Chronic pain is one of the most common reasons people seek medical care in the USA. According to the National Health Interview Survey (NHIS), in 2016, 50 million people in the United States had chronic pain.
Chronic pain is one of the most difficult issues to deal with, as it intrudes itself into every aspect of a person’s life. Once pain becomes chronic, it tends to cause emotional difficulties because of the stress and the negative impact on our quality of life.
Chronic pain and trauma
Researchers and clinicians have begun to understand there is often a connection between trauma and chronic pain. This is because many adults suffering from chronic pain in midlife have a history of childhood adversities.
For example, an investigation into the histories of women suffering from chronic pain conditions such as (for example) fibromyalgia has found these women reported high rates of sexual and physical abuse during childhood.
Research investigating other forms of chronic pain such as lower back pain, chronic headache, and chronic pelvic pain have also found many people suffering from these conditions report high rates of trauma in their histories.
Early experience and non-verbal trauma
While the exact mechanism underlying the link between trauma and physical pain is unknown, in our previous post, we discussed how the neural pathways for physical and emotional pain overlap and how emotional trauma is linked to chronic pain.
Child attachment and trauma researchers such as Bessel van der Kolk have begun to understand that trauma lives in the body. Much of this trauma is considered to be non-verbal for two reasons. First, even though we do not fully develop our language skills before age three, we can experience trauma, fear, illness, and physical injury before we are able to use language to describe and interpret the experience. Therefore, the body and the nervous system are having a traumatic experience and forming a memory that has no words.
Second, when trauma activates the fight or flight system, the “lower” structures in the brain, those responsible for preparing the body for a response (i.e., increased heart rate, breathing, stress hormones) take over and suppress the frontal lobe where higher thought and reasoning occurs. This pattern is beneficial as it ensures survival. The lower structures in the brain react much faster than our rational/analytic brain. For example, if we encounter a dark object that looks like it could be a bear in the woods, we want to run away. We do not want to engage in wasting time analyzing whether we are in danger. Our higher-order thinking self that relies on language-based thought would want to consider that perhaps it’s not a bear, and maybe it’s a dog, or that it’s not moving rather than guaranteeing that we avoid being hurt.
It is thought that when we experience a trauma, we cannot process it with reason and language because the higher processes are sort of “offline” during a traumatic experience. Instead, our bodies respond in ways that are likely to increase continued existence rather than thinking through the experience. Additionally, current thinking is that the brain returns to a similar state when remembering trauma. The area responsible for higher thought (reason) and speech goes offline, and we are unable to articulate or make sense of what happened.
Therapy for trauma can help chronic pain
Neuroscience research shows that the only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves. – Bessel van der Kolk
If our stress response system is chronically activated during childhood and we do not have a supportive adult to help us calm down or feel safe, the body can begin to internalize the situation. Some researchers argue that early trauma is stored in the body in a non-verbal way, and as a result, the body comes to “know” the word is not safe, and often a companion interpretation for the child is he or she is not worthy of protection and love. These experiences, if allowed to continue over time (as in the case of an abusive or neglectful childhood) becomes an internal model and developmental representation of the self and the world.
What this looks like in terms of chronic pain is the nervous system, chronically activated without a supportive adult, is never given the chance to learn how to cope with stress and emotional pain.
The benefits of therapy lie in the supportive and safe connection that happens in this sacred environment. Additionally, exploration, understanding, and healing of past trauma through therapeutic work can help you move past the emotional and physical effects of trauma. Therapy for trauma and chronic pain also helps cope with the emotional consequence of dealing with chronic pain.
Alternative therapies such as yoga and hypnotherapy are also useful for working with the body to clear the effects of trauma. The practice of yoga has been shown to ease the symptoms of anxiety and panic. Breathing calms the nervous system and gives us a chance to manually take back control of our overactive and hyperaroused nervous system. The next time you are feeling anxious and your body begins to react, try long, slow, deep breaths and see what happens. Understanding that chronic pain may be rooted in trauma can offer an alternative to powerful pain medication and bring you to a healthier, happier future.
Reach out today
Dr. Terry Crump is a clinical psychologist, board-certified clinical hypnotherapist, and author in the Metro Atlanta region specializing in individual therapy, hypnotherapy, and family consultations around health concerns. Contact her today to make an appointment.