Driving home in the car two days ago, surfing the radio stations per usual, I caught an NPR story about the connection between emotional and physical pain in adults suffering from chronic “medically unexplained pain” like Irritable Bowel Syndrome (IBS) and fibromyalgia.
The notion that emotional and physical distress and pain are all connected will come as no surprise to victims of incest and other forms of sexual abuse and harassment. Many such victims acknowledge the physical symptoms long before the emotional ones. In fact, sometimes it’s the physical symptoms that force victims to dredge up the emotional wounds in therapy.
But here’s where the news report gets interesting.
The Cool Part
New research, the reporter said, shows that “Repeated exposure to psychological trauma, or deep anxiety or depression — especially in childhood — can leave a physical imprint on the brain that can make some people…more vulnerable to chronic pain.” And that pain can continue long after the emotional wounds have scarred over.
Let me emphasize three important findings wrapped up in that statement:
- Physical pain can be the result solely of emotional trauma; no blow, cut or illness required.
- It is the brain that generates physical pain (not some other organ or tissue).
- The brain can keep generating physical pain after the original, emotional pain has gone away. Not exactly the “gift that keeps on giving” — that would be too generous — more like the troublesome relative who refuses to leave your home.
In my layperson interpretation, it’s as if your brain has been trained to feel pain and it can’t turn off that switch even if you have escaped the traumatic environment, analyzed the impact and moved on as best you can.
Hearing this while driving in my car, I shook my head as an “Aha!” slammed into my forehead.
For years, I’ve suffered from migraines — 31 years, to be exact. I also suffered some emotional trauma as a child, which I believe I have come to terms with after therapy, self-analysis and much time. But while my emotional pain for years has been minimal, flaring up only upon hearing or reading about a story similar to mine, my migraines are relentless. I have good phases and bad phases. Lately, I’ve been in a bad phase, experiencing one or two migraines every week, so this news report was timely for me.
Is it possible, I wonder, that my migraines are the result of my brain continuing to “create pain” long after the emotional wound has healed? Am I focusing too much on potential foods triggering my headaches and not enough on my past?
The good news is, researchers are discovering how therapy can aid many adults with chronic pain.
So if you suffer from chronic physical pain — whether or not you remember childhood trauma, or extended periods of depression and anxiety — you owe it to yourself to learn a bit more. Read on for more information about the science and the treatment.
As for me, I’m going to start a journal like the patient profiled in the NPR story did. Wish me luck.
The Scientific Findings
The Source: The new research is described in a report called Emotional Awareness and Expression Therapy for Chronic Pain: Rationale, Principles and Techniques, Evidence, and Critical Review, by Mark A. Lumley and Howard Schubiner, published in Current Rheumatology Reports, © Springer Science+Business Media, LLC, part of Springer Nature 2019.
The Treatment: Emotional Awareness and Expression Therapy (EAET) “combines some techniques from traditional talk therapies (such as probing a patient’s life experience for insight and context) with those of cognitive behavioral therapy, which focuses more on skills training and changing harmful patterns of behavior,” according to NPR.
Excerpts from Report: “Patients need to learn that their brain—rather than their peripheral tissues—is the organ that generates or amplifies primary pain.”
“The brain has been strongly shaped by experiences throughout one’s life, including painful injuries or procedures; abuse, neglect, or victimization; and interpersonal or intrapsychic conflicts. Stressful experiences can generate or amplify pain, especially when avoidance of uncomfortable experiences (trauma memories, emotional conflicts, interpersonal interactions, and even pain itself) leaves patients feeling helpless and fearful, preventing both psychological growth and the reduction of pain and other symptoms.”
“EAET reliably reduces pain and interference, although improvements in anxiety and depression are less reliably achieved and may be delayed.”
Another Professional Opinion
As NPR reports:
“‘This is a real phenomenon,’ says neuroscientist Amy Arnsten, a professor of neuroscience and psychology at Yale School of Medicine. Under healthy conditions, she says, higher circuits in a part of the brain — the prefrontal cortex — can regulate whether individuals feel pain and how much pain they feel. But these higher brain circuits can weaken and even atrophy when we’re exposed to chronic stress, Arnsten says, ‘especially stressors where we feel uncontrolled or frightened.’”
“[These stressors can make] people more vulnerable to feeling pain. And if those prefrontal circuits aren’t working to help regulate the sensation, Arnsten says, individuals may feel prolonged pain long after a physical injury has healed.”
“What’s more, without proper regulation, she says, the brain can generate pain when there’s no physical damage. ‘The brain actually has pathways where it can go down and control our body,’ she says, ‘and actually create a pain response.’”