How Hypervigilance to Pain Hurts

Think of the last time you experienced pain. When an injury occurs and your body sends you pain signals, they are incredibly useful. They protect you from further injury and are important messengers that trigger physiological responses that have evolved to keep you safe.

What happens in your body in response to pain is complex. The cascading effect of chemical messengers in the form of hormones and neurotransmitters is the focus of volumes of research and theories. It is not a simple process and how you experience, cope, and manage pain is entirely unique to you.

There is however some understanding of how the way you think about your pain can keep you trapped in a vicious cycle. The fear-avoidance model describes how you can get caught in an unhelpful loop with your pain. Your fear of pain causes you to avoid a variety of activities, many of which are perfectly safe for you and highly beneficial for both your physical and mental health.

Part of this mental loop involves catastrophic thinking, where you believe that the outcome of a given activity will likely cause you great pain. You become ruled by your fear of pain. Thoughts of engaging in nearly any kind of activity fire up your imagination of all the possible terrible outcomes. In your mind, an overexaggerated prediction of the amount of pain that will result from even the most basic of activities leads to inactivity, withdrawal from friends and family, depression, and often anxiety.

Constantly scanning your body for cues that it’s hurting magnifies any subtle pain messages and negates any other types of messages.

Another part of the loop involves hypervigilance to pain, or a heightened state of attention to the perception or even the possibility of pain. Living in this state of high alert keeps your sympathetic nervous system (the fight, flight, or freeze response) endlessly activated. You might recognize that feeling when the smallest sound makes you jump.

Spending most of your time in a heightened state of response is exhausting on your body. All of your resources are spent in an effort to keep you ready to do one of three things: fight, flight, or freeze. Your body pumps out adrenaline, cortisol, and a host of other substances, rallying the troops for battle.

This is not a state of being that supports healing. Constantly scanning your body for cues that it’s hurting magnifies any subtle pain messages and negates any other types of messages. It also makes you afraid to engage in any kind of activity, which reinforces your belief that chronic pain can only result in suffering.

You can end this vicious cycle and begin to move toward recovery. Here are some of the ways.

• Calm your nervous system. It’s essential that you shift gears as far as your nervous system is concerned. Slowly and gradually turning from operating on high alert at all times to the healing and restorative parasympathetic nervous system requires a daily, and often hourly practice.
• Cognitive Behavioral Therapy (CBT). Widely recognized as an effective treatment for pain, CBT focuses on unlocking thought patterns such as hypervigilance and catastrophizing so you can develop a less debilitating relationship to your pain. This is a highly structured approach that is done under the care of a qualified professional.
• Yoga. By focusing on the connection between movement and breath, yoga allows the practitioner to become aware of the nuances of what is happening in the body, in the mind, and in their interaction. By shining the light of awareness on these patterns, yoga can help unhook unhelpful mental states. (Read: “Lessons from Yin Yoga for Managing Chronic Pain.”)
• Mindfulness-based stress reduction (MBSR). Developed by Jon Kabat Zin, this eight-week program has been shown to be highly effective for managing pain. As the name suggests MBSR is focused on the non-judgmental attention to what is happening in the present moment.
• Guided visualization. When practiced consistently, guided visualizations can serve to reset the nervous system, shift mental focus, and create a state for healing.

[Listen to: “Guided Meditation: The Healing Waters.”]

There is no one clear path for everyone that will break them out of the feedback loop that keeps them suffering from chronic pain. As an individual, you will have to find your own way to freedom, but you don’t have to do it alone. Find a support group or a therapist that can help you navigate your path back to a full life.

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