All in Your Head

While new research identifying the brain as ground zero for pain empowers some patients to take more control over their recovery, others find that it further stigmatizes their suffering.

“Patients come in all the time and say, ‘Please don’t tell me it’s all in my head,’” says Tobi Fishel, a psychologist for the Center for Integrative Health at Vanderbilt University. She says being told that their problems are psychosomatic, emotional, or otherwise “not real” is a common source of frustration. “When a patient hears that, they experience it as, ‘You’re crazy, you’re making it up, you should just push through it, and you’re not really experiencing this pain,’” she says.

But just because pain is a matter of perception doesn’t make it any less real, says psychotherapist Eric Garland. “It’s a false distinction,” he says. “The whole idea of pain being in your head is ridiculous, because anything that’s in your mind is in your brain, and anything that’s in your brain is in your body.”

Instead, patients—and health-care providers—should think of the mind as a powerful tool in the struggle for control over chronic pain.

“Once people get that, it’s fairly liberating,” Garland says. “It can be empowering for people to realize that your mental experience can impact your physiology.”