Thinking Psychological About Chronic Pain: what it means and how to do it

TMS. MindBody Pain. Psychosomatic Symptoms - they really mean one and the same thing: that the origin of pain could be due to a psychological issue, and not a physical one. When this is the case (and it is the case with thousands of chronic pain cases globally), then it would make sense to set off in search of the psychological root to pain, especially if the symptoms have become chronic.

If you’re at all familiar with Dr John Sarno’s 12 Daily Reminders for people with chronic back pain, then you would know that Sarno insists on ‘thinking psychological’ about symptoms.

But what does this mean? And how can you apply it to your situation? This is what I’ll attempt to explain in this post.

When should we start thinking psychological about chronic pain?

First of all, it’s good to keep in mind that we need to rule out serious medical conditions before we address our pain as a mindbody issue.

This does not mean that we give up just because our doctor sees a sign of degeneration or some sort of abnormality in our body. These so-called ‘degenerative’ issues may not be to blame for your pain at all - and there are ways to arrive at this conclusion either by yourself or with the help of a professional.

So ruling out a medical condition actually means ruling out the presence of a recent injury, tumours, infection or other conditions that do not ‘qualify’ as mindbody or neuroplastic symptoms, and that may require urgent medical treatment.

If you’ve been having ‘treatment’ for chronic pain with no success (visiting a PT or chiropractor for over 3 months with only short-lived relief is one such example), then this may be one clue that you need to address your symptoms as a mindbody problem.

For this reason, we normally consider it as safer to start addressing symptoms from a psychological standpoint when these have persisted for over 4 months and/or when doctors cannot find any explanation for what’s causing the pain.

That said, do be wary of ‘theories’ related to past injuries, wear-and-tear or ‘defects’ in your body - these very often are wrongly blamed for causing chronic pain, and the sooner you believe that, the quicker you get back on track to recovery.

And now, let’s get on with how to think psychological for chronic (TMS) pain.

What does it really mean to ‘think psychological’?

Thinking psychological means digging up all sorts of emotional reasons for why you may be in pain. Some of these reasons may not be the direct cause of your pain on their own, but may have caused the tension and stress to accumulate in your body to a point that you started to experience physical consequences.

In short, when you think psychological, you should not be thinking about any possible physical or structural reason behind your pain.

Instead, the idea is to turn your focus to what is happening on an emotional level. What sort of stressors are you going through? What was happening in your life shortly before or when the symptoms started? These are some of the questions you need to start asking yourself.

The results of looking into the psychological roots of pain can vary, but with mindbody pain it could mean the difference between remaining stuck with chronic symptoms and healing completely. That’s because once we allow some of the repressed tension and negativity to surface and as we process these emotions, our body and nervous system are more likely to relax.

How to think psychological to uncover the root cause of psychosomatic pain

Let’s say you’re having a really bad flare-up today. If you were to think psychological, you would ask yourself what happened on an emotional level that could have led to this flare-up. You would think back to the conversations you had prior to the flare-up, or to any news that came up and that may have upset or bothered you.

Sometimes the answer is obvious: you might have received some really bad news or had a very triggering argument with someone. But sometimes the reasons are less obvious, because you may be repressing certain emotions.

Repressed emotions are the biggest fuel for mindbody pain - you’ll be well aware of this if you’ve read Dr Sarno’s books. That’s because we cannot ‘vent’ or address these emotions in any way if they’re buried deep in the unconscious. Instead, they are left to accumulate, until it gets too much - and as a result, we get a flare-up or the onset of mindbody pain.

But luckily, there are ways of bringing some of these emotions to the surface. The first step is always to start asking yourself questions, and to be open to the idea that something may be bothering you more than you thought. I suggest you follow the below steps to get started with thinking psychological:

1. Write down a list of ALL the things that bother you, including those issues that you think are only ‘minor annoyances’.

2. Journal freely about how each issue makes you feel (even though you feel like you’re being childish and complaining too much). You’ll find more in-depth guidance about journaling in my Online Recovery Program.

3. Ask yourself what you may be in denial about. Are you trying to paint a pretty picture of your marriage, parenthood, career or lifestyle, when in reality, there’s something that you really don’t like about one of these aspects?

4. Be brave - it’s ok to feel that your marriage, career or the lifestyle that you’ve worked hard to build may not be perfect (I know, it’s hard to admit this to yourself sometimes, but stay with me and be brave!). It’s ok to feel like you’ve lost control or that you’ve made a mistake. The important thing is that you start acknowledging these feelings.

5. Don’t worry about having to change things to create the perfect life. This isn’t possible. Instead, repeat the journaling or self-awareness exercise often so that you don’t allow strong negative emotions to stay totally repressed. With time, you’ll know what to do to change some things for the better.

What if I’m not sure that my symptoms are psychosomatic?

Even if you doubt whether all your symptoms are due to a mindbody problem, you can still benefit from thinking psychological to get to the root of any troubling emotional issue that may be lurking in the background.

You could do this in addition to the physically-focused treatments you’re taking and explore whether your reflections reveal anything else that’s adding fear and worry in your life. As you probably already know, negative emotions like fear and worry make all sorts of symptoms worse, even symptoms that are purely ‘physical’.

In addition, research in other areas is showing that other diseases and conditions besides unexplained chronic pain also have an emotional element (for instance, one such research has shown that depression is worse for cardiovascular disease than smoking [see source]).

So the bottom line is - never ever ignore your emotional wellbeing. Get into the habit of thinking psychological anyway!

Watch my video for more guidance

If you are still unsure how to embark on the psychological work for your chronic symptoms, I suggest that you start with my video below. In it, I go into a little bit more detail to explain this important aspect of healing. Enjoy and feel free to check out my programs if you’re interested in taking this work seriously.