The Biggest Misconception About Chronic Pain

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When people use the phrase “𝗮𝗹𝗹 𝗶𝗻 𝘆𝗼𝘂𝗿 𝗵𝗲𝗮𝗱” to describe stress-induced pain, the implication is that the pain exists only in your mind — in your thoughts — in your fantasy.⁠

Not only is this notion dismissive and hurtful to those experiencing pain, it’s quite simply untrue. Anyone who’s ever experienced stress-induced pain (i.e. the kind of pain that has medical doctors telling you “there’s nothing wrong”) can attest that the pain is very, very real.⁠

Back when I was getting stop-everything migraines for over a decade, I never suspected that there was anything physically “wrong” with me — I knew that my migraines were stress-induced — but that knowledge did nothing to reduce the excruciating pain sensation. The pain wasn’t fantasy, and I wished that I could just think it away. But the pain was definitely there, and it was definitely real.⁠

So when clients ask me, “are you saying the pain is all in my head?” I reply “absolutely not.” But I AM saying that the pain — ALL pain — is in your 𝗰𝗲𝗻𝘁𝗿𝗮𝗹 𝗻𝗲𝗿𝘃𝗼𝘂𝘀 𝘀𝘆𝘀𝘁𝗲𝗺: the control system centered in your brain that controls autonomic functions such as digestion, heart rate, emotions and yes, 𝗽𝗮𝗶𝗻 𝘀𝗲𝗻𝘀𝗮𝘁𝗶𝗼𝗻𝘀.⁠

Whether the pain you’re feeling was triggered by something 𝗽𝗵𝘆𝘀𝗶𝗰𝗮𝗹 (like a broken arm) or something 𝗲𝗺𝗼𝘁𝗶𝗼𝗻𝗮𝗹 (like a stressful workday or a trauma trigger or a stress-perpetuating coping strategy like people pleasing)… the 𝗽𝗮𝗶𝗻 𝘀𝗲𝗻𝘀𝗮𝘁𝗶𝗼𝗻𝘀 you feel are signals created by your central nervous system — i.e. in your brain.⁠

When the central nervous system senses threat — which can be physical, emotional, or both — it responds by sending a variety of SOS signals, and one of those signals can be 𝗽𝗮𝗶𝗻. (Others include racing heart, panic, startle response, etc.)⁠

All pain sensations are created by the 𝗰𝗲𝗻𝘁𝗿𝗮𝗹 𝗻𝗲𝗿𝘃𝗼𝘂𝘀 𝘀𝘆𝘀𝘁𝗲𝗺. They are NOT created by 𝘁𝗵𝗼𝘂𝗴𝗵𝘁𝘀 in the mind, although thoughts do have a big 𝗶𝗻𝗳𝗹𝘂𝗲𝗻𝗰𝗲 on 𝘁𝗵𝗲 𝗻𝗲𝗿𝘃𝗼𝘂𝘀 𝘀𝘆𝘀𝘁𝗲𝗺.⁠

For example, habitual thoughts that communicate internalized emotional abuse (like “I’m a terrible person” or “everybody hates me”) prolong and perpetuate the emotional threat that initiated those thoughts. Such thoughts send ongoing threat messages to the central nervous system, and the nervous system may respond by sending SOS signals such as 𝗽𝗮𝗶𝗻 𝘀𝗲𝗻𝘀𝗮𝘁𝗶𝗼𝗻𝘀 that you feel in your body.

Does that make sense?

So the next time someone tells you the pain is “all in your head,” you can tell them:

“No, the pain is in my central nervous system just like 𝗮𝗹𝗹 pain is, because that’s how pain works!”

For more support with anxiety and chronic pain, take the FREE QUIZ: “Why the *bleep* am I still in pain?!” to help you get some clarity.

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