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Pain: Sending The Right Signals

Our bodies and brains are complex, and each of us is impacted by pain in our own unique way. However, we ALL experience pain at two (actually, more, but let’s say two for purposes of clarity here :-)) distinct levels: sensory and affective. Our sensory perception of pain includes things like where the pain is, what it’s quality is (burning, stabbing etc.), and how severe is it (on a typical 0-10 scale for example). That last part, though, is also impacted by the 2nd level, the affective experience of pain. This part of our pain perception, often processed by our limbic system, takes many cues from our environment and our emotional selves. This part of our brain, for example, is more primed for pain if we experience a lot of stress, depression, or fear in our lives. In effect, this is the part of our pain response that controls how much we suffer beyond just knowing that it exists. Interestingly, this part of the brain can also be harnessed in a positive way: once we understand what the signals are that activate these areas, we can turn them “on” or “off”. What are some of the most important areas that impact our “affective” pain response? (If these sound like a vocab lesson you’d rather avoid, don’t worry about the name of the brain area - instead, focus on the language that the area speaks): 1. Anterior Cingulate Cortex - this part controls our suffering from pain and the need to “do something” when we feel it. It’s also the part that is disengaged when we give away our healing capacity to our doctors. What helps? Calm acceptance of the sensation as a signal from the body that need not go away 100% to have quality of life. 2. Anterior Insula - this is like our internal thermostat, guiding us to understand if damage is occurring. What helps? Remembering that we’re “whole” and safe in spite of our pain, and that it isn’t a guarantee that damage is occurring. 3. Prefrontal Cortex - this part gives meaning to our pain and integrates it into our self-concept: “who will I be in the future with this pain?” What helps? Reframing the experience to understand that the experience of pain now does not reliably predict future pain.

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