If you have followed me at all, you know I am a huge proponent of a few things. One, all pain is real. Two, all pain is complex and multilayered. Third, no one theory/approach in the science of chronic pain is the only way to do things, nor is it a complete explanation. I think all of the current research compliments each other and needs to be combined to really best understand what we go through and how to best help us. In this blog post we will explore some key elements as to why retrain pain, retraining the brain, and or calming the nervous system isn’t enough to get you active again.
Why “Retrain Pain Brain” Alone Might Not Be Enough
The reality is, chronic pain is a chameleon; it changes colors, adapting and morphing under the influence of a myriad of factors. It’s not just about our neurons firing away relentlessly. There’s a biological aspect, certainly – our physical selves. But there’s also the psychological component, our thoughts and emotions, and let’s not forget the sociological aspect, how our environment and social constructs shape our experience of pain.
I’ve come to understand that focusing solely on “retrain pain” is akin to trying to fix a leaky roof on a burning building. Yes, cognitive techniques like mindfulness and talk therapy are invaluable tools. They’ve helped me gain a better grasp of my mental landscape, which in turn, influences my experience of pain.
However, these techniques don’t directly address the biological underpinnings or the external factors exacerbating the situation. If I had jumped back into all the tasks of living, gone back to the gym without building up my tolerance, amongst other things, my pain would have remained.
Additionally, I did, in fact, ignore or maybe better said, was unaware, of many of the sociological influences on my pain. If you aren’t sure what I mean by that, keep reading.
Ignoring the complex interplay of biology, psychology, and sociology in chronic pain management is a bit like navigating a maze with a partial map. Sure, you might make some progress, but you’re likely to hit dead ends without the full picture. This realization doesn’t diminish the value of any single approach; rather, it underscores the necessity of a more holistic view. Embracing this multifaceted perspective is not just beneficial; it’s essential for those of us seeking not just relief, but a deeper understanding and a more sustainable path forward.
The Perils of Poor or Incomplete Diagnostic Workup
Imagine, if you will, navigating a complex maze—a labyrinth where each turn could reveal a vital clue about your pain’s origin or lead you down another confusing corridor. This maze is the process of diagnosing chronic pain, and without a comprehensive map (read: diagnostic workup), you’re essentially wandering in the dark. My initial forays into seeking help were met with quick dismissals, and an overwhelming sense that they thought my pain was in my head. I felt it was an enigma, doomed to remain unsolved.
When Your Environment is Part of the Problem
Consider, for instance, the stress of not knowing where your next meal is coming from or if you’ll have a roof over your head tonight. Food insecurity and housing instability are profound stressors that amplify chronic pain. They keep your body in a constant state of alert, making it difficult for any form of pain management to take root effectively. Trying to “retraining pain” under these conditions is like trying to calm a storm that’s continuously being fed.
When Being You is the Real Pain
Medical bias is real. I dislike the use of the term gaslighting, because I don’t think it is done intentionally, nor is it done with the express purpose to make us feel crazy. However, the undereducation of health care professionals in all fields about the complexity of pain, chronic illness and frankly women is real. It often leads to dismissal, invalidation, and making us feel crazy. None of these helps retrain pain. Nor do they calm the nervous system, they in fact make our conditions worse. They often put is in a state of constant vigilance, hyper arousal, we fear the worst because no one will listen (catastrophizing), we lose hope, and we end up feeling helpless.
It doesn’t go unnoticed by me that all of these things listed are things that are associated with continued pain and disability. Maybe one day the medical world will start to understand their treatment of people with chronic illness and pain drives many of those factors. Until then, we, as patients within a broken system need to understand we will most likely experience medical bias.
Where will we see that bias and be under treated:
- Overweight (or perceived to be overweight)
- Female
- “Older”
- BIPOC – Black, Indigenous, and People of Color
- Transgender
How often is your pain blamed on anxiety, menstruation, or weight? FAR TOO FREAKING OFTEN.
Abusive/Difficult Relationships
Navigating out of an abusive or neglectful situation, whether it’s with a family member, a partner, or even a close friend, was pivotal for me. It was about reclaiming not just my emotional health, but also taking a stand against a significant contributor to my chronic pain.
In the throes of abuse, our bodies are constantly on alert, living in a perpetual state of stress that only serves to amplify the pain we experience. It’s a cycle that feels almost impossible to break free from: the emotional turmoil feeds the physical discomfort, which then reinforces the mental strain. I learned that addressing this cycle by seeking help and resources to extricate myself from these toxic relationships was crucial. It’s not an easy path, and it’s one that might feel insurmountable when you’re standing at the start. But, speaking from experience, it’s a necessary step towards healing.
I want to stress the importance of support systems and resources for anyone trapped in an abusive relationship. It’s not merely about finding an escape; it’s about building a foundation for a life where your well-being—both physical and emotional—is prioritized. Tackling chronic pain means addressing all facets of your life that feed into it, and unfortunately, that sometimes means confronting the hard reality of abusive relationships. Not to simply retrain pain, but to reform your life.
Toxic Work Environments
Diving into my own story, post pain, I’ve come to understand the profound impact a toxic work environment can have on our health. It’s a subject that hits close to home for me, as I’ve navigated the choppy waters of workplaces filled with stress, hostility, and a glaring lack of support. These environments do more than just sour your mood; they seep into your physical well-being, amplifying pain and making it harder to manage.
Imagine spending your days in a place where the air is thick with tension, where every task adds another weight to the already heavy burden of chronic pain you carry. That is the reality of so many of us. Working in an environment like that taught me an invaluable lesson: no amount of internal retraining or cognitive reframing can fully counteract the constant external stressors of a toxic workplace. The stress response triggered by such environments puts your body on high alert, exacerbating pain and hindering any progress you might be making elsewhere in your chronic pain management journey.
What struck me the most was the realization that change needed to come from two fronts. Yes, working on my internal coping mechanisms was crucial, but so was advocating for a healthier work environment or, when necessary, making the tough decision to step away from a situation that was harming my health. It’s a daunting step, but one that can significantly shift the trajectory of your chronic pain management, paving the way for a more holistic healing journey. Understanding that the environment you spend a significant portion of your day in can deeply influence your physical health was a game-changer for me, driving home the point that sometimes, the best medicine involves changing the scenery, not just a lesson in how to retrain pain.
Recognizing the Impact of Societal and Political Tensions
Recently, I’ve been starkly reminded of how societal and political tensions aren’t just background noise—they’re intricately woven into the fabric of our daily lives, influencing our stress levels and, by extension, our pain. Amid the ongoing COVID-19 pandemic and the palpable political divide on nearly every issue, I’ve felt the weight of these larger issues compound the challenge of managing my long covid.
Living through such times, it’s become clear to me that these aren’t distant problems; they are intimately connected to our well-being. The constant barrage of news, the heated debates, and the uncertainty of what tomorrow brings—all of it feeds into a cycle of stress that continue to drive our symptoms. It’s a reminder that to truly address chronic pain, one must look beyond the confines of their own body and consider the broader context we’re all a part of. I wish we could retrain some government officials !
Conclusion
Chronic pain, with its intricate tapestry of biological, psychological, and sociological threads, demands an understanding. The thing all these things we talked about have in common is that they keep us in a state of fight or flight. We must acknowledge these challenges to changing our brain/nervous system, if that is going to be a focus of rehabilitation. It’s been a learning curve, one that taught me the importance of advocating for thorough diagnostics, recognizing the weight of my environment, and acknowledging the impact of societal pressures on my well-being. This holistic perspective has not only broadened my understanding but also illuminated paths to managing pain that I hadn’t considered before. It also puts into perspective how we go about approaching retrain pain/ calm a nervous system.
Let’s be real. That laundry list above is grim, yet it is also very real. Just like we can’t run a marathon before we can walk around the block – we can’t retrain pain or a brain and get out of fight or flight mode while we are smack in the middle of stress we can’t control. It’s not hopeless. It doesn’t mean that mind/body work or reframing work won’t help better your life. It does mean if you feel like you are struggling and you are still in the midst of endless stress, well, that is probably a more important problem to solve first.
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