Understanding chronic pain (A1)

Many chronic pain patients feel their body is broken and that recovery is impossible. They’ve seen countless doctors, tried hundreds of treatments. They’ve been warned by doctors their bodies will never be “normal” again. These are powerful messages that can activate the “nocebo effect”—creating self-fulfilling negative expectations that come true and create a snowball effect. This partly explains why so many people with chronic pain get worse over time.

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In this situation, many health professionals have come to believe their patients’ best hope is for better pain management and coping—some doctors even say chronic pain is permanent and nothing can be done to fundamentally change it. Dr. Schubiner, the Psychophysiologic Disorders Association, and diagnostic paradigms like Emotional Awareness and Expression Therapy (EAET) adamantly reject this message. Why manage pain when it can be reduced, unlearned, and often, fully resolved?

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The latest neuroscience is clear that chronic pain can be a learned condition, created in the brain through a process of “interoceptive predictions” that lead to a vicious cycle of pain and fear. This is how people can have phantom limb pain, which is pain projected into mid-air: the brain is creating it. Pain being switched on by the brain is a common occurrence—it’s estimated that one in seven people have chronic brain-generated symptoms like pain, fatigue, or GI issues. About 80% of us will experience it at some point in our lives—it’s part of being human, and it is usually reversible through retraining the brain.

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Many thousands of people have gone from having debilitating pain to being pain-free. Recovery is possible. And paradoxically, believing recovery is possible—despite all the negative predictions in our brains and incorrect messages from doctors—is one of the keys to getting better.