3 Examples of Conditioned Pain Responses
3 Examples
Here are three examples of how responses relating to pain can become conditioned. The effects of this can arise before, during or after a situation.
These responses are designed to warn you from what is being recognised by your brain and your body at that moment. It may be picking up cues that you haven’t even seen, acknowledged or noticed, and when the brain and body let you know, it can come as a real shock as it hits your conscious reality.
Knowing that the sensations just need your acknowledgement, interpretation, and understanding can be enough to turn them down or off if they aren’t required in such intensity to continue what you are doing.
Example 1 - Morning Pain
A common phenomenon that patients describe is waking up with pain, but it isn’t always as consistent as they think.
Occasionally there are mornings where the pain isn’t as bad as other days. Now there is a prediction the brain and body make on what level of warning is required for the activities that may occur. The brain loves to predict how you will feel when you are doing the thing on which you are placing your focus. It is just like pre-match nerves.
If for so many times, your body has known that your routine is to get up and push yourself so hard to do A, B and C for X, Y and Z, then it practically knows how you will feel with that pattern of behaviour.
So even though you may not be conscious that you are triggering these mechanisms, your anticipation of going to someplace to do something or see someone can dictate how much pain you will experience on getting out of bed.
And this is based on what your brain and body have experienced in those situations previously.
If it perceives those situations as stressful in terms of load on you as an organism, it gives warnings to create a sense of unease, not to do them again. However, if all of those warnings have been ignored, pain is there as a last chance saloon to stop the behaviour from repeated.
So if some days that someone wakes and the pain is less, there’s a good chance the brain and body of that person have recognised that what the person is focusing on is less or a threat to the things they focus on, on the days when they wake with pain.
Sometimes, the pain can come on the most leisurely days, and in this instance, it doesn’t represent when lies ahead, but what the person was doing the day or night before and was not aware of how that behaviour was overloading their system.
Example 2 - The Broken Stick
In this scenario, I’ll describe how my son experienced the feeling of his stomach dropping and the sensation of nausea as he recognised a situation that reminded him of something painful.
A few months ago, he broke both bones in his forearm whilst playing football. He described hearing a crack and the time as he fell onto his outstretched arm and saw the apparent deformity that came with the break.
Fortunately, he recovered well and is back playing football. A few weeks ago, he was at school and saw a friend fall onto his arm and heard the same ‘cracking’ sound associated with the broken arm. He felt his stomach ‘drop’ and soon after followed the sensation of nausea, as he expected to see the deformed arm of his friend.
Surprisingly his friend got up off the floor and left behind a broken stick. It was the stick breaking and not his arm which had created the ‘crack’. That sound, along with the other contextual cues, was enough for my son’s brain and body to go into the physiological response associated with what it thought had happened and not what had happened.
As soon as my son realised the truth of the situation, he could understand how his brain and body had fooled him. The sensations in his stomach and nausea quickly subsided, and the whole experience now gives his brain and body an alternate possibility to someone falling on their arm.
Example 3 - The Work Boots
A patient had the issue of foot pain after putting on his work boots for five minutes. He’d had this issue for eight months and couldn’t understand why the pain came with such a stimulus. He had got into the habit of tightening up his laces so much that it distracted him from the discomfort enough so he could get on with his twelve-hour shift.
However, once the next shift came, he had to go through the same routine, and he became increasingly frustrated with the ongoing pain and fearful that he was damaging himself more.
Interestingly when he put on any other boots, shoes or trainers, it wouldn’t bring on the pain. It baffled him.
Once I explained the context of the boots and what they represented, it made complete sense to him. He had not had a day off for eight months. He continued working in a very stressful emergency service role despite many other signals that suggested it was too much for him.
As the body recognises the potential for overload and the pattern of activity potentially causing it has started or is about to start, the warnings to prevent or stop that behaviour come thick and fast. Its the responsibility of the person experiencing those warnings to understand them correctly and act appropriately to make the body feel safe in a situation where it doesn’t.
Blocking or distracting those sensations never lasts, and when the adrenaline that comes through blocking or distracting has gone, the warning will appear on the presentation of the next cue when it appears. He was able to completely relieve the pain once he saw it for what it was. His pain was a sign of protection and not proof of any damage.
Each of these conditioned responses provided clues to suggest how the brain and body are offering sensations and pain as protective responses to what may happen, what is happening what looks like is going to happen.
Once we assess those feelings correctly and understand the communication from our unconscious system, we can act appropriately and decide not to go ahead and do the behaviour, carry on with it but understand how we feel doing that, and get through it without being overly concerned knowing that it doesn’t represent damage.
Whatever we choose, there has to be a period of calming that nervous system through how we think, breathe, move and what emotions come with all those things.
These mechanisms are triggered by doing things we love, being in places we love or spending time with people love. Understanding the physiological mechanisms that create these experiences makes them easier to process, but it’s essential to make sure we healthily process them. Only then can we calm those responses from recurring with the same intensity next time.
Do you have a response like this linked to persistent pain?
If you have persistent pain, then it didn’t become that without them.
If you recognise that, and you want to change them, then change is possible.
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