3 Ways We Experience Pain: Unrelenting, Manageable, and Relief

Pain is one of the ways we can sense the inner condition of our bodies (embodied self-awareness, ESA). Other parts of ESA are interoception (warm/cold, itchy, nausea, comfort), proprioception (balance, boundaries, body image), autonomic feelings (from the internal organs like a racing heart or upset stomach), and emotions (fear, anger, joy).

Both physical and emotional pain seems real and concrete, but how we feel our pain is actually an interpretation of the ESA of our pain, created in dedicated circuits in the brain and nervous system, and it can be changed.

At the body site of the pain (like a lesion or broken tissue for physical pain and heartache for emotional pain), there may be a consistent input signal coming into the brain. How we interpret that signal, our embodied self-awareness of the pain, can be felt as intense or mild, sharp or merely achy, noticeable or not noticeable. How we relate to the pain emotionally (fear or acceptance) is also an interpretation.

Our experience of pain, therefore, may be changed perhaps permanently by training our awareness to learn how to tolerate the painful sensations.

Paying attention to pain has the effect of modulating the experience, making it more manageable and less unrelenting. Of course, in some major physical or emotional traumas, the wound is so deep that it cannot be easily changed by paying attention to it. We need medications, physical therapy, and/or psychotherapy to cope.

One example of modulation of how we experience pain is when we laugh together with other people. As this happens, the brain produces endogenous opioids in the nervous system that suffuse the whole body via the blood. Like opioid medications, these endogenous neurochemicals increase the threshold for the perception of pain. That means we are less likely to feel the pain unless it is one of those deep wounds.

Try this exercise if you are willing to see if your Embodied Self-Awareness might change how your nervous system interprets pain.

Suppose that you encounter pain somewhere in your body. It could be in your chest, neck and shoulders, head, gut, pelvis, or limbs. You notice that all you want is to get away from that pain and end it. Trying to “get rid” of pain makes it worse and makes you feel that the pain is unrelenting or dysregulated.

Suppose that you could, at least for a moment, shift into a modulated (manageable) state by stopping your effort to suppress your awareness of the pain. If you can allow yourself to feel the outlines of the pain, you may notice that the muscle tension around the painful area begins to thaw. You generate modulated thoughts to describe what is happening to yourself (OK, the pain is, in fact, less intense now. Just slow down and pay attention to how the pain experience changes).

The pain lessens for a bit until your nervous system can’t hold onto it any longer and, again, you want to escape, and the unrelenting feeling of pain comes back. Dysregulated worries about your condition flood your thoughts, and the seemingly unbearable intensity of the pain and tension returns.

Then once again, you might catch yourself at the edge: the balance point between beginning to feel the pain (manageable, modulated embodied self-awareness) and feeling overwhelmed by the pain (unrelenting, dysregulated ESA).

Let’s suppose you try once more to feel the pain. This lasts for a short time, and then you notice the shifting between modulated and dysregulated embodied self-awareness: the sense that you are moving between the unrelenting and the possibly manageable experience of pain.

With practice, you can learn to discern that on the dysregulated-unrelating side, the thoughts border on worries and helplessness. On the modulated-manageable side, you begin to have thoughts that you are able to hold and sense the pain and that you are getting closer to feeling it.

If you persist in noticing this cycling, a moment may arrive, a kind of tipping point, when you can feel a growing sense that you can hold more in your awareness.

If you get to this point, as you are able to tolerate feeling the pain more, your thoughts become more positive and hopeful (I can do this. It just takes practice.). This is how you can tell that you are more centered in a modulated state of pain management and less likely to slip back into dysregulation.

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The longer you can hold onto this modulated state, the closer you come to encounter a moment when the pain may actually begin to lessen.

You might suddenly be flooded with a parasympathetic relaxation accompanied by those endogenous opiates and feel-good hormones, a deeper breath, a respite during which the pain vanishes for a short period: Relief! When that happens, you know that you just made a shift from being reasonably well-modulated – able to tolerate/manage the painful feelings -- into a brief state of restorative embodied self-awareness.

The transition from modulated to restorative ESA differs from the transition between dysregulated and modulated ESA. When we shift from modulated to restorative, the transition occurs suddenly and without any prior indication. One minute, you are doing your best to stay focused on feeling the pain, and then, without any planning or effort, you feel yourself gradually sinking in, your breath getting slowly deeper, the pain ebbing into the background.

And, just as suddenly, you are back in ordinary modulated reality. Your body feels normal – meaning that it has weight and tension and the pain is there right where you left it, and the dysregulated intrusive thoughts – not fully formed – are again rising like clouds with dark undersides, but the next pain storm has not yet begun. There is a moment of sudden clarity in this manageable space in-between relief and despair.

On each occasion that you make this transition to Restorative ESA, you may be able to feel its pull more easily. It feels safer to fall into it and easier to soften and let go.

However, unlike in modulated ESA, you can’t choose to stay there because there is no choice. There is only to be. Finding relief from pain by dropping into Restorative ESA is not like a tunnel where you know you are going somewhere and will arrive at the other end. The restorative state can’t be seen or understood, so there is simply no way to think about or figure out how to get there. We only notice it when we are actually there.

Restorative ESA is a kind of pain relief medicine created out of neural, hormonal, and immune system functions that relax, soothe, and restore our wounds and traumas, both emotional and physical. Restorative ESA medicine relies on your own body’s natural resources for self-repair, and the dosage is automatically tailored to your needs.