Mind body syndrome

Safe Self-Talk to Support Healing From Chronic Pain and Symptoms

 
Excessive negative thoughts about symptoms can worsen the sensations over time1,2. Thinking and beliefs influence our nervous system's safety or danger, and contribute to chronic dysregulation, leading to sensitization, where the brain and nervous system begin to produce chronic pain or symptoms.

Common negative thoughts about our symptoms can sound like1,2:

  • “My symptoms are permanent, and nothing I do helps.”
  • “My body is becoming more damaged each day!”
  • “Something is really wrong with my body!”
  • “My symptoms are only going to worsen over time…”
  • “This is hopeless, my body can’t do anything!”

So, how can we shift our thinking about pain and symptoms?


In our approach, we support clients in developing safe self-talk about their symptoms, sensations, emotions, and nervous system state.

Safe self-talk about our symptoms can help the brain reappraise physical sensations and situations as safe, instead of dangerous1,2. However, for safe self-talk to work, our words need to be credible! This is why learning how our nervous system works and relating our pain or symptoms to the criteria for neuroplastic symptoms is so important! To learn more, check out our blog post on Criteria for Neuroplastic Pain.

Examples of Safe Self-Talk for Chronic Symptoms:

  • “I know I’m ok; my brain is just misinterpreting normal sensations in my body.”
  • “I see how my symptoms are inconsistent, moving around, and triggered by emotions. This shows me it’s neuroplastic, and my body is healthy and capable.”
  • “I don’t need to control or change these sensations. There is nothing to fix or figure out!”
  • “My body is healthy. My brain is just being overprotective.”
  • “It’s physically safe to move this way.”
  • “I can respond to my symptoms with deep care and compassion.”
  • “I don’t need to like these sensations; I just need to remember they’re safe!”

The goal of using safe self-talk is to reinforce to the brain that it’s safe to feel these symptoms, the body is safe, and movement or activities are safe. Over time, this can support the reduction or elimination of our chronic pain or symptoms 1,2. The key to using brain retraining practices effectively is to do them consistently, but not intensely. You can practice safe self-talk throughout the day, each time you notice a negative thought about your pain or symptoms, and also while engaging in somatic practices with pain or symptoms. As you practice this strategy, please know it’s normal to feel danger and not fully believe our safe self-talk at first! Over time, safe self-talk becomes more natural, effective, and believable.

Now it is your turn to create your own safe self-talk for chronic pain and symptoms. Different phrases work for different people; effective and safe self-talk is unique to you and your symptoms. Find the self-talk that feels right for you! Remember to use the neuroplastic pain or symptom criteria you related to when building your self-talk to make it more credible.


If you need support with your healing, book in for a free 20-minute virtual consultation with one of our therapists:

1. Gordon, A., & Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC. 

2. Pain Reprocessing Therapy Center (2021). Pain reprocessing therapy training.

 

What Causes Neuroplastic Pain?

 

By Tanner Murtagh MSW, RSW

Many forms of chronic pain and symptoms are not the result structural damage or systemic diseases, but occur due to a rewiring of the brain and nervous system1,2,3. This is known as neuroplastic pain. Neuroplastic pain is triggered and perpetuated when the danger circuits in our brains become over-activated and our nervous systems are chronically dysregulated4,5.


Neuroplastic pain can develop in the following ways:

  1. Initial Injury
  2. Perceived Injury
  3. Stressful Situations or Life Transitions
  4. Trauma and Childhood Adversity
  5. Depression, Anxiety, or Obsessive Thinking
  6. Common Maladaptive Coping Mechanisms
  7. Feeling Unsafe in Your External World

  1. Initial Injury

    Neuroplastic pain can begin with a structural injury4. Typically, physical injuries heal within a few weeks to a few months, as our body is designed to heal. However, after an injury has healed the brain may maintain the neural pathways associated with the pain because the brain has learned to produce pain to protect you6. These learned neural pathways can be triggered and perpetuated by fear, difficult emotions and nervous system dysregulation, causing pain to continue long after an injury has healed4.


  2. Perceived Injury

    When in chronic pain, our primary fear is, “there is something wrong with my body”4. However, sometimes we incorrectly perceive an injury or believe our body is damaged. Research on pain and the brain shows us that, in absence of physical damage, fearing our body is damaged and expecting pain can trigger, amplify, and maintain pain in the brain7,8,9. At our clinic we frequently witness how fear and belief the body is damaged is enough to trigger pain, even when a client’s body is healthy.


  3. Stressful Situations or Life Transitions

    Stressful situations and life transitions, even positive ones, can trigger neuroplastic pain3,4. Events such as divorce, unemployment, going to university, having a baby, starting a new job, living through the pandemic, and experiencing the death of loved one can all cause difficult emotions and dysregulation in our nervous system. This can result in neuroplastic pain, as the brain triggers pain as a protective mechanism when the nervous system senses danger2. Pain being produced due to perceived danger is a normal survival response and a common part of being a human being.


  4. Trauma and Childhood Adversity

    Trauma can cause the brain and nervous system to become chronically dysregulated, which includes responses of fight, flight, freeze, or shutdown5. Trauma and adverse childhood experiences increase the likelihood of chronic pain developing10,11. In fact, adults are 2.7 times more likely to develop chronic widespread pain if they have significant trauma in their past, and 4 times more likely to develop chronic fatigue syndrome10,12. The connection between trauma and chronic pain and symptoms makes sense, as trauma causes our nervous system to function in a more reactive state that more readily perceives danger.


  5. Depression, Anxiety, or Obsessive Thinking

    Depression, anxiety, and obsessive thinking are signs that the nervous system is dysregulated and functioning in survival mode5,13. In our brain, the amygdala, posterior insula, anterior insula, anterior cingulate cortex, and mid cingulate cortex are involved in producing pain, emotions, anxiety, and depression14. When we are experiencing mental health concerns, both emotional pain and physical pain sensations can be produced, as shared brain regions are responsible for both14.


  6. Common Maladaptive Coping Mechanisms

    People with neuroplastic pain commonly engage in maladaptive coping mechanisms, which include perfectionism, conscientiousness, and people pleasing4. These coping mechanisms typically helped us create safety at some point in our lives, but as life changes, living this way can make us prone to self-criticism, worrying, and placing pressure on ourselves4. Over time, these coping mechanisms can cause chronic nervous system dysregulation, making us prone to developing chronic pain and symptoms.


  7. Feeling Unsafe in Your External World

    Studies have shown that social factors such as poverty, isolation, abusive or toxic relationships, race, gender and sexual orientation influence the likelihood of chronic pain developing and persisting15,16,17. Social experiences of violence, abuse, and oppression can cause us to feel unsafe in our communities and environments. “Pain is a danger signal”, and when we feel unsafe in our external world, neuroplastic pain can be triggered and perpetuated3,4.


As you can see, there are many ways neuroplastic pain can be triggered and perpetuated, unique to each person. The first step is assessment; as we gather evidence the pain is neuroplastic in nature, we can begin healing the pain at a brain and nervous system level. At our clinic we provide effective, evidence-based treatment to support our clients in reducing or eliminating their chronic pain.


Book a free 20-minute consultation with one of our therapists and begin your journey out of chronic pain today.

 

  1. Woolf C. J. (2011). Central sensitization: implications for the diagnosis and treatment of pain. Pain, 152(3 Suppl), S2–S15. https://doi.org/10.1016/j.pain.2010.09.030

  2. Clarke, D. D., & Schubiner, H. (2019). Introductions. In D. Clarke, H. Schubiner, M. Clarke-Smith, & A. Abbass (Eds.), Psychophysiologic disorders: Trauma informed, interprofessioal diagnosis and treatment (pp. 5-25). Psychophysiologic Disorders Association.

  3. Gordon, A., Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC.

  4. Pain Reprocessing Therapy Center (2021). Pain reprocessing therapy training.

  5. Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation. WW Norton & Co.

  6. Hanscom, D. (2019). Making the right choice about spine surgery. In D. Clarke, H. Schubiner, M. Clarke-Smith, & A. Abbass (Eds.), Psychophysiologic disorders: Trauma informed, interprofessioal diagnosis and treatment (pp. 83-98). Psychophysiologic Disorders Association.

  7. Castro, W. H., Meyer, S. J., Becke, M. E., Nentwig, C. G., Hein, M. F., Ercan, B. I., Thomann, S., Wessels, U., & Du Chesne, A. E. (2001). No stress--no whiplash? Prevalence of "whiplash" symptoms following exposure to a placebo rear-end collision. International journal of legal medicine, 114(6), 316–322. https://doi.org/10.1007/s004140000193

  8. Bayer, T. L., Baer, P. E., & Early, C. (1991). Situational and psychophysiological factors in psychologically induced pain. Pain, 44(1), 45–50. https://doi.org/10.1016/0304-3959(91)90145-N

  9. Picavet, H. S., Vlaeyen, J. W., & Schouten, J. S. (2002). Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. American journal of epidemiology, 156(11), 1028–1034. https://doi.org/10.1093/aje/kwf136

  10. Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European archives of psychiatry and clinical neuroscience, 256(3), 174–186. https://doi.org/10.1007/s00406-005-0624-4

  11. Green, C. R., FloweValencia, H., Rosenblum, L., & Tait, A. R. (2001). The role of childhood and adulthood abuse among women presenting for chronic pain. The Clinical Journal of Pain 17, 359-364.

  12. Afari, N., Ahumada, S. M., Wright, L. J., Mostoufi, S., Golnari, G., Reis, V., & Cuneo, J. G. (2014). Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis. Psychosomatic medicine, 76(1), 2–11. https://doi.org/10.1097/PSY.0000000000000010

  13. Dana, D. (2019). 2-Day Workshop: Polyvagal Theory Informed Trauma Assessment and Interventions

  14. Schubiner, H. & Kleckner, I. (2019). Introductions. In D. Clarke, H. Schubiner, M. Clarke-Smith, & A. Abbass (Eds.), Psychophysiologic disorders: Trauma informed, interprofessioal diagnosis and treatment (pp. 5-25). Psychophysiologic Disorders Association. 

  15. Mills, S. E. E., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: a review of its epidemiology and associated factors in population-based studies. British journal of anaesthesia, 123(2), e273–e283. https://doi.org/10.1016/j.bja.2019.03.023

  16. Schubiner, H., Jackson, B., Molina, K. M., Sturgeon, J. A., Sealy-Jefferson, S., Lumley, M. A., Jolly, J., & Trost, Z. (2023). Racism as a Source of Pain. Journal of general internal medicine, 38(7), 1729–1734. https://doi.org/10.1007/s11606-022-08015-0

  17. Zajacova, A., Grol-Prokopczyk, H., Liu, H., Reczek, R., & Nahin, R. L. (2023). Chronic pain among U.S. sexual minority adults who identify as gay, lesbian, bisexual, or "something else". Pain, 164(9), 1942–1953. https://doi.org/10.1097/j.pain.0000000000002891