Trauma and Chronic Pain (Part I)

Is there a link between trauma and chronic pain?

If you suffer from prolonged neck, shoulder, back pain, migraines and/or tension headaches, TMJ, bothersome gastrointestinal conditions such as acid reflux, ulcers or irritable bowel, have a diagnosis of fibromyalgia, eczema or psoriasis, Do Not Rush to make another appointment with a physician. The connection between trauma and chronic pain may be the underlying foundation.

Sounds paradoxical? Who would be better equipped with knowledge and skills to treat physical ailments if not a medical doctor, you ask? Think psychological, emotional, trauma or mental health, not physical! Physical pain and symptoms are the language of the body and the body is trying to communicate with you, potentially signaling emotional distress. Shifting focus from the physical aspect to your emotional states may be the first step to feeling healthier!  

There is an epidemic of chronic diseases in the United States. More than 1 in 5 adults experiences chronic pain according to 2020 research data, with neck, back, hip, foot pain locations among most commonly mentioned. Add to that 16% of the adult population who suffer from migraines and intense headaches which, it’s worth noting, are one of the most common reasons for an emergency department visits.

Fibromyalgia is another widespread chronic pain condition. The disorder affects an estimated 10 million people in the U.S. with 75-90% prevalence among women! Typically because women are raised to be ‘nicer’ and tend to internalize emotions more. Furthermore, chronic gastrointestinal (GI) illnesses negatively impact the lives of more than 70 million of Americans yearly. The numbers, alarmingly, have not shown any improvement over the years despite trillions being spent on various treatments, procedures, and pharmaceuticals. It seems doctors haven’t got a clue how to treat these common chronic pain conditions. Maybe they just don’t have the right diagnosis or not looking in the right place.. 

My interest in somatic manifestations of psychological processes and desire to advance my understanding of the link between trauma and chronic pain causation and available treatments are not incidental. A generally healthy adult in my 30’s, I was one of those tens of millions of people hurting (needlessly), going from one doctor to the next, doing multiple tests, and frustrated with the absence of clear diagnosis. My body produced a number of physical symptoms such as excruciating neck pain, low back pain, brain fog and pressure, blurred vision, headaches, muscle tension and pain, skin sensitivity and stomach problems. The symptoms appeared “out of the blue”, waxed and waned in intensity, confused doctors with the absence of clear physical abnormalities that could have explained them, and made my life pretty miserable. I tried both conventional and unconventional treatments (yeap, psychic healers too) with no results. Like most people dealing with chronic unexplained pains and other disorders mentioned in this blog, I felt increasingly hopeless, desperate and was willing to try anything to feel better. Even accept the diagnosis “it’s all in your head”!

“There’s nothing like a little physical pain to keep your mind off your emotional problems” – Dr. John E. Sarno
Trauma and Chronic Pain: The Mind Body Connection 

The connection between our mental health and our physical pain is vast!  There are many illnesses that have been identified as Mind Body or having a psychosomatic component. In addition to most common neck/shoulder/back pains, most gastrointestinal problems, frequent/painful urination, facial pain and TMJ, chronic tendonitis, chronic fatigue syndrome, autoimmune disorders and skin conditions have been associated with psychosomatization.

What comes to mind when you hear the words psychosomatic disorder? Most people mistakenly think of it as some imaginary disease of confused or selfish people. Even medical doctors often wrongly assume it refers to stress making disease worse or stressful consequences of having a disease. Moreover, the connection between emotional trauma and chronic pain is not understood (and pretty much ignored) even by psychologists or psychiatrists. So, millions of people who suffer from the disorder – a disorder which not accepted, studied or effectively treated – are not able to get help.

Psychosomatic medicine deals with disorders that APPEAR to be purely physical but which may be rooted in deep-seated emotions we are unaware of. Yes, the concept is fairly simple.

  1.  The mind-brain has great power over the body
  2. Human physiology is intimately connected to emotions and feelings.

We experience that connection daily. Blushing when embarrassed or ashamed, perspiring when nervous or stressed, feeling butterflies in the stomach when excited are some examples of physical reactions generated by emotions. These sensations are benign, automatic and usually disappear as soon as trigger situations pass. But what happens to the body when more intense, deep-seated, painful negative feelings “store up” in our system? What if the feelings are too embarrassing or too dangerous to process consciously so they need to be repressed and buried in the unconscious brain? What happens to squashed, stuffed, buried, ignored or repressed emotions?

Dr. Sarno – Professor of Rehabilitation Medicine, the Director of NYU Rusk Institute of Rehabilitation and a pioneer in the field of Mind Body ailments  – posited that the mind, powerful enough to make decisions we are unaware of, acts as a protector. Its goal is to “hide” unconscious emotional pain, rage, profound sadness, shame, guilt, etc. and save our rational, thinking part of the brain from experiencing those devastating emotions. The brain is capable of creating physical ailments in order to distract and divert the attention from the unconscious. Mind Body Syndrome (MBS) is a condition in which the brain is the root cause of physical illness; real physical symptoms are engendered by internal conflict and are not due to structural abnormalities or explained by test results.  

Read my next blog for more information on mental health and physical pain and:
  • Ways to tell you may have MBS
  • Diagnostic criteria for MBS
  • How internalizing stress and emotions can lead to chronic pain 
  • Personality traits contributing to the development of MBS
  • Past trauma and current life stressors as related to MBS 
  • MBS treatment approaches
  • Psychotherapy for MBS

 

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