Dr James Alexander, PhD- Psychologist

Chronic pain is being generated by our unconscious for a purpose. It is there to deflect our attention away from some 'emotional truth' (which is invariably negative and painful). We learnt this emotional truth (often/usually not factually true) in a painful context, e.g when we were being traumatised by an accident, or abuse as a child, etc. For example, a child may learn in this context, 'I am not good enough', or 'the world and all the people in it are dangerous'. There is usually an adaptive reasoning to the emotional truth which was learnt in a bad situation, e.g the kid who 'learnt' that they arent good enough has managed to restore some sense of control ('the bad things happen because of my actions, therefore if i just try harder, things will get better'- while not accurate and still painful, it at least restores a sense of control and is less frightening than the realisation that s/he is at the mercy of a psychopathic adult). The person who learnt that the world is a dangerous place is actively taking actions to ensure their safety. As such, the emotional truth (rather than being a 'pathology') is in fact a solution to that particular context. Because we learnt the lesson well, the same learning then gets unconsciously applied to a whole bunch of situations which it may or may not be appropriate. This can cause problems in our lives.

The chronic pain results when we fail to acknowledge the painful emotional truth on a conscious level. In stead of doing this, we tend to take up an 'anti-symptom' stance, wherein we do all we can to get rid of the pain. The way to overcome the pain is to acknowledge its role in protecting us from the painful emotional truth. What is our emotional truth? The only way to answer this question is to delve into the negative. This will involve our negative thoughts, beliefs and experiences. If we try to ignore these, via maintaining a positive stance, then this simply plays into the purpose of the chronic pain- there is no reason to think that this is likely to get rid of the pain. And people will just keep on trying harder and harder to strengthen their anti-symptoms position.

Ironically, the way forward is to consciously acknowledge the negative that is going on for us at an unconscious level. Do we need to indulge in the negative, making us feel even worse? No- we just need to acknowledge it. Do we need to do battle with the negative (as per CBT and RET)? No- this has the effect of just adding to the strength of the negative thoughts, giving them more power. In regards to what do beyond finding and acknowledging our negative thoughts, i think what helps in order to reduce chronic pain is what Acceptance & Committment Therapy (ACT) suggests- see them in much the same way as we see clouds floating across the sky. Yes, they are there- we can see them; but we dont have to demand that the clouds not hold the shape that they do, trying to change them.

However, i would add that for most people, i dont see ACT as being a sufficent method to overcome chronic pain- research on its outcomes with chronic pain has not demonstrated this result. I think ACT is instructive in terms of how to respond to negative thoughts, but in order to get over chronic pain, we need to devle into the negative emotions which our pain symptom is trying to protect us from- that is, stop denying it and try to become consciously aware of it. Many of the journaling suggestions and basic TMS tips can help us discover what our emotional truths are. If this is too difficult on your own (we can meet with defense mechanisms which are there to prevent us from becoming aware of the emotional truths), then getting some therapy such as brief psychoanalytic therapy, EMDR, or Coherence Therapy can greatly help.