Pain Psychology: Is it really all in your head?

Chronic pain negatively conditions the mind and body but this is reversible!

Posted Aug 22, 2014

© beawolf - Adobe Stock
Source: © beawolf - Adobe Stock

If you have chronic pain, you may have heard the pejorative statement that “it’s all in your head.” On the contrary, nothing could be further from the truth. Your pain is real. However, on a very technical level, all pain is in the human head because this is where pain is processed. No matter where you may feel pain in your body, your brain processes your pain. Your brain also processes your emotions, and the metaphor I use is that certain emotions and pain "share real estate" in your brain. It is therefore unsurprising that psychology is so important when it comes to managing pain. Pain psychology is a pathway for you to learn information and skills so you may best control the factors that worsen pain. In doing so, you lessen your own suffering and gain control.

A key pain psychology skill is learning how to change your pain responses. The human body and brain is hardwired to respond to pain in a specific way— increased heart rate, increased respiratory rate, tight muscles, agitated thoughts, and vasoconstriction. These 5 elements make up the pain response. The same 5 elements make up the stress response. Indeed the pain and the stress response are the same, so it’s no wonder that many people observe that stress makes their pain worse! It would be wonderful if the automatic way the human body responds to pain actually helped your pain, but unfortunately, it’s the opposite: pain responses serve to worsen chronic pain. Living with chronic pain for months and years leads to negative conditioning in the brain and the body --toward pain and distress—that’s the bad news. The GOOD NEWS is that you can recondition mind and body away from that negative conditioning and toward a healthier state – one that leads to greater comfort, less distress, and less need for pain medication.

I am excited to be speaking on this topic at the Stanford – Western Pain Society – American Academy of Pain Medicine conference taking place at Stanford University on September 19-21. Details and registration here.

Hope to see you there!

In Health & Wellness,


About the Author

Beth Darnall, Ph.D., is the author of Less Pain, Fewer Pills…. She is a pain psychologist, pain researcher, and clinical associate professor at Stanford University.

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