a hot stove, the nerve in your hand zings a message to your brain and says “Hi brain, this stove is pretty hot, what do you want me to do?”.  Your brain quickly replies “take your hand off the stove, fast”. Your muscles are instructed to act accordingly, and your hand moves away, fast. The system has worked. The perception of pain resulted in an action that protected you.

Fear and anxiety elicit similar responses. When faced with a lion in your garden (or in my case, a spider crawling in my mouth that woke me last summer), your brain will rightly perceive the threat and initiate a “fight or flight” response. Your heart rate rises, stomach blood flow reduces, muscles contract and your hands will begin to shake. Your brain is preparing you to either fight or run. Again, the system is working and a significant threat elicits the appropriate response. (Though it was difficult to run from the spider in my mouth.)

But what happens when fear, anxiety, and pain are longstanding?

Injured tissues have fairly well-defined healing times. Yet we know that in many cases pain persists, just as we know that fear can persist long after the threat has gone.  The brain concludes that a threat remains and that you need more warning and protection.

Why?

There are many reasons, but an important one relates to thoughts and beliefs. After all, these are nerve impulses too.  For a person with back pain a thought like ‘Aunt Mary had back pain and ended up with surgery that didn’t work” can zing a similar danger message to your brain to that of touching a hot stove. However, it is harder to “unthink” a thought than take a hand away from a hot stove. Persistent thoughts can increase fear and lead to a sustained change in both your long term behaviour and brain physiology.

This change to how your nervous system is perceiving and responding can manifest in different ways; feelings of anxiety or agitation, reduced patience, disturbed sleep, reduced appetite, or anger.  Consider these symptoms as pain in disguise.  The response to the “pain” can be blunted – temporarily – with things such as alcohol or medication.  But they can also be improved in a healthier and more sustainable way with tools such as mindfulness, introspection, and exercise. These techniques are just as useful at helping reduce longstanding “physical” pain, as they are at reducing pain in disguise; agitation, anger, disturbed sleep etc.

We are living through a time of greater stress. Our brains are receiving more impulses and inputs. There is more noise. We don’t like it, and wished we weren’t experiencing it, but we can use it as an opportunity to learn about ourselves, become calmer, stronger and more resilient. We can endeavour to worry only about what we can influence. Things such as our mental and physical health.

Keep Moving,

Cameron Tudor

Clinical Director