Living with long term-pain, especially after years of medical appointments, tests and the endless searching for answers, it’s natural to develop habits of thinking and reacting that feel as if they’re ‘fixed’. Even when you begin learning about neuroplastic symptoms or discover Dr. John Sarno’s work on Tension Myoneural Syndrome (TMS) and finally see a way forward, something inside can still feel stuck. The term for that gridlocked feeling is mental rigidity.
Mental rigidity is the habitual, inflexible adherence to certain cognitive, emotional or behavioural patterns. This isn’t a personality flaw or what people sometimes refer to as stubbornness; it’s the brain’s protective response shaped by threat physiology, and it can silently keep chronic pain alive. It’s the mind’s resistance to change, even when you know that change would be helpful, and can show up in various ways such as repeating the same thoughts. A frequent repetitive thought for people with chronic pain is that there must be something structurally wrong. Mental rigidity makes it difficult to imagine alternative explanations for symptoms.
We often hear about worst-case scenarios, so it’s understandable that there can be a tendency to cling to fear-based interpretations. This extends to familiar emotional patterns, even painful ones. It takes courage to embrace a new perspective and consider new behaviours, because they may feel unsafe. It’s easier to stay with what is familiar. And as this rigidity is often unconscious, it feels like the only possible way to think.
Mental rigidity and chronic pain
Chronic pain sensitises the nervous system. Over time the brain becomes highly skilled at predicting danger, even when no danger is present. This is what Sarno describes when he says that the brain uses pain as a distraction from perceived emotional threat. From a physiological perspective, ‘threat circuitry’, which involves the amygdala, limbic system and autonomous nervous system, can narrow our thinking. It pushes us into survival mode where flexibility is replaced by a rigid tunnel vision. As a result, the mind keeps returning to the same explanations, worries and habits, in the belief that familiar thinking constitutes safety. As Albert Einstein is supposed to have said, insanity is doing the same thing repeatedly and expecting different results. In other words, by changing nothing, nothing changes.
As we all know, an endless succession of medical specialists who can’t find anything wrong can exacerbate felt pain or anxiety. In neuroplastic pain terms, this very rigidity can reinforce the pain loop. The brain continues to expect pain, so it continues to produce it.
Mental rigidity strengthens the neural pathways associated with fear and pain, preventing new, safer interpretations from taking hold. It can limit your ability to experiment with movement or with daily activities, turning uncertainty into threat and maintaining hypervigilance. This is why many people learning about neuroplastic symptoms may initially struggle, although they understand the concept perfectly well intellectually. Emotionally and physiologically, the old patterns can still dominate.
From mental rigidity to flexibility
Safety is the key. You need to gently create conditions where you feel safe enough to think flexibly. Forcing any demands on yourself is unhelpful. It’s good to begin small. Think of cognitive flexibility as a new skill that you can acquire in lots of different ways. Perhaps try taking a new route, switching a routine or experimenting with small behaviours. Teaching the brain that change is safe helps it apply that to pain-related beliefs.
At the same time, practise becoming curious. Instead of saying ‘This pain means damage’ or ‘I am consumed with anxiety’, try asking yourself ‘What else might this mean?’ Curiosity widens the mind, opens up new options and creates flexibility. Naturally, the habitual fear-based thoughts will at first continue to pop up but you can notice them without responding. You don’t need to suppress them; just recognise them as part of the threat response. It’s normal for the mind to resist new explanations at first but with time, consistency and compassion, the brain learns that flexibility is safe.
When I start work with a new patient we make a plan that doesn’t seem over-challenging or insurmountable. For example, someone with persistent pain may not have been able to walk outside for a long time. We might agree on a promise to open the back door every day and step outside for a minute or two, progressing gradually to five minutes. After a week or so this might lead to a gentle stroll around the garden or doing a bit of weeding. Gradually, a walk beyond home can be considered and slowly, by small increments, the distance is increased. This pattern can be applied to anything you’d like to try again. What it requires is patience and a feeling of safety.
You can also begin some calming practices that ease the nervous system into parasympathetic mode. Attend to your breathing; meditate; try flowing movement; laughter; social connection: any of these calming activities and many more will help to reduce threat physiology and create the space for more flexible thinking. By taking small actions aligned with safety, you can gently resume activities you’ve been avoiding. One of the most effective ways of disrupting rigid patterns is by giving your brain direct evidence that the danger it predicts isn’t real.