Chronic pain (pain that lasts 3 months or longer) is common, with NHS statistics showing that one third of adults suffer from it, rising to over half in people in their late 70s and beyond.
A lot of people think medication is the only cure for pain. However, there is a point where medication has reached its limits, and something else needs to take over. This is when the brain needs rewiring in order to understand that the original damage has healed, and its safe to stop sending pain signals. The tissue damage is gone, but the brain has got stuck in a loop, where its continuing to manufacture pain as a method of protecting you from further damage.
Pain medication is essential and highly effective for acute pain. This is short term pain caused by surgery, or an accident. It is also crucial for end of life pain caused by progressive illness.
But long term use of medication for chronic pain, or pain with no organic cause, can cause many issues.
Use of painkillers
Long term use of opiodes, like Morphine and Codine, can worsen pain. The opiode receptors in the brain become desensitised, therefore the medication has little or no pain relieving effects. This can mean users up their usage in an attempt to control the pain, increasing dependancy.
You will never deal with someone’s chronic pain unless you deal with their psychological wellbeing alongside it.
The NHS are finally catching up to this, with new guidance stating that you will never deal with someones chronic pain unless you deal with their psychological wellbeing alongside it. Conditions such as Fibromyalgia – where there is no clear organic cause for pain, but the pain is very real, and life limiting, need to be tackled differently to acute pain e.g from a broken bone.
Fellow Solution Focused Hypnotherapist, Claire, had spent many years working as a Pharmacist. She decided to train as a Solution Focused Hypnotherapist as she was meeting so many patients in the Pharmacy, who could not find a way to end their chronic pain. She saw a very real gap where medications effectiveness ended, and nothing else took over. After learning more about how pain signals can continue to be sent by the brain, long after tussue damage had healed, Claire realised the power of supporting people to rewire their brain out of the pain loop. As her Hypnotherapy work with pain clients increased, she saw positive result, after positive result. Clients who had been in pain for years, but doctors could find no physical reason for it.
This situation is incredibly frustrating for the sufferer, as they are the only person who can measure the degree of pain they are in. A Doctor has no way of understanding the level of pain you are feeling, and this can lead to sufferers being made to feel like they are over-reacting, making the pain up, or that it is all in their head. Which in the kindest possible way, it is. When I say this I don’t mean the pain isn’t real, or felt strongly by the patient, but that the brain is creating it. Pain is created by the brain as a protector – a safety response to keep you out of any further danger.
For those in Chronic pain, your brain has been receiving a message for a long time from a part of your body, that at some point, maybe in the distant past, was damaged. Your brain has got used to sending pain signals to this area, and has realised that by doing so it has kept you alive. However, because it’s been going on so long, somebody needs to tell the brain that it’s safe to stop sending the messages. This is what we call a ‘pain loop‘
A ‘pain loop’ is when the brain is running these pain messages in the background, with no stimulation needed. Claire compares this to our ears ringing, long after we leave a loud music concert. The stimulus has gone, but the sensation remains. The brain has created a little program that is running separately, all on its own, doing that one job. Pain killers can only help when there is actual physical damage in the body, they can’t help with these pain loops.
Pain Loops
This was the case for a lovely client who came to see me with Functional Abdominal pain – persistent stomach discomfort that occurs without any physical cause. This pain was causing her to isolate herself as she didn’t have the energy to socialise. Her life had become reduced as her confidence had suffered, she had stopped exercising – something she used to enjoy, and her mood was low. Over the first few weeks of getting to know this client she told me that when she was young she associated being ill with being safe, and having a reason to rest., as it meant she could stay at home. I found this really interesting, and mentioned to her that it sounded like her brain had learnt to provide her with pain when she was stressed, in order to keep her safe.
This helped her start to make the connection with pain as a protective response, and the importance of gently pushing out of her comfort zone, so that her brain could learn that movement and socialising were perfectly safe, and the pain was no longer required. After a few more sessions she began dressing more confidently. She began getting out walking and socialising regularly, and she became motivated and upbeat. She began to notice warning signs anytime the pain was returning, noticing the stresses that were causing it. She began to view the pain as a warning sign that her stress bucket was too full, and a sign to take more time for self care, rather than a reason to withdraw and stop doing activities she enjoyed. None of this happened by accident, it happened because she was following the Solution Focused Hypnotherapy framework to take positive action towards creating a sense of safety for her brain. She had changed the relationship with her pain.
So why is Solution Focused Hypnotherapy so effective in tackling Chronic pain?
In short, we help people take control of the factors in their lives which are making the pain worse.
We reassure people that they are not broken, or going mad, they just need a framework to enable them to retrain their brain.
We provide people with science based tools to proactively reduce stress. Stress makes pain worse because it causes the brain to enhance pain signals. This happens because stress makes the brain feel we are in more danger, and as pain is a protector it means the brain produces more pain signals to keep us away from danger. The higher the stress, the higher the Cortisol levels are in our body, and Cortisol irritates nerve fibres, causing us to feel more pain.
Science Based Tools
One of the science based tools we use to help clients, is trance (deep relaxation). When a client deeply relaxes, several things happen to create pain relief. Firstly, cortisol levels come down, reducing that irritation on the nerve fibres. Secondly, our brain relaxes and moves away from the Primitive fight/flight part. This creates that all important sense of safety, and sends that message that pain is no longer needed. Trance also allows the muscles to deeply relax, releasing any muscular aches or trapped nerves that could be adding to your pain levels. One client experienced the disappearance of a 12 year old hip pain, during his first session of trance. This was an incredibly positive experience for him, as it showed him that there are times when the pain isn’t there, and this gave him hope for the future.
It also gave his brain some data, on when the pain doesn’t occur. This is another way we help clients navigate a route out of pain. We get them to focus on times when the pain is less, or absent, and ask them to get specific about what is happening at that point. This enables the client to plan actions to build more of these things in to their lives, meaning the client is taking control of the pain. By asking them to break large goals down, into small actions, we enable the client to feel that progress is manageable, and not overwhelming.
Movement
One such behaviour is movement. Movement can become severely reduced with chronic pain. The body has become fearful of moving, and can start to see it as dangerous. Sufferers can start to worry about moving, and worry that the pain will never go away. Because of this, pain during movement may have become severe, as the brain tries to stop you doing anything that could cause further damage. When a chronic pain sufferer starts to use regular, gentle movement again, it helps to safely reassure the brain that movement is safe, and can be repeated. This causes a reduction in pain signals.
Many clients I see with chronic pain have become isolated. Pain has drained their energy, and prevented them from connecting with others. Through the work we do together, they are able to calm their nervous system enough to create capacity to venture out again. Once this connection and movement returns to their lives, they experience so many pain relieving properties. Connecting with others produces serotonin (happy chemical), and Dopamine (reward chemical), both of which interrupt pain signals, and lower cortisol.
This lovely cocktail of feel good chemicals is something we also cultivate in each of our Solution Focused Hypnotherapy sessions. Clients are asked to write down every day between sessions, whats been good/better/ what they’re looking forward to/what they’ve been proud of. This is a science based tool that retrains the brain away from the fight/flight vigilant brain, and back into the helpful intellectual brain, where they feel safe and calm. At the start of each session the clients talks to me about what they’ve written down, and this creates that lovely flow of serotonin and dopamine.
Everything we work on with our clients is about helping them update the info in their brain
So it understands it’s safe to stop sending pain signals. Chronic pain isn’t a sign that something is broken beyond repair, it can simply be the product of a nervous system that has been on high alert for too long. A brain that has learnt over time to stay vigilant, long after the danger has passed.
If you’re suffering from Chronic pain, you’re not broken, or making it up, but it might be time to tackle it in a different way to medication. Our brain is listening to us all the time, and what we are telling it about our pain. Getting support to change this narrative can give you back your life, energy, motivation, and happiness.
