Talking about neuroplastic pain can provoke controversy. A lot of people misinterpret the approach of Pain Reprocessing Therapy and the concept of neuroplastic pain as a perspective that your chronic pain is all in your head.

That could be furthest from the truth. Your pain is REAL.

Please know that I am not another practitioner trying to tell you that you are crazy, that you are making it up, that you want to be in pain, or minimizing the very real experience of pain or other related chronic conditions.

Research shows that unconsciously repressed emotion and chronic stress keeps the nervous system hyper-vigilant, which optimizes pre-existing neural pain pathways and makes the nervous system more sensitive to pain.

This does NOT mean that emotions and stress that signal a pain response are any less real than physically caused pain.

In fact, studies show that the same parts of the brain light up whether pain is from suggestion or from a physical stimulus.*

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Think about the effect of acute emotional and stress responses on the body...

Your face really does turn red when you are embarrassed.

Water does indeed come out of your face when you are sad.

You really do get a headache after a stressful day.

You get a very palpable stomachache before giving a public speech.

​These are commonly accepted universal experiences that we all have, because we are humans and we have nervous systems. It becomes less commonly accepted that chronic health conditions could possibly be related to chronic emotional distress.

Our medical system fails a lot of people with chronic, complex conditions. It's fantastic for life-saving acute emergencies and very straightforward medical issues such as broken bones.

But what about the person who has chronic fatigue, chronic musculoskeletal pain, and irritable bowel syndrome? It's very likely that this person will go down a rabbit hole of very expensive attempts at trying to figure out what is physically wrong with them.

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How do emotions and stress provoke such a strong physical experience of pain, especially chronic pain?

The answer, my friends, lies in your brain and autonomic nervous system.

This is not some woo-woo statement. This is neuroscience.

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Here are a few facts about the autonomic nervous system (ANS):

• The autonomic nervous system (ANS) controls nerve fibers that affect every area of your body.

• The ANS controls breathing, temperature, heart rate, and other automatic and involuntary functions.

• Strong emotions that are held inside such as anxiety and anger cause increased muscular tension.

• This muscle tension takes place without our conscious awareness and causes very real and sometimes severe pain which can include muscle spasms.

• Often, we are not aware of these emotions.

• The ANS affects the muscles, blood flow, nervous system, heart, gastrointestinal tract, and genitourinary tract.

• These different systems affected by the ANS can create several different symptoms that are included but not limited to tingling, numbness, burning sensations, dizziness, tinnitus, anxiety, abdominal pain, bloating, heartburn, nausea, vomiting, diarrhea, constipation, urinary pain/itching/burning, urinary frequency, palpitations, rapid heart rate, migraine headaches, fatigue, and depression.

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Why is this so hard to get a hold of? Why is it so damn challenging to get OUT of chronic pain?

It's because the brain and nervous system are creating a pain experience that happens very automatically and reinforces itself over time.

The root of your chronic pain may not be purely physical, but it is a physiological process that takes place when we experience pain.

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Emotional memories often underlie this process.

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A little story to give you an analogy (intertwined with some nerdy neuroscience bits)...

Let's pretend that you are someone who has always been prone to nausea and headaches. Never a big deal, but those two symptoms tend to show up for you once in a blue moon.

Imagine you have a job you have been working at for a little while now, maybe a few months to a year or so. You like your job, but your boss is a nightmare to work with. They are emotionally abusive and micromanage every little thing you do.

On your drive to work every week, you take the same path to get there. Your drive to work is stressful because you have to meet with your boss every morning at the start of your work day. Your drive to work is infused with anxiety and dread.

Emotional memories are imprinted in a network in the brain that registers and stores emotions.

After a while you start to notice that you get a headache and feel nauseous on your usual route to work. These symptoms seem to be occurring on a more daily basis now than they did when you first started your job.

The areas of the brain connected to this emotional memory are connected to the hypothalamus which is the control center of your autonomic nervous system (mentioned above).

During stress, this network sends signals to the hypothalamus to activate the ANS which produces stress hormones cortisol and adrenaline which turn on the sympathetic nervous system (which results in the nausea and headache symptoms).

You finally worked up the courage to quit your job, but now you drive down the same path you used to take to work a year later to go get ice cream on a gorgeous summer day with your best friend...

And here's the thing: this pre-wired emotional network in your brain doesn't know the difference between you going to get ice cream with your bestie versus having to spend a day getting emotionally abused at your old workplace.

The imprint is this: driving down this road = potential danger = automatic nausea and headache.

Rather than risking danger, your brain turns on this protective response in hopes that you will change your behavior and protect yourself (quit your job, call into work, avoid the situation), even though there is no risk at all (summer day, ice cream, and BFF).

​So, in sum....this process happens automatically and underneath our conscious awareness. You can't just make this process stop with conscious will. It's a process of retraining your nervous system.

For folks who have had adverse childhood experiences or chronic, repeated stress, the brain tends to have a very sensitized emotional network, and can have a globalized perception of threat.

This globalized perception of threat could come from internal experiences such as being afraid of your own internal sensations such as emotions and other sensations in your body. It could also come from external experiences such as certain people, places, times of day, certain seasons, certain smells or sounds.

So many different things could be a trigger for this automated physiological pathway of sensory stimuli to brain to nervous system to pain. And then what often occurs is that we respond to the pain with more fear, anger, despair, and distress. This is how the pain cycle perpetuates and reinforces itself.

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I hope that I did not create an association of pain onto your next ice cream stand experience!

Here is this week's somatic practice:

Ask yourself this question in regard to any internal or external experience you are having:

Where do I stand in relation to this experience?

Remember that although we may not have much control in the moment of how our nervous system responds to our internal or external world, we do have some choice as to how we relate to our nervous system's response.

In other words, you do not have to be a victim to your nervous system. You can start by bringing your internal witness online, and bringing some loving presence and compassion to those difficult, automatic experiences of dysregulation or pain.

For example, if you notice your nervous system just wants to collapse, or you find yourself wanting to get distracted, just take one small intentional step toward that experience that supports you to embody the energy you desire to cultivate more of WITHOUT bypassing how you are feeling in the present moment.

It could be one intentional long inhale and long exhale. It could be putting your feet on the ground and feeling the support of the floor rising up to meet you. It could be lifting gently through the crown of your head and freeing some space in your heart. It could be saying an affirmation or mantra out loud.

As you are going through your day, just simply check in with your internal experience.

Notice how you are in relationship to whatever it is that you are seeing, sensing, feeling, doing, thinking.

​*The University of Pittsburgh on Hypnosis and Pain: Researchers used a hot probe to trigger pain in their volunteers. fMRIs showed brain activity in the thalamus,anterior cingulate cortex, mid anterior insula, and parietal and prefrontal cortices. These brain regions are part of a network for experiencing pain. When the subjects experienced hypnotically induced pain, the fMRIs showed a similar pattern of brain activity, proving that the brain’s response to pain is the same when confronted with actual physical injury and perceived injury.

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