Many of you reading this lived with chronic pain for several years, seeing countless health practitioners and specialists in order to try and discover what was wrong. Sometimes you’d get small insights from these health professionals that helped, and at other times you’d find yourself in more pain.
The nature of neuroplastic pain means that it can be increased by the distress of not knowing what’s wrong. Eventually people reach a point where, instead of just focusing on the source of physical pain, they begin exploring a mind/body approach. When someone comes to me for help, I encourage them to read as much as they can before their initial consultation, including the work of Dr John Sarno. It’s important to familiarise themselves with this approach as it’s so different from what they may have previously understood about the root of their pain.
Early in the process of understanding how neuroplastic pain works, I suggest that it’s a good idea not to think about the pain. The reason for this is that thinking about it gives the pain space in your brain and exacerbates it. What we want to do is reduce the pain and not increase it. In practice, this means desisting from scanning your body for pain from the minute you wake up. This is hard, as I’m asking you to break a habit formed over the time you’ve been experiencing chronic pain in order to disrupt a well-worn neural pathway. And as we all know, habits, once formed, can be difficult to break. This situation is exacerbated by something called the ‘ironic effect’.
The ironic effect, also known as paradoxical thought suppression, is a phenomenon described by the social psychologist Daniel Wegner in his famous ‘white bear’ experiment. (You may also have heard of this as the ‘pink elephant’ concept). In this experiment participants were told not to think about a white bear. The result? They thought about the white bear even more. The very act of trying to suppress a thought makes the mind constantly monitor itself. Ironically, that monitoring brings the thought right back into focus. In short, the harder we consciously try not to think about something, the more attention we give it.
The ironic effect and chronic pain
When someone first learns that their pain may have a neuroplastic basis, there’s often a natural temptation to ‘think the pain away’ or to avoid giving it attention altogether. You may have caught yourself saying things like: Don’t think about the pain. Ignore it and it will disappear. Stop noticing it, it’s just the brain being difficult. The brain, though, doesn’t respond well to suppression. Just as with the white bear, the effort to avoid thinking about pain creates a mental spotlight that shines directly on it. The result is that the pain feels louder, more intrusive and more frequent.
This isn’t a sign of failure, but a predictable feature of how human attention works. In moving forward, the goal isn’t to suppress pain-related thoughts, but to change your relationship with them. You can allow thoughts without engaging with them: if a pain-related thought arises, simply acknowledge it and then continue with whatever you were doing.
Redirect your attention gently, not forcefully. Attention is like a well-trained dog; it responds better to calm guidance than to shouting. Instead of telling yourself ‘Stop thinking about this pain right now!’ you could try ‘I’m choosing to put my attention on …’ (something meaningful).
Live your life while the thoughts come and go. Recovery from neuroplastic pain often comes not from controlling thoughts, but from demonstrating safety to the nervous system. This can be achieved through a return to normal living, movement, enjoyment, connection and purpose.
One of the most successful ways of creating somatic (body) safety is developing the habit of doing three roll-downs first thing in the morning. As you get out of bed, take a moment to breathe in while lifting your breastbone. Check your feet are planted on the floor hip-width apart. On the out breath, nod your head and roll down as far as is comfortable. Breathe in. Breathe out, replacing the vertebrae one bone at a time as you return to the upright position. Repeat twice more. Focusing on your breath and the movement of your spine will remind you that the spine is a robust piece of kit. It likes moving and weight-bearing. An early reminder every day that your body likes moving, and is safe to move, shifts your focus onto what you can do, rather than stimulating your pain signals.
Understanding the ironic effect helps remove a layer of frustration. You’re not thinking about your pain because you’re doing something wrong, you’re thinking about it because you’re human. Once you stop battling your thoughts, you can create the conditions for the brain to settle, heal and rewire.