When the central nervous system (CNS) (brain & spinal cord neurons) become sensitized, it is referred to as “central sensitization” which is a term I’ve used frequently for over a decade now to describe some of my patients experiencing chronic pain.

Lorimer Moseley says that because of the complexity of pain perception he avoids using the term “central sensitization” as it is an inaccurate term, as the sensitization is not just within the CNS but it is a sensitization of the entire pain system. So instead he uses the term “Pain System Hypersensitivity” (PSH).

I think we call appreciate the term PSH, but a fascinating new term that I’ve only recently learned is the term to describe the opposite end of the pain spectrum, “pain asymbolia”. Pain asymbolia is a condition in which pain is experienced without unpleasantness and without being bothered by it. Those with pain asymbolia recognize the sensation of pain but are immune to suffering from it.

This rare condition may occur after a brain injury, stroke or pathology that damages the connections within the limbic system, specifically the cingulate gyrus.

“Asymbolia for pain denotes the inability to recognize the unpleasant or disagreeable component of a painful or threatening stimulus” – Rubins et al 1948

This 2020 paper discusses an incredibly fascinating theory about this rare condition. They theorize that pain asymbolia is associated with a pathological phenomenon where a person claims that experiences that they feel simply do not “belong to them”, as though the experience is not “theirs”, or that they feel detached from them.

“In pain asymbolia, subjects report feeling detached from painful experience as though it is happening in their body but is not theirs.” – Klein 2015

When experiencing pain, it is important to consciously appreciate that pain does not belong to us as that sense of belonging may magnify the emotional responses to pain. Please view my music video where I discuss how “It is not MY pain, so it’s not mine to keep”.

Pain is a both a physical and an emotional experience that is felt as belonging to the self. However in pain asymbolia, pain does not matter as it does not belong to them, despite being fully aware that the pain experience is happening within their own body.

In pain asymbolia, there is a sense of lack of ownership of pain and a lack of desire to change it. There is also the absence of care about one’s own body; hence pain as a protective mechanism becomes irrelevant.

Not caring about your own body is not the same as hating your own body. When one hates their own body, it means that somewhere inside they actually care about their own body; whereas not caring means one is simply indifferent about their own body. Being indifferent or resentful of one’s own body are both unhealthy mindsets. The ideal approach one can have is to care about one’s own body yet be unconditionally accepting of it no matter what.

See my VIDEO on this topic.

It sounds simple, common sense yet profound, to be caring and unconditionally accepting of one’s own body is how we should be after millions of years of evolution. It is how all other animals are. Is there an animal that does not care about their own body and their own survival? No.

Is there an animal (other than humans) that hates, resents or is critical of their own body? Not to my knowledge. Most likely elephants don`t ever think that they’re too big; Chihuahuas don’t think they are too small and crows don’t think they are too dark. The irrational mindset of disliking one’s own body is not innate, but a belief system instigated only by family, culture and societal influences.

“Pain asymbolia is a form of depersonalization for pain”Gerrans P 2020

Another amazing paper titled “Pains that Don’t Hurt”, published in the Australian Journal of Philosophy proposes that pain asymbolia is a lack of motivation and a lack of capacity to care about your own body.

“…a pain will represent damaged states as bad only to a subject who cares about their own body.”Bain D 2024

An incredibly fascinating concept reviewed in this paper is that opioids reduce not the pain itself but the felt significance of pain. Opioids are a form of “emotional castration” and dissociation from the self, producing a mild form of pain asymbolia. It is often stated by those with opioids dependency that they feel “numb” and “not themselves”.

Opioids reduce two basic human desires; the desire to care when pain is experienced and also the desire to care when joy is experienced, which may eventually lead to depression (Mazereeuw G et al 2018).

It is my strong belief that “detaching” self from pain is a wrong way of approaching pain management as in the long term, it backfires. Detachment from pain reduces one’s desire and motivation to actually do anything about the pain itself, whether it is to exercise, make dietary changes, improve social connections practice mindfulness or seek medical care.

Though pain does not ‘belong’ to us, we are still responsible for taking care of it! –B Jam

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