We are evolutionarily hardwired to link physical pain with harm because this association keeps us safe.
What do we do when physical pain is not linked to a physical injury? How does one tactfully explain to a patient that the pain is not related to a physical injury?
“Between stimulus and response, there is a space. In that space is our power to choose.” – Victor Frankl
When the brain repeatedly hears messages like “movement equals danger” it’s no different than seeing scary pictures or watching a horror film.
The words we tell ourselves creates the scrip to the movie we believe to be our life. If the movie script is horrifying, the brain becomes vigilant, turning up the alarm to generate more pain even when there’s no actual threat present.
If the movie script is slowly changed to “I am safe, I am strong, I am healthy and I will get better”, the brain naturally becomes less vigilant, turning down the alarm to generate less pain or no pain predicting no threat.
Is the message that is repeated in your head that is transferred to your unconscious mind, “I am in danger, my body is broken, what if I never get better” or is the message, “I am safe”?
The fact is that what you repeat matters, and only YOU can decide what you repeat. So what do you say about your body when no one’s listening?
“…expectancies shape pain-intensity processing in the central nervous system…” – Atlas et al 2012
In this study, subjects were manipulated or influenced to expect either higher or lesser pain before experiencing a painful stimulus. Not surprisingly, when expectations were influenced to make subjects anticipate less pain, they reported significantly lower pain intensity and visa versa.
The brain doesn’t just react to a sensory signal; it responds based on what it expects to happen!
The funny thing is that the highest predictor of someone benefiting from physiotherapy is their expectation or belief if physio will help them or not.