If you’ve experienced chronic pain, you may know how frustrating it feels to get caught in what we call the pain-fear cycle. This cycle can be exhausting, impacting your mental and physical well-being. But by identifying and understanding what your brain interprets as dangerous, we can begin to change your response and ultimately reinforce safety to your nervous system. |
What is the Pain-Fear Cycle?
Your brain can learn to fear almost anything, including emotions. Perhaps you grew up in a home where certain emotions, like anger or sadness, weren’t allowed or expressed. Or maybe you had a caregiver who was always sad or angry, causing you to fear these emotions. Therefore, when you experience these emotions, your brain immediately goes into fight or flight, leading to an increased likelihood that you will interpret threat in your environment even when there is none. You might feel anxious, causing you to scan for potential threats and start interpreting everything, including sensations, through this lens of danger. So, you may even feel pain without any physical damage. Pain reprocessing therapy helps you learn to reinterpret and process these emotions as safe. After all, emotions themselves are not dangerous and never last forever.
The pain-fear cycle is a common pattern in which pain triggers fear, which in turn amplifies pain, keeping you stuck in a loop. When we experience pain, the natural response is to protect ourselves and avoid the movements or activities we fear might worsen our discomfort. While this response can help in the short term, it can unintentionally intensify pain over time by increasing fear and avoidance behaviors.
This cycle can affect every aspect of life, from our ability to work or socialize to our connection to and safety within our own bodies. But, recognizing this pattern can be an empowering first step towards rebuilding a safe and trusting relationship with your body.
How the Cycle Works
Pain Appears: You feel physical discomfort – whether it’s back pain, migraines, or another symptom.
Fear Response: Fear kicks in. You might worry about the impact on your day, dread a pain flare-up, or feel anxious about the future.
Fear Increases Pain: Fear makes the brain more likely to misinterpret safe signals as dangerous, causing more pain.
Avoidance: To cope, you may avoid physical activities or situations that seem to cause or worsen pain. Unfortunately, this reinforces the brain’s association between pain and fear.
More fear leads to more pain, more pain leads to more fear, and the cycle continues.
Over time, this cycle becomes deeply rooted, making it hard to break free.
How Pain Reprocessing Therapy Can Help
The pain-fear cycle is breakable. Pain Reprocessing Therapy (PRT) helps retrain your brain to reinterpret the pain signals it’s receiving, helping to calm the nervous system and disrupt the cycle. Here’s how PRT can make a difference:
Breaking the Link Between Pain and Fear: PRT helps you reframe and reprocess how you experience sensations, reducing the automatic fear response that amplifies pain.
Reducing the Fear Around the Pain: PRT addresses the thoughts, beliefs, and behaviors around your symptoms may be keeping your danger signals activated, and therefore keeping your pain activated. There may be a fear that there is something wrong with your body, which reinforces a physical threat. Or, there may be a fear of the way the pain impacts your life, which reinforces an environmental or social threat.
Addressing Your Relationship to Fear in General: PRT touches on factors outside of your pain, but in your environment, that may put you in a state of fight or flight, to help you regulate your general response to fear.
Research Roundup:
Increased bias to report heat or pain following emotional priming of pain-related fear
A group of researchers sought to determine if fear can change how participants perceive sensations. Study subjects received hot pulses on their skin while looking through a series of photos that were either scary or neutral. Even though the pulses were all the same, the subjects experienced more pain when looking at the scary images. Sometimes, the participants reported pain even when there was no hot pulse, and they were only looking at the frightening images. The fear experienced from viewing the pictures put their brains on high alert and generated pain even when the probe was off. This study proves that being in a state of fear can change the way we perceive signals from our bodies and create pain even in the absence of physical danger.
This study demonstrates how fear can alter our perception of sensations and even create a sense of pain without any input to the body. This highlights the powerful impact of emotions on our physical experiences and the role of fear in the perpetuation of pain.
Kirwilliam, S. S., and S. W. G. Derbyshire. "Increased bias to report heat or pain following emotional priming of pain-related fear." PAIN 137, no. 1 (2008): 60-65.
My Migraine Breakthrough by Lee Canter
Lee Canter’s chronic migraine journey can be summarized by the following grim numbers: 7 years practically bedridden, 10 doctors, 15 medications, 3 hospitalizations, 2 pain psychologists, and 6 alternative medicine treatments. None of these brought him the relief he needed. His life was consumed by the darkness of this debilitating disease. But his resourceful book does not dwell on how sick he was; instead, it focuses on what he learned that enabled him to cure his migraines once and for all. If you find your life consumed with pain and the fear of pain, his story is a must-read.
Upcoming Events
Professional Certification Training New Upcoming Date! January 11–February 7, 2024 Details: A comprehensive, 21-hour training program combining asynchronous videos and live virtual trainings. Learn the neuroscience behind pain, help patients break the pain-fear cycle, and develop a toolkit of research-backed pain elimination strategies. Perks: Join our first training of the new year, earn 12 CEUs, and build your referral network with a certified listing on our Directory of Practitioners.
New Upcoming Date! Wednesdays, January 8–February 26, 2025Details: Join an intimate group of patients and expert PRT facilitators to understand why pain develops and persists, and learn the most effective brain-rewiring techniques to interrupt your pain-fear cycle.Perks: Find support among peers who understand the challenges of chronic pain and take your final step toward recovery.
Dates: Six-week course beginning October 28, 2024. Join us on Wednesday evenings or Friday afternoons. Details: Already completed a Certification Training? Join a small group of PRT providers meeting weekly with an expert facilitator to discuss, share, and receive consultation on complex cases and patient barriers in your caseload. Perks: Gain insight from practitioners across various disciplines, acquire new tools to overcome challenging cases, and earn an Advanced Application designation in our Directory of Practitioners.
Date: November 5, 2024 Details: Already completed a Healing Workshop? Maintain symptom reduction and refresh your toolbox alongside a supportive group of peers. Join us the first Tuesday of each month to reinforce your new habits and behavioral shifts to prevent relapse. Perks: Maintain your highly-deserved recovery by tackling tricky behavioral patterns that can lead back into the cycle of fear and pain. Our next class will focus on self-compassion and shifting self-talk. |
Pain Reprocessing Therapy Center, Wilshire Blvd, Los Angeles, CA |
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