Pain is perception and therefore is unique to the individual. No two individuals experience pain the same way. And yet, there are many one-size-fits-all promises about how this treatment, or that therapy, or this diet will help cure your pain. To treat chronic pain, we must look at the individual as a whole person from a holistic and trauma-informed perspective.
Pain is a signal of a threat or a danger, either in the body or the environment. When you experience pain, a warning signal is sent to your brain saying, “Danger! Proceed with caution.” You can then choose how to proceed. If you ignore the pain, it often pops back up. If you tend to it but only address the symptoms of the pain, it often pops back up. This leads to a vicious cycle of feeling pain and trying to mask it, only to re-experience it again.
To break this cycle, first, it is important to look for underlying medical conditions that may be causing the chronic pain. For example, if your hip hurts, you might have a bulging disc, arthritis, or hip dysplasia. But what happens when all the medical tests come back inconclusive with no definitive answer? Or, when corrective surgery to address the underlying problem leaves you still experiencing pain? Does this mean the pain is just in your head and you need to get over it?
The answer is, no! It is not all in your head! Rather, you might consider switching your approach to pain management and adding somatic or embodied therapy with a trauma-informed lens to support nervous system settling.
READ: Why choose embodied or somatic therapy for trauma?
When the body experiences acute pain, signals are sent to the spinal cord and the brain. These neural pathways extend into the limbic system of the brain where an emotional quality to the pain is developed.
Pain is also stored in our memories. This is known as procedural memory. Procedural memories involve specific sequential movements and neuromuscular pathways. Over time, these become reinforced, patterned, habitual, and committed to memory. This is where the phrase, “it’s like riding a bike” is coined. Once you have learned how to do the movement, it is committed to your procedural memory for you to access easily and fluidly.
Unfortunately and fortunately, chronic pain operates in a similar manner. Our bodies and brain remember the pain as a procedural memory as a form of protection and self-defense. If you were hurt after stepping off the curb, then your body will try to protect you from stepping off the curb in the same manner in the future. Sometimes, this means that the brain will be on high alert and signal the pain as if it was then, even when it is not necessary in the present moment. In fact, the pain response may be stronger than the actual threat, thus creating a chronic re-experiencing of pain.
When we understand chronic pain through this lens, we invite exploration and curiosity about how the body may be stuck in hyper or hypo-arousal from a traumatic event. In other words, one may experience an incomplete attempt to fight, fight, or freeze, which activates a procedural memory of pain. From a somatics-based approach to therapy, we begin to heal chronic pain by increasing our tolerance for experiencing and noticing sensations that live in the body and allowing ourselves to reclaim movement as a support, not a threat.
For example, many have learned to not move in response to pain. They rest the affected area and may avoid moving out of fear. You may hold onto your body, building tension, in an attempt to suppress the pain from coming on and ultimately keep it trapped or stuck in your body. With embodied and somatic therapy, we begin to explore ways in which titrated movement allows the energy of the urge to fight or flight to move through the body and settle the nervous system.
To learn more about treating chronic pain from a trauma-informed approach, contact us for a free consultation.
About the Author
Elise Harowitz, MA, LPC, BC-DMT, is a trauma therapist in St. Louis, MO helping clients heal their relationship with their bodies and find a greater self-understanding and growth. She integrates dance/movement therapy, somatic experiencing, mindfulness, and play with children, teens, and adults.
Sources
Andersen, T. E., Lahav, Y., Ellegaard, H., & Manniche, C. (2017). A randomized controlled trial of brief Somatic Experiencing for chronic low back pain and comorbid post-traumatic stress disorder symptoms. European journal of psychotraumatology, 8(1), 1331108. https://doi.org/10.1080/20008198.2017.1331108
Berger, D. (2021, June). The Threat Response Cycle. Beginning 2 Somatic Experiencing. St. Louis.
Podolak, J. (2020, March). Advanced Pne: Focus on Function. Reading.
Schwartz, A. (2017, June 2). Chronic Pain Relief [web log]. Retrieved February 18, 2022, from https://drarielleschwartz.com/chronic-pain-relief-dr-arielle-schwartz/#.Yg_XQy1h1hB.
