Changing How Your Brain Perceives Pain

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When living with chronic pain, over time, the brain becomes hypersensitive to pain signals, which increases pain. Pain is a danger signal. When something happens, such as touching a hot surface or twisting your ankle, nerve endings in the body send a signal to your brain, and the brain interprets this signal as pain. In this way, all pain is regulated by the brain.

Danger signals are a good thing. They keep us safe, particularly if there is an acute event, like falling and breaking an arm. However, the brain isn’t always accurate, and at times, it can interpret a neutral or safe signal as threatening, and therefore painful, even when there is no threat or danger present. The pain you feel is very real, but the danger may not be.

Pain is not always the result of structural damage in the body; rather, it is the result of a misfiring pain alarm. With chronic pain, the brain often creates a false alarm. It is telling you, “Danger!” when you are actually safe. You can recalibrate this alarm to be more accurate by changing how you relate and respond to pain.

It is natural to think of unpleasant and uncomfortable sensations as dangerous and threatening. To worry not just about the pain sensation itself, but also about how the sensation may impact your day. Is the pain going to lead to you not being able to attend an important meeting, or will you have to miss out on a social event you are looking forward to? In this way, pain is threatening not solely based on the sensation, but also the impact of the sensation on your daily life.

A perceived threat leads to fear, and fear puts your brain on alert. When we are on high alert, sensations or signals that were once neutral are now perceived as threatening.

And the more threat or danger your brain perceives, the more pain signals it will send. This can create a vicious fear-pain cycle that keeps pain going.

Learning to reprocess pain by thinking of it simply as a sensation, and operating from a place of safety rather than threat, can decrease the negative impact of pain. Here are some ways you can start to turn down the volume on your high-alert brain and decrease a sense of fear and threat:

• Nonjudgmentally notice how fear or a sense of threat related to pain arises throughout your day. Are you constantly on guard and bracing for pain?
• Remind yourself that your brain is trying to help you, and it is likely misfiring and telling you there is a threat and danger when there isn’t one. This may look like genuinely saying to yourself, “Thanks, brain. I know you are trying to keep me safe, and I am OK. There is no threat here right now.”
• Nonjudgmentally notice the ways you may be activating your nervous system, fueling a sense of being on high alert. For example, are you trying to problem-solve and fix any indication of pain, are you constantly trying to push through pain, are you ruminating about the pain, or are you aiming to be perfect or people-please? All of these characteristics can seem helpful, at least to a degree, but can also cause your nervous system to be constantly turned on.
• Practice slowing down, breathing, and aiming for what is sufficient vs. what is perfect.
• Remember that unpleasant does not automatically equal bad. A sensation can absolutely be unpleasant, yet that does not necessarily mean it is bad or that it is dangerous. You can have unpleasant sensations and still be OK.
• Practice giving your sensations space and allowing them to be present vs. fighting with them. The exercise that follows is a good starting point.

Giving Sensations Space Exercise

1. Pause and orient (10 to 15 seconds)

Sit comfortably. Take a couple of slow breaths and notice three things in the room (a sound, the air on your skin, the support of the chair). This helps the nervous system shift out of threat mode.

2. Gently notice the sensation (20 to 30 seconds)

Bring awareness to the area of discomfort without changing anything. Name it neutrally:

• “There is tightness.”
• “There is heat.”
• “There is pressure.”

3. Make space around it (45 to 60 seconds)

Imagine the sensation as one point inside a much larger field of your body. Visualize expanding the area around it by a few inches, then a few more, as if the sensation has room to move, breathe, or float inside a spacious container.

• If helpful, try phrases like "You’re allowed to be here,” “You don’t need to change,” or “I’m giving you space.”
• Do not push the sensation away or try to change it; the goal is openness, not for it to go away.

4. Shift attention outward (20 to 30 seconds)

Now, widen your attention to include:

• your feet on the floor
• your breath in your chest
• sounds in the room

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Let the uncomfortable sensation be just one part of your overall experience, not the whole picture.

5. Close with safety (10 seconds)

Offer the body a gentle message of safety:

• “I’m safe right now.”
• “My body can soften.”
• “This sensation can come and go on its own.”