Chronic pain is not like normal pain. It is trained in. It’s a groove in the brain.
Strangely enough, the brain couldn’t care less whether it makes pain or not. The brain doesn’t care about anything; it’s just an organ in the body that generates cells, chemicals, and electrical signals. Only YOU care if the brain makes pain or not. Only you can care.
Therefore, you are the key to the process of retraining your brain so that it doesn’t make unnecessary pain. It can’t be done for you or to you—but you really can do it.
That’s what I’m going to talk about here.
Pavlov’s Dogs
You’ve heard of Pavlov’s dogs. There were perhaps hundreds of them, dogs like Arleekin (clown), Genghis Kahn, Barbus (big dog), Jack, Krasavietz (beauty), Mikah (nice girl), Moladietz (good boy), and Murashka (cute little thing). The psychologist’s favorite, apparently, was Druzhok (buddy).
These dogs were individuals, just like us, with preferences and far more varied responses to their situation than the schoolbooks tell us. We owe them a considerable debt, because they assisted Pavlov in teaching us that we animals have the capacity to be programmed, almost like robots, but by environmental cues.
When Mikah’s master rang a bell each time he put down Mikah’s supper dish, Mikah’s brain paired the sound of the bell with food. Thus Pavlov found he could make Mikah salivate whenever he rang a bell. Of course, the sound of a bell has nothing, in principle, to do with a tasty meal; from the point of view of cause and effect, it’s a miswiring. But Mikah’s brain had been so altered.
As you might imagine, evolution has an inbuilt solution for when cause and effect is mis-wired in animals. Food should cause salivation, but bells shouldn’t. So eventually, if you keep ringing a bell but never present food, the dog will stop salivating. Pavlov discovered this as well. Take away the evolutionarily wired cause (here, food) but leave the conditioned one (the bell) and the evolutionarily wired effect (salivation) eventually goes away, because its real cause has ceased. This is called the extinction of the conditioned behavior—the inappropriate response to the bell.
The Bell of Chronic Pain
Why then would evolution allow pain in humans to persist chronically, if there is no good (true) reason for it? Is chronic pain more like a true signal (food) or a false one (the bell)? Should it cause fear or not? You first have to think about Mikah to answer this.
She keeps hearing a bell, and she anticipates food, but it never comes. Gradually the bell loses its interest for her. She doesn’t care about the bell.
But if we have chronic pain, we’re not like that. Even though the danger never comes. I know this from my own body. I had chronic neck pain—danger signal—for 30 years. But the danger never came. The shoe never dropped, the catastrophe did not arrive. Just more and more pain and fear, so intertwined I could hardly disentangle them. More and more bell, no food.
Pain is a signal, like a bell. It makes us do things, like move or stop moving, but the associated feeling is negative. We don’t like it, we don’t want it. We are super-interested in the bell stopping. And that’s not how the extinction of behavior happens. It comes from not caring anymore, like Mikah felt about the bell. So we’re in a fix—we care about pain and we can’t imagine not caring. Could evolution still have a hidden trick up its sleeve for us?
The Tool of Introspection
Dogs are intelligent, but not psychologically self-aware. They lack a well-developed-enough pre-frontal cortex to support self-reflection. So when they feel something, they are already in response; they cannot simultaneously reflect on their response. Much less can they analyze why they are responding in the way that they do.
As humans, we have greater capacities than dogs—for heightened experiences of both pain, pleasure and everything in between. Since we are—or at least can be—self-consciously aware of our responses, we can actually train these responses ourselves, unlike dogs. We don’t have to rely only on the instincts provided us by evolution. In fact evolution bestowed on us an additional option, a very special tool: the experience of open, unbiased introspection.
A Little Gap as Big as the Universe
Viktor Frankl, the reknowned neurologist and Holocaust survivor, famously wrote:
Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.
I’ve loved this quote from the moment I first heard it, because it’s so true to experience. But I want to add a little something to it that pain has taught me, if I may be so bold.
This is that, it’s not just that there is a tiny space inside for decision-making, like the gap between dominoes, but rather, this space is you. The stimulus (e.g., pain) and the response (e.g., fear) actually occur in the space of you, isn’t it so? You’re the one who feels and knows them. The space is an entry point to connect to yourself—to however you are actually feeling in this moment. What is that space actually like? What does it feel like?
The message here is that that “little” space, which for a chronic pain sufferer can feel so constricted by tension and fear, can grow over time. With practice, you can become more and more spacious. It’s something you do step by little step, literally rewiring your brain each time you introspect in the right way.
The Peace of Not Caring
The type of introspection we are encouraging carries the feeling tone of safety. What is the feeling of safety? Spaciousness and peace, gifted with a little vibration of happy, satisfied pleasure. A shark’s tooth is sharp; a hawk’s stare or a stone is hard; a rose is soft; water is fluid. What is the feeling tone of you? THAT is what we are interested in here. We want to notice that tone, and we want to allow any unnecessary disturbances created by pain and fear to settle themselves out.
The reason we learn to “not care” about these disturbances is because we come to understand, as the truth, that the pain and fear cannot truly hurt us. They are just signals. The more deeply we understand and feel that, the more deeply we can “not care” in the way I describe it here. It’s not aggressively ignoring; it’s the “not caring” of not minding: “Ah, I see you, and I really don’t mind. You’re fine as you are.”
What is the feeling of safety? Spaciousness and peace, gifted with a little vibration of happy, satisfied pleasure.
Something subtle here: When you feel spaciousness and peace as an experience, you can also feel it as your own being, deep inside. Whenever you’re not disturbed, when the “waves of the lake of you” settle back down, you have an opportunity to contact peace, not just as an ephemeral experience, but as a deeper part of yourself. It’s like if you were to look outside and see a storm but glance inside and feel a calm lake. Not just “I know I’m safe” but “I am safe here, through and through”. This experience is possible, it’s enjoyable, and it can be cultivated.
Right now when you feel within you might feel just pain and tension. It can seem that way; I know that well. We want to look and feel a little further, until we start to feel the actual feeling of our inner being. I well understand that this can be challenging and may even sound absurd to someone in a lot of pain. And yet, somewhere in your experience, even if it’s just in one toe, there might be an experience of okay-ness, and that’s a start. The pain is simultaneously a big obstacle as well as a powerful spark to learn. You can let your pain make cultivating that feeling of safety be your highest priority, even if the starting point is no feeling of safety at all.
No doubt somewhere inside you are already open, loving, courageous, playful, interested, peaceful—many people who suffer from chronic pain have such inner qualities in spades—but such qualities need inner spaciousness in order to arise and show themselves.
With chronic pain, what has happened over time is that YOU (and therefore, your brain) have become caught in a pain-fear cycle. Stimulus and response start to act like a robotic cause-and-effect chain. Pain causes fear which causes pain which causes fear which causes … etc., etc. … you know it all too well. When that seemingly iron chain begins to loosen, stimulus and response begin to happen more and more within the spaciousness of your awareness. You can recognize this spaciousness, and begin to orient towards it.
Feel Your Own Being
As a human rather than a dog, you can consciously feel your own being, at any moment, and you can respond. Is it tense, closed, frightened, upset, irritated? What’s the quality of that space in which stimulus and response are occurring? You can know that, not just react to it. As you begin to notice that space, you embark on a journey that becomes less about changing the stimulus (pain) or the response (fear), but about noticing and attending to the overall quality of your being-space. You learn to make that space safer. Or even better: to find and feel the safety that is already there. Not a safe space somewhere, but an inner spaciousness that feels safe.
When you begin to get the hang of this, you begin not to care so much about the fear and pain that used to consume you. You trust that it’s being handled by the safe space inside of you—as you discover for yourself that it is indeed being handled. How strange and unexpected, for a chronic pain sufferer like me.
We are much bigger than we realize! Our body and brain can uncreate what they create. Like Mikah, we can help them by not caring about false bells.
You trust that it’s being handled by the safe space inside of you—as you discover for yourself that it is indeed being handled.
I hope that this is evocative rather than esoteric. There are specific tools that we can use to connect to and grow this space, beginning with mindfulness, somatic tracking, and positive affect induction. These are practical methods, and they work when done carefully, in the right spirit. You can learn, and you can’t help it—your brain is a learning machine!
Getting back to Pavlov and his dogs, the bell is like your amygdala ringing in pain and fear to sensations that are actually harmless. This method has the power to drive the response (fear-pain cycle) to extinction because it can remove the stimulus (also the fear-pain cycle) permanently. If you no longer respond to either pain or fear in the way you did before—by cultivating that spacious peace inside, one moment at a time—you will grasp the root of the problem. At that point, it’s game over, pain and fear.
Let’s pull that root!
