The Relationship Between Pain & Fear
Mary Ruth Velicki MS, DPT
For several months after I was diagnosed with interstitial cystitis (IC), I scoured the internet for information and joined a few online chat groups that were meant to support women with IC. Whenever I engaged in those activities, the pain would ramp up. When I’d read the online postings of other sufferers, I would add their issues to my own worst-case scenario, and my anxiety would mount. When others in my situation wallowed or vented, the pain intensified and my future seemed bleak. In order to get better, I decided to stop reading, to trust my team of knowledgeable and supportive caregivers, and to choose interactions that nurtured and uplifted me
Five years into healing, when I was in the final stages of editing my memoir, I decided to read through the literature to make sure I was using the most current diagnostic labels for the pain condition. I came upon a description on Wikipedia that postulated that chronic pelvic pain reflected dysfunction of the neuroendocrine system, the part of the body that responds to stress. Upon reading this, my nervous system ramped up, my pelvic-floor muscles tightened, and my bladder hurt. Talk about a self-fulfilling prophesy!
When I arrived for my next physical therapy appointment, I said, “Wow, this condition is really bad! If the part of my nervous system that responds to stress is having problems, then my fear of the condition is actually helping to create it. No wonder this condition is so hard deal with; there is a direct feedback loop between pain and fear.” Iben (my life coach at the time) told me that my experience was common among her clients who had chronic conditions. When people heard medical information or labels about their condition, they often responded with fear, and this fear would create a stress reaction in their bodies, which then exacerbated the condition or maybe even helped to create it.
Studies on pain perception from the neuroscientist Dr. Lorimer Moseley suggest that the level of pain experienced by a person may be directly related to the perceived threat of the stimulus. The brain receives all types of inputs and filters out those that it deems crucial for survival. When an input is considered threatening, we may experience it as pain. This concept made me wonder whether the condition itself can become the threat, especially when it is chronic and symptoms flare up sporadically and unexpectedly. Over the healing years, I let go of many fears and past emotional traumas. Then, I discovered that one of my biggest past traumas and one of my greatest fear triggers was the pain condition itself.
The week after I read through the literature in my fifth healing year, I was sitting in a church and I could feel my bladder was tender. I decided to consciously flow love to this area of my body, and to my surprise the pain stopped. I was pain-free the entire day.
The next day, I was sitting in the passenger seat while my husband drove us to a show, and my bladder started hurting again. During the hour-long drive, I placed my hands over my lower abdomen and breathed deeply, gazing at all the trees on the side of the freeway, which at the time seemed oddly connected to me and comforting. Again, my bladder pain subsided and it did not return for days. After about a week of these calming activities, I returned to a pain-free state again.
At this point in my healing, I decided that if/when the painful condition made another appearance, I would try to limit my fearful reaction. I would consciously calm my mind and treat myself with love and compassion. From this time forward, whenever the pain ramped up, I practiced changing my mindset from fear to love, and eventually the practice helped my body-mind settle down.
About seven years into healing, I began working with clients with chronic pain and found that helping them move out of the fear state was a key way to calm their nervous systems and decrease their perception of pain. Working gently and non-invasively, being sensitive to body responses, and giving the client the power to control the session all helped to alleviate fear. I suspect that these actions are often more crucial in the effort to decrease pain than the physical treatments I provide.
Ten years into healing, my old symptoms surfaced at a low level on rare occasions. But when this happened, I no longer spun in fear. It was also possible to talk with people in pain and to read the literature about pain without having my fear, anxiety, or pain surface. The energy of that fearful state seemed to no longer resonate with my internal state, and so it moved quickly through or past me. I had lived in a fearful state for much of my life, and the pain condition seemed to be the physical representation of fear. In addition, the pain had been a traumatic experience in its own right. If I can experience physical pain without hopping into a fearful state, it should give others hope that it is possible for them, too.