Pain: Not All In Your Head, It’s In Your Brain

Did you know it's always the brain that decides when to create pain? Let's learn how we can influence it.


Being told your pain is all in your head is annoying.

I used to immediately shut down when any advice sounded like they were saying my pain wasn’t real. The problem is, we perceive pain—all pain—through our mind. I was ignoring information that ended up helping me when I finally listened.

Without our brain, we don’t feel pain. If you slam your finger in a car door, your body signals your brain about the injury before you recognize the pain in your finger. I was awake during the C-sections when my children were born. I felt no pain. The spinal tap blocked the messages warning me of danger so the surgery my body experienced didn’t reach my brain. All perception of pain comes from the mind but that doesn’t mean the pain isn’t real. All pain is real.

We often talk about our mind and body as if they are separate from each other but everything is connected. We experience our body through our mind. When you’re under anesthesia you don’t feel what is being done to you because it blocks that signal.

Functionally, our body operates as a whole. We wouldn’t say that the pain of a heart attack or amputation is “all in the head” because we can point to a physical cause but, in reality, it is the way we process the information in our mind that makes us feel physical pain

Before I understood the science, I interpreted comments about pain and my emotions, stress level, and thoughts as if the person was telling me I was imagining the pain. Now that I understand the way our biochemistry and neurons affects pain, the knowledge of how they interact helps me live pain free.

I think it’s important to understand how our thoughts are connected to how much pain we experience because reliable pain relief solutions are available when you accept that changing the way you think can relieve pain. As soon as something is “in our head,” it affects our body. If you’re defensive about the topic, you’ll miss out like I used to.

The association between thoughts and pain is never just in the head. It is, however, normal and common for pain to fluctuate based on what we do with our thoughts. Our body’s biochemistry changes as our stress level fluctuates. Our stress level moves up and down as our thoughts change. It’s just the way humans are wired. We all do this.

The definition of pain from the International Association for the Study of Pain includes emotions

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

The experience of pain is subjective. I like medium pressure when I get a massage. Deep pressure hurts because of the way I perceive it. Someone who likes deep pressure perceives it as pleasurable. We’re both right. Not liking deep pressure doesn’t mean I’m a wimp. I just have a different perspective about how deep pressure feels.

It all boils down to this, our thoughts are responsible for how much stress we experience. Our emotions tell us how much stress we’re experiencing. Our biochemistry changes when our stress level shifts. The amount of pain we experience increases as our mood declines.

This part is fascinating. Our thoughts are mood congruent. The brain automatically focuses on things that match our emotional state. When we’re upset, thoughts about other things that upset us come to mind. When we’re happy, thoughts about things that make us happy come to mind. The same is true of physical sensations. More pain is congruent with a bad mood; less pain is congruent with a good mood. When we understand the way stress changes our biochemistry which then causes changes in our perception in sync with our emotions, the information helps us manage our pain.

For example, have you ever forgotten that you were hurting while you were enjoying something and only realized that your pain had temporarily disappeared when it returned? It’s not that the pain went away. Your pain was incongruent with the emotions you were experiencing. Your brain stopped telling your conscious mind to pay attention to the pain.

It all boils down to the fact that your brain regulates the thoughts that come to your mind. Your senses experience far more than your brain communicates to your conscious mind. Your senses communicate millions of bits of data in every moment. A filtering system in your brain decides what information is important and makes you consciously aware of only that information. One way to change the information your brain pushes to your conscious mind is to change your mood.

This sounds strange the first time you hear about this process but it’s easy to prove that your brain filters the information you receive. Until you read these words, you probably couldn’t feel your clothing touching your skin. Your brain decided it wasn’t important information. Now that I’ve drawn your attention to your clothes, you can feel them.

Another common example is when something delicious is baking in your oven and you don’t smell it until you step outside and come back in. People sometimes refer to this as nose blindness when it’s not a pleasant odor. Nose blindness occurs when our nose perceives the odor, but our brain doesn’t bring it to our conscious awareness. A common example is a teenage football player not noticing the odor from the dirty gym clothes scattered around his room. If someone mentions the odor to him, he can focus on how the room smells and become aware of the odor.

One of the filters your brain uses is new information. When you enter your home and chocolate chip cookies in the oven smell wonderful, it’s new information so your brain signals your conscious mind. Once you’re back in the house for a little while, even if someone continues baking cookies, your brain no longer registers it as new information and you’ll stop noticing the aroma unless you focus on it.

In the same way, when we feel good, the brain filters out much of our pain. When we feel bad, pain is congruent with our emotional state so our brain heightens our awareness of the pain. Once we understand this connection, learning how to regulate our emotional state to help manage chronic pain begins to make sense.

To be clear, I’m not saying that all your pain will disappear if you’re in a good mood. I’m saying that when you’re in a good mood, you’ll experience less pain. Depending on the source of your pain, you may still be in a lot of pain. Many people with chronic lower back pain only experience it when they are stressed.

Emotion regulation and stress management skills will help you vanquish as much pain as possible. If you experience less pain when you’re in a good mood, learning to improve your mood on purpose will help you benefit from that relief more often.

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