Because thoughts are nerve impulses too…
Who is responsible for making the final decision as to whether something is dangerous for us, and determining whether action is required to overt harm?….The brain of course! We as human beings have a distinct advantage over animals, because we can learn quickly from experience, plan for future events, and make an attempt to predict outcomes.
This means we can recognise an event (or input) as potentially harmful before there is any chance for input at a physical level. This is all very well, and an essential survival mechanism for us. However, when the system becomes oversensitive (as it is in chronic pain states), inputs unrelated to physical damage, but judged by our brain as harmful, can be enough to cause pain.
It is well evidenced that some people with persistent pain need only to think about a particular movement or watch someone else perform a movement for it to cause pain. For some patients, even just imagining a movement is enough to cause a swelling in the painful part of their body. Many patients say: “It hurts more when I think about it.” From what we now know about pain, this makes perfect sense. Your brain has been trained to protect you from anything that it perceives might cause harm to your bodily tissues.
On top of all this, thoughts like: “my doctor thinks it’s all in my head”, and “someone I used to know had back pain, and they ended up in a wheelchair”are classified as threatening to a brain concerned about survival. Even being fearful of certain day-to-day activities, which you feel will stand a chance of causing you injury can increase pain. Often people cease common day-to-day activities because of this fear. We commonly term this: fear-avoidance-behaviour.
We all know that pain is transmitted by nerve impulses from the body to the brain, but it may be interesting for you to begin to realise that:
Thoughts and feelings are nerve impulses too!
Research has evidenced that thought impulses and patterns are so powerful, that they can maintain pain states within the body, even in the absence of any physical damage. Therefore, when all of your bodily tissues have healed after an injury, the pain can remain. For the sake of this article, we can call these unnecessary thoughts as: ‘cognitive distortions.’ Listed below are a series of the cognitive distortions concerning long-standing (chronic) low back pain:
“I’m in pain, so there must be something harmful happening to my body.”
“I’m staying home to rest, not going out. I think I’ll just keep out of things and lay low for a while.”
“Even their fancy new-fangled body scanner can’t find why I’m in pain. If they can’t find it in the first place how are they going to fix it?”
“I’m so frightened of my pain and injuring my back again that I’m not doing anything.”
“I’m not going back to work until the pain goes.”
This is just a small selection of the many cognitive distortions common to people in pain. What are your most common cognitive distortions, and what would happen if you were to begin to better understand them, and come to realise you have the ability modify them? If everytime a cognitive distortion popped into your head, you exchanged it for a more positive, suitable thought, how would that affect what you do…, your behavior…, your mood…, and even your pain?
