What If Your Doctor Can’t Explain Your Unpredictable or Shifting Pain?

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A client tells me about the physical pain she’s been experiencing that has significantly affected her life, and makes an off-hand comment about whether her pain is “real pain.” What would fake pain be I wonder? As we talk more I come to understand that for her, “real pain” is pain that has a traceable physical explanation. A broken bone vs. mysterious moving pains that no doctor has been able to explain.

If you’re experiencing unexplained pain, it is real. Maybe it’s confusing and unpredictable and frustrating, sure, but real nonetheless. As to those voices saying it’s all in your head: that is simply old and obsolete thinking. Whether the pain is from a broken arm, or an overwhelmed nervous system, the pain is just as painful to endure and the source of the pain you are experiencing is just as valid. And you are no more to blame as responsible for the pain that comes from an overwhelmed system as you are for the pain of a broken arm.

How our systems can get overwhelmed:
​You may know the feeling that much of the time your system doesn’t feel aligned. That the various systems of your body aren’t working in cooperation. For instance, your heart-rate and breathing may not be cooperating with your muscle system. So, as your heart rate and breathing settle towards a slower rate, and you feel the impulse to take a deeper breath, the muscle system doesn’t cooperate with a corresponding relaxation but instead stays contracted. Instead of a deeper breath, you feel the difficulty of breathing with contracted muscles, and instead of settling, you end up feeling more revved up again, and your heart-rate speeds up as your breathing stays shallow. In trauma-informed somatic work this is an example of a lack of coherence and it’s a strong correlate for difficulties with emotional regulation and with chronic pain. 

How that overwhelm leads to unexplained pain.
​When a lack of coherence is the norm, we end up living with the feeling of being in “high alert” much of the time, or we may experience a feeling of being tuned out or disconnected. Either way, there is a high cost for our system to maintain these nervous system states. One such cost, is an impaired nervous system. Chronic fatigue, Lupus Fibromyalgia or other autoimmune disorders can be a result. There can be body patterns of “bracing,” holding muscles tightly contracted, or suppressed impulses to move, in which the muscles fire in patterns that make movement difficult and that lead to musculoskeletal pain. That is a kind of pain which is quite changeable, and often moves around the body — and it’s pain for which no x-ray or MRI machine will find an explanation. 

A Somatic Trauma Approach
​Working with a somatic approach can address these types of chronic pain when many other approaches haven’t helped, through leading you to cultivate new levels of coherence in the body. Through working with body sensation, attention to posture and gesture, gentle movement and hands-on support, we can address the ways that our body/mind is behaving as if the gas and brakes are being pressed at the same time. We can begin to experience the potential of our own body/mind acting as psychiatrist Daniel Siegel writes, in a “flexible state of harmony.”

– Dan Rindler, GCFP, SEP, February 2023

Coherence in Nature: It’s beautiful how this school of fish all change directions as a harmonious, dynamic system!