This is the first chapter of the series about Brain Synchronisation
Pain has been described as a distressing sensory or emotional experience, and to consciously feel pain, cognitive processing becomes crucial. Neuroplastic brain adaptations in response to chronic pain result in the modulation of cognitive areas, which influences the experience of pain. Imaging studies suggest a spatiotemporal restructuring of brain activity with respect to chronic pain, in which pain representations are progressively transferred from the sensory to emotional and limbic structures. The transition from acute pain to chronic pain is an example of how the brain systems can shift in order to integrate initial drivers of acute pain, potentially contributing to the complexity of the brain changes manifested by chronic pain.
In either scenario, cumulative effects from repeated attacks that involve the sensory system, either by itself or through an afferent pathway, can trigger changes in the brain leading to a cascade of events presenting as chronic pain. Consistent with the subliminal processing argument, both examples suggest that there is a tipping point leading to the delayed presentation of chronic pain.
Other examples include delayed grief as we age, grief as we experience depression, grief as we experience trauma in our early lives, and so forth. The basic premise is that there is a developmental process in brain changes reaching the threshold for activation of behavioral phenotypes. Subtle, conscious or sub-conscious processes that are underway contribute to a brain condition that defines a chronic pain phenotype, typically associated with an elaborate phenotype involving sensory, emotional, cognitive, endocrine, and other processes. Here, we present the concept that, for many patients, sub-conscious ongoing changes in brain function are important players in the ultimate presentation of chronic pain.
It is now fairly obvious that much chronic pain is a result of a psychologically-induced physiological state -- and in turn, the result of hidden conflicts between our conscious and unconscious minds. Pain activates a number of brain areas, linking sensation, perception, emotions, memory, and movement responses. Chronic or inflammatory pain may sensitize the nervous system (see below under Sensitization) by inducing chemical, functional, or even structural changes, all of which function to prime the pump of pain-processing.
Burning and stinging pain caused by tissue injury enters the CNS through the paleospinothalamic tract (AST) and the archispinothalamic tract, reaching brain stem nuclei and PF-CM complexes, where it is then transferred to deeper pain. Psychic responses to pain involve all well-known responses to pain, such as distress, anxiety, crying, depression, nausea, and excessive muscle excitability throughout the body. When the visceral and the sensory cutaneous impulses come together, information is transmitted to higher centers, and the brain interprets the pain to come from the skin (Figure 7.10).
Because neither the brain nor spinal cord contains any nociceptors, it is likely that the disease process either directly activates the nociceptive pathways, or prevents activation of pain-suppressing pathways. For instance, if someone is given a placebo for pain, the brain changes its pharmacology to make its own painkillers, like endorphins.
I have seen in clinics physical symptoms like pain, above symptoms, improved by the modalities which helped to address the unconscious, unresolved stress. During my time writing this paper, patients suffering with debilitating physical symptoms due to multi-chemical sensitivities, dysmenorrhea, neck or back pain, and migraines, noticed a life-changing improvement due to being open to the possibility that their physical problems could stem from their perceived, unresolved, unconscious traumas of past events. Interesting findings are emerging in clinical trials with subjects who suffer from difficult-to-measure symptoms, like chronic pain, anxiety, fatigue, and depression.
Future studies should be modified to include psychophysiological, psychophysical, pharmacological, and brain imaging techniques for evaluation of cognitive effects in chronic pain. There is also some indication that EMDR may be effective for reducing pain, including postoperative pain, as well as chronic nonspecific back pain accompanied by trauma.
The use of music therapy has been associated with better sleep quality, reduced anxiety for individuals receiving hemodialysis, and reduced pain scores in acute postoperative pain, as well as during endoscopic procedures. Beth Darnall and Shawn McKie, Redlich professors of anesthesiology, perioperative and pain medicine, were recently awarded $4 million by the National Institutes of Health to investigate a similar intervention for patients suffering with chronic back pain. The randomized controlled pilot study is comparing mindfulness meditation, cognitive therapy, and a cognitive treatment that relies on mindfulness to treat chronic low back pain. Mindfulness meditation and mindfulness-based cognitive therapy show therapeutic benefits and increased responsiveness to opioid-based treatments for patients with chronic low back pain (Zgierska et al., 2016; Day et al., 2019, 2020).
Mindfulness-based practices are focused on changing the catastrophization of pain, an important component in nonpharmacologic treatments of chronic pain. Cognitive-behavioral therapies refer to psychological therapies used to reduce the perception of pain. Pain catastrophization as a treatment process variable in cognitive behavior therapy of adults with chronic pain. Long-term effects of oral sustained-release morphine on neuropsychological functioning of patients with chronic noncancer pain.
If you are feeling the sting of pain, quietly tell your brain you know what is going on--you might even be telling it to boost blood flow to your pain site.
More recently, researchers have been looking into theories about the subconscious belief system, as it seems what your conscious mind believes about a placebo, or about pain, for that matter, does not really matter.