What is Pain and Why Does It Hurt?
Excerpt from Hypnosis: The Pain Solution
(4-CD audio program with Maggie Phillips, PhD)

Pain is a warning signal and is protective, warning us when we pick up a hot skillet that we will get burned if we do not put it down quickly, for example.

Acute pain makes sense and serves a purpose. Usually it occurs in response to a specific injury, such as a cut, burn, or fall. Persistent pain is diagnosed when the original cause of the pain is resolved yet the pain continues. This pain serves no useful purpose. Chronic pain is diagnosed when the persistent pain does not respond to typical interventions such as medication and structured exercises over a period of at least several months and becomes a chronic condition. Chronic pain is viewed as a health problem in and of itself, and is considered separate from the condition that originally caused it.

A complex biochemical and electrical process takes place when the nerves in the area of the problem send signals through the nervous system about the sensations they identify. The signals move through the spinal cord to the brain, where they are registered and interpreted as pain. That's when we feel the pain as hurt.

Pain starts with peripheral nerves, located throughout the body, which sense an unpleasant stimulus like a cut, intense pressure, sting, etc. Peripheral nerves specialize in a particular type of sensation and relay information about the sensations they have detected to the spinal cord. Severe pain sensations are relayed immediately. Dull, aching pain is relayed more slowly, and therefore receives a lower priority.

In the spinal cord, the signals meet up with specialized nerves thought of as gate keepers which further sort the pain signals. Researchers Ron Melzack and Patrick Wall discovered that a structure called the dorsal horn at the back of the spinal cord acts as a gateway for all the messages that are trying to pass through. When severe pain signals extreme danger to the body, the "gate" is wide open and these signals follow an "express route" to the brain. "Weak" pain messages, such as those related to a scratch on your finger, may be blocked out partially or even entirely by the gate system. It also appears that certain psychological factors such as a person's emotional state, how they perceive the meaning of the pain, and awareness of other sensations that might compete with the pain can serve to open and close the gates. This "gate theory" of pain has been used to explain how people can react very differently to the same root cause of pain, such as whiplash during a car accident. For some people, this is a temporary inconvenience with mild to moderate pain for awhile while for others, life comes to a complete halt-they develop chronic pain after trying months of treatment, find little or no consistent relief from their pain symptoms, and are unable to return to work. Sadly, they may end up leaving their chosen career or vocation for a life organized around pain.

We now have good research that demonstrates that psychological factors such as beliefs about pain, prior experience with pain, social and family support, etc. can directly impact the experience of pain at the site of injury, affecting the peripheral nerves. They help determine whether to open or close pain gates in the spinal cord, and in terms of turning on certain chemicals, such as endorphins, which can stop the experience of pain, and chemicals which enhance pain, such as protein "P," which stimulates increased pain and expand its area of impact in vulnerable areas of the body.

When pain messages reach the brain, they are routed to the thalamus, a center which handles tactile information. There the information is processed in terms of the individual's emotional mood state, how attentive they are, and in conjunction with their past history of pain. The thalamus then sends an assessment to the larger brain which includes an area that stores physical sensation called the sensory cortex, the limbic system, which governs emotional feelings, and the thinking area of the brain, the frontal cortex. Your pain experience therefore consists of a complex combination of sensing, feeling, and thinking. On the basis of this processing, further signals are sent down to the spinal cord to close the gates, which will block pain signals, or to open the gates wider, which will intensify the pain.

In addition to understanding the biology of pain, it is important to understand the psychology of pain. Psychological beliefs, feelings, and attitudes play an important role in regulating the pain experience; you can learn how to use hypnosis to modify these factors and thereby modify your pain. For example, many patients find that their pain is worse when they feel hopeless or depressed, feelings that may open the pain gate, and that they can help to close the pain gates when they are focusing on an activity that is pleasurable.

While learning to shift your thoughts and feelings to begin to regulate the pain gates, it is also important to understand how stress can affect pain. For example, if you have a work injury which causes soft tissue damage, your biological and psychological reactions will influence the type of pain experience you have (see above). However, if on your return to work, a supervisor becomes unsympathetic to your work needs, and pressures you beyond your limits to assume a full work load immediately without the modifications your doctor has recommended, the resulting anxiety and distress will increase your pain further. If there is no way to resolve this situation, the stress may end up pushing you into a chronic pain condition. Fortunately, hypnosis can also help you develop better reactions to the stresses that can worsen your pain in your workplace, in your family life and other relationships. You can learn simple strategies to help you stay calm, decrease anxiety, and turn on positive messages that can keep the gates in your nervous system closed to increased pain. In addition, the activation of your creative unconscious mind may help you find unexpected solutions to the stressful situation.

Trauma is another important ingredient in your individual pain equation. A high percentage of chronic pain patients manifest the long-term changes in brain chemistry that are associated with unresolved trauma. The trauma may consist of childhood sexual, physical, and psychological abuse, a series of accidents, injuries, losses and/or illnesses occurring in adolescence and adulthood. Another source of trauma might be difficult surgical procedures or invasive medical/dental interventions that were traumatizing. And, of course, over time, unrelenting pain itself becomes traumatizing.

Regardless of the nature of the traumatic event, however, the body responds similarly to all trauma. The nervous system becomes overactivated in response to signals that there is significant threat to survival. If this persists for a long time, as in childhood abuse, or is reinforced by a series of losses or car accidents or injuries/illnesses, the body becomes confused when its alarm system stays perpetually turned on. Resulting chemicals such as adrenaline and cortisone are dumped into the nervous system creating imbalance, anxiety symptoms, and startle reactions. In addition, overwhelming painful emotions become expressed through the body because the limbic/emotional center of the brain becomes dysregulated.

Biologically, we are wired like all animals. Animals in the wilds are exposed to threat of death on a daily basis, yet they do not exhibit signs of trauma. Their natural instincts allow them to complete behavioral patterns that release the freezing and constriction that occurs with fear such as fighting back or running away. Since we can rarely accomplish this as human beings, we are left with the somatic changes associated with unresolved traumatization—freezing in the body, the tendency to disconnect from or avoid feelings or reactions related to the trauma (dissociation). Simply put, we are left with massive constriction of muscles, tendons, fascia, tissues which, if unresolved, creates ongoing physical pain. At the same time, we have usually disconnected from our awareness the multiple and complex sources of this constriction (such as a fall out of a tree in elementary school, a slip down a steep flight of stairs in high school, followed by a skiing accident as an adult).  Cellular memory of the protective movements made by the body in a car accident, for example, are immediately stored in the brainstem (primitive area of the brain). In later situations of perceived life threat, they will be resurrected again and again by the nervous system in attempts to help the organism with “survival.”

Again, you can learn how to use hypnosis in order to intervene in what can become a relentless vicious cycle of fear and constriction – pain – more fear and more constriction which triggers even more pain.

In this CD program, you will learn some basic ways of using hypnotic suggestion to help close the gates on pain, to create a more healthy response to stress, and to intervene in the complex consequences of traumatic events. This program will help you in important ways to understand the biology and psychology of pain, and to apply your learning to relieve the stresses and posttraumatic difficulties that underlie and maintain your chronic pain condition. In addition, you will learn many tools to relieve and resolve your pain symptoms.  Finally, you may also discover through your responses to the diverse assortment of CD sessions that you need more help in a particular area. This information will be helpful to you and your treating professionals in further evaluating your treatment needs.

These and other benefits will be yours as a result of regular practice in listening to and following the suggestions contained on the CD tracks. We hope that your experience will foster the healing that is needed to begin reversing your pain condition.

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