Hi, I’m Taija Ventrella, I used to suffer from chronic migraines and daily neck/shoulder pain, but I don’t any longer. I am so glad you’re here. 

This week we’re going to focus on learning about the neurology and psychology of chronic pain, and I will give you an introduction to my program for healing your chronic pain and experiencing expansiveness in your life. 

But let’s start with my story. I started getting migraines and neck and shoulder pain in my early teen years. They progressed throughout my mid-teens and peaked in severity in my late 20s and early 30s. There were periods where I was in pain every single day for months, and it was rare for me to experience more than a week at a time pain-free. 

Throughout the years, as my pain got worse, my world also got smaller. The list of activities I couldn’t do, and stimulus that I couldn’t be exposed to grew and grew, until I felt like I was living in a bubble. I watched my friends with envy as they got to explore the world, while I felt stuck at home - I always needed to be within 30 minutes of a dark room and an ice-pack. 

Throughout that time, I tried so many treatments - both modern and alternative modalities - to find relief. I saw migraine specialist doctors, several physical therapists, took so many supplements, tried special diets, avoided alcohol, sulfates, and chocolate, got regular massages, acupuncture, and even tried the magical sounding daith piercing that is rumored to cure some people’s migraines. Sometimes these methods would seem to help for a few weeks, but inevitably the pain always came back. 

In my late 30s, I got to a point where I just couldn’t take it any longer – I told my partner at the time that if I couldn’t figure out how to be in less pain, I didn’t want to continue living. I was ready to try anything. 

I came across a workbook called Unlearn Your Pain, by Dr Howard Schubiner. I did the exercises in the book religiously, while doing a number of other therapies and exercises that I had discovered over the years. I did the work for about an hour a day – I considered it an intensive treatment. Two weeks in, I knew it was working and that I was on the right track. Three weeks in, and I felt that I had found the cure for my chronic pain. 

Neurology of Pain

Pain has a very important role in our bodies. It lets us know that our bodies are either being injured or at risk of being injured, so we can move away or avoid the source of that threat. If you put your hand on a hot stove, you need to be alerted so that you can move your hand off the stove as quickly as possible. When you get a cut and are bleeding, you need to know that so you can clean and bandage the cut. When you twist your ankle, you need to know that it is vulnerable so you can give it the rest and support it needs to heal.

It works in your brain like this: you experience tissue damage in some part of your body, and a signal is sent through your sensory neurons from that body part to your brain. Your brain interprets this information. If your brain decides it is no big deal and you are safe, usually you won’t feel too much pain. If your brain determines that the injury is real and your body is at risk, then your brain will send a signal back to that body part, and you’ll feel pain. This is a neural pathway: information is sent from a tissue, to the brain, and then a signal is sent back to the tissue.

New neural pathways are learned all the time, and at some point, you learned the neural pathway that is associated with your chronic pain - this is why it’s sometimes referred to as neuroplastic pain. Neuroplastic pain is responsible for the vast majority of cases of chronic pain, and it is not inherently structural to your body. 

With neuroplastic pain, usually your body has already learned this pathway from an injury that happened sometime in the past. But now, the thing that triggers that pathway is not a new injury, but instead a stressor or some other trigger, which we will talk more about later. Whatever the stressor or trigger is, your brain perceives danger, so it sends a pain signal to whatever part of your body is involved in your neural pathway. 

Development of Chronic Pain

For many people with chronic pain, the neural pathway of their pain was caused by an actual injury. For example, one might have sprained their ankle, and that’s where their brain learned the pathway. After most injuries, the tissues have fully healed within a few months. But for some people, now that the pathway has been built, their brain will activate it again and again, any time they’re experiencing stress, and they will continue feeling the pain for months or even years, until they learn a new pain-free pathway. 

For others, like myself, sometimes chronic pain develops in the absence of an initial injury. It is hard to know exactly where the neural pathway of pain was learned, but somewhere along the way, it was. 

It might have even been a coincidence - maybe I had a normal, non-chronic headache, like most people do at some point in their lives, at a time that was particularly stressful for me. My brain built a pathway that connected stress with a headache, so then, every time after that when I was stressed, my brain used that pathway to cause another migraine. 

The Role of Stress and Trauma

Adults who have experienced emotional trauma are more likely to develop chronic pain. (Anda, et. al., 2006). And the majority of people with chronic pain were under significant stress at the time their symptoms developed (McEwen, 1998). Many people can look back to the time of onset of their symptoms and identify these patterns. 

Trauma leads to an increased risk for chronic pain by sensitizing our nervous systems, and sensitive nervous systems sense danger where there is none, as well as cause us to focus on the dangers around us (real or perceived) to try to protect us from experiencing those traumas again. However, this is an overcorrection, because we learn to create danger in our minds when we are actually safe.

That is why it’s helpful to address some of our traumatic histories and let go of past hurts to move heal from our chronic pain. 

But the good news? Doing this work will heal so many other areas of our lives and open us to new experiences and abilities that we haven’t yet been able to access. In addition to healing my chronic pain, doing this work has helped me move through so many other hard and limiting things in my life. 

The Role of Repressed Emotions

At the core of all of the current programs for healing chronic pain is recognizing and releasing our repressed emotions, especially anger and rage. Although we might not recognize it easily, most of us have been taught to repress our emotions, by society and by our often well-meaning parents. 

Why? Well for one, dominant Western society is very phobic of big emotions. Adults and children are shamed and judged for having big emotions. 

Yet, big emotions are a fact of the animal kingdom - we all have them, and we’re supposed to. Emotions give us valuable information about ourselves, our relationships, and our places in the world. For example, anger lets us know that our boundaries have been crossed, fear lets us know that we need to be alert to danger, and guilt lets us know we are not acting in accordance with our values. 

Yet, as children, many of us have been told not to cry, or have been punished for being angry, instead of being held in our big emotions and shown healthy ways to work with them. And when parents teach us to suppress our emotions, we listen to them, because nothing is more important to a young child than the approval and care of their parents - it’s what ensures their survival. 

Adults also are punished for expressing emotions. In our culture, women may be given more license to be emotional beings, but we are still judged and dismissed for our emotionality. Men, on the other hand, are only allowed to express one emotion - anger - which happens to be the one most associated with chronic pain. (I theorize that is a big reason why more women than men develop chronic pain). 

This one was hard for me to wrap my head around at first, because I have always seen myself as a very emotional and expressive person. But what I learned through this work is that I was only scratching the surface, and allowing myself to fully feel and express certain emotions, while mostly suppressing my anger and rage. When I think back, I can remember saying or writing in my journal, “I am angry,” but that is not a full expression of that emotion. Naming emotions is a great first step, but it is not enough.  

We will talk a lot more about this in the coming weeks. 

The Role of Fear

As we discussed, pain occurs when the brain misinterprets safe signals from body as if they're dangerous. It's like a sort of false alarm.

The feeling of fear reinforces danger signals in the brain. When you have fear about your pain, it reinforces to your brain that you're unsafe, which creates a positive feedback loop that causes more pain.

“If you attend to pain through a lens of safety, the pain will eventually fade, because all neuroplastic pain is, is sensation plus fear, and if you take fear out of the equation, it's just a sensation.”

- Alan Gordon, Tell Me About Your Pain Podcast

Your Brain Decided that Physical Pain is Less Scary Than Dealing With Your Emotions

At some point, a deep, subconscious part of your brain decided that pain is safer than scary emotions and safer than dealing head-on with whatever is currently stressing you out. 

So, when stress and scary emotions bubble up, your brain says, “I know what to do!” and triggers your pain pathway to distract you from what it thinks is a bigger threat. 

Part of the healing process then,when you notice pain, is to turn your attention to what’s really stressing you out or bothering you, and saying, “thanks brain, but I don’t need the distraction. I’m going to handle this head-on.”

I will show you how to do this in the coming weeks. 

The Neurons that Fire Together Wire Together 

Have you ever heard this phrase? What it means is that neural pathways are potentiating - any pathway in your brain that fires will be more and more likely to fire again in the future. 

Think of it like this: if one person walks through a field of tall grass, you can kind of see the path they took by the way some of the grass gets pressed down. If another person follows that path, more grass gets pressed down, and the path becomes more clear. If ten people then follow that path, lots of grass gets pressed down and the path becomes very easy to see. If 1,000 people follow that path, the earth becomes so compressed that grass can no longer grow on the path. Now imagine you’re standing on one side of the field, looking at the path. Why would you forge a new one when it’s so easy to take the path that is already clearly laid in front of you? 

Your brain works the same way. If you have spent months, years, even decades reinforcing and strengthening the neural pathways that lead to pain, it will take a lot of work to forge new pathways, and to aerate the soil of the old pathways so that grass can grow there again. 

But, you can do it, and this program will show you how. 

Psychology of Pain

There are many different things that can feed into the frequency, severity, and emotional burden of chronic pain. Most people who experience chronic pain can recognize many of these patterns in themselves. 

The Belief Something is Wrong in the Body

People with chronic pain tend to hold the belief that something is “wrong” in their body causing their pain, that their body is somehow “flawed,” “weak,” or even “broken.” Our brains are so powerful that if they think something is wrong in the body, they can make something feel wrong. 

An excellent example of this is iatrogenic pain, which is defined as pain that is caused, or worsened, by medical tests, diagnosis, or treatment by a trusted medical professional. We can also cause this effect by our own beliefs about pain. 

An example of iatrogenic pain is beautifully shown by studies done in Norway and Lithuania regarding whiplash and car accidents (Schrader 2006). Schrader observed that Norwegians who survived car accidents had significantly higher rates of persistent neck pain and headaches than Lithuanians who had been in similar car accidents. In Norway, when someone gets in a car accident but doesn’t have serious injuries, they are often diagnosed with whiplash and told to take a few days off work and take over-the-counter painkillers. In Lithuania, whiplash is rarely diagnosed, and people are told to return to work and operate as normal. The actual stimulus that Norwegians and Lithuanians had sustained on their bodies was the same, but one group was told they had an injury, and one was not. The people who were told they were injured had neck pain persisting weeks and months after their car accidents. The people who had been told they would be fine, were fine. 

I have also experienced iatrogenic pain in my personal life. In 2014, I was seeing a physical therapist for my chronic neck pain. He assessed that my neck was weak and unstable, so we were doing lots of exercises to strengthen and stabilize it. After weeks of me diligently doing my exercises, and him being unable to tell that it was making a difference, he told me that the vertebrae in my neck were irregularly long and narrow, so they were just inherently going to be unstable, and there was probably nothing I could do about it. Wouldn’t you know it? In the weeks and months following this “diagnosis,” my neck pain got worse. 

What we believe to be true about our bodies (and ourselves, and our lives) can be self-fulfilling prophecies. 

The Expectation of Pain

If some part of our brain, even the subconscious part of it, expects that we will have pain, it will trigger the neural pathway that causes our pain. 

When I was in pain all the time, I had so many triggers that I *knew* were going to cause me pain, so they did. What I learned in my healing was that these things don’t necessarily have to cause pain. But because I had built my neural pathways that led from the trigger to the pain,  they did cause pain.

For example, I used to think that my body getting overheated was a trigger that would cause pain. It turned out, getting hot didn’t automatically cause a migraine, but it did initiate the pathway that caused a migraine. 

All of my triggers ended up being like this - triggers of a learned neural pathway, not of pain directly. And, once I was able to convince myself that I could be exposed to these triggers without them causing pain, I started experiencing it more and more. 

It didn’t happen overnight, but the more exposure I got to my triggers without being in pain, the more I believed I could, and it became a positive viscous cycle. And now, I engage in activities that were triggers for me all the time, without pain, which further reinforces my truth that my triggers weren’t true triggers, they were expectations. 

The Ways in Which Chronic Pain Serves and Protects Us

This one was really hard for me to accept at first, but was essential to understanding and healing my pain. 

It’s probably not true anymore, but at one point, it was likely that your pain did help you out in some way, or even kept you safe. 

Here’s an example: my mom loved me dearly, but she was really busy and caught up in her own world a lot of the time. When I first started getting headaches in my preteen years, she would drop everything to be by my side, hold my head in her lap, stroke my hair and massage my scalp. It was attention that I desperately wanted, and couldn’t figure out how to get any other way. Migraines solved that problem for me.

My dad was dealing with chronic stress and a lot of anger throughout my entire childhood. He was very often just simmering in anger, and therefore often unable to show up for me with love and tenderness. What happened when I had a headache? He instantly softened and focused on me with loving care. He would calm his voice and his energy, get me a glass of water and an ice pack, close the blinds, and ask me what else he could do for me. 

Although I wasn’t consciously aware of the pattern, it was very easy for my subconscious brain to see that when I was in pain, my parents showed up for me the way I wanted them to all of the time. 

These are just some of my personal examples of how my chronic pain served me, but there are many ways that it can serve others. Chronic pain can give us a sense of feeling special and deserving care. It can give us an easy out to say no to doing the things we don’t want to do or are scared to do. It can force us to remove ourselves from situations that don’t feel safe. 

Coping Mechanisms That Are Associated With Chronic Pain

Many current chronic pain healing programs talk about personality traits that are associated with (and believed to be a causative factor) in chronic pain. I prefer to think of these factors not as personality traits, but instead as adaptive coping mechanisms to feeling like we were unsafe, not enough, or too much when we were younger and our personalities were developing. I am referring to “traits” such as perfectionism, being overly conscientious, being overly responsible, being overly critical, and having low self-esteem. 

Personally, I see all of these factors within myself, and it is helpful to think of them as mechanisms I developed to try to keep myself safe, rather than as core parts of my personality, because that way I feel more self-efficacy around unlearning these ways of being. 

These mechanisms, as I’ll be referring to them going forward, probably increase pain by increasing the overall stress we experience as we move through the world. But, If you identify with these mechanisms, rest assured that you don’t have to become a different person to treat your chronic pain.

I love this quote from Dr. John Sarno, the pioneer of the treatment of chronic pain in the Western medical model, which is also a great transition into the Stronger Than Chronic Pain program for healing your pain:

“The secret of chronic pain is not to change oneself, but recognizing that the combination of realities of your life and personality cause you to generate an enormous amount of anxiety and anger, then to express it instead of repress it.”

Each week, I will give you new brain training exercises, writing exercises, meditations, and resources to read or listen to. I recommend you try all of the exercises a few times, but then focus on the ones that feel the most helpful to you, but continuing to do all three categories of assignments: brain training, writing, and meditations. 

I also recommend you do a writing exercise daily, followed immediately by meditation. 

This work is meant to be done intensively, for about an hour per day, 5-7 days per week. 

Before I had healed my chronic pain, I had done many of these exercises intermittently, using the Curable app and also just on my own. When I finally took on doing these exercises as an intensive project - nearly every day for about a month, that’s when I achieved real healing. 

I don’t want you to be perfectionistic about it and give yourself a hard time if you don’t do it all every day, but I do want you to do enough work to really find success with this program. So I recommend blocking off about an hour on most days. Maybe block time in your schedule 7 days per week, knowing that one or two days something else might come up and you might not do the exercises. 

I also want you to try to immerse yourself in thought and media about chronic pain. I recommend writing down a motivational sentence or two in our planner, on your mirror, and on a notecard at your desk. Put them places you will see them multiple times per day. I will give you specific suggestions of what to write. I will also be including resources for you to check out on a weekly basis. I recommend reading books and articles about chronic pain, watching documentaries, and listening to podcasts whenever you can. You won’t need to do this forever, but the more you can immerse yourself right now, the more effective the program will be and the more likely you will be to find significant relief from chronic pain. 

This program is very repetitive by design. You will be doing the same, or similar, exercises day in and day out. Why? Because, as Dr. Sarno stated in Healing Back Pain, which is on your recommendation list, 

“The conscious mind is swift; it can grasp and accept things quickly. The subconscious is slow, deliberate, not quick to accept new ideas and change…”

Because we will be working with your subconscious mind to shift your neural pathways away from causing your chronic pain, we must be repetitive and immersed in the right kinds of thought. 

This program, like all contemporary Western chronic pain programs, is based on the work of Dr. Sarno, along with other parts pulled in from other healing modalities. Sources will be cited and credited throughout the program, but I need to give special thanks to Dr. Sarno for his paradigm-shifting work.

I also want to acknowledge that indigenous cultures across the world likely find this work natural and even obvious, as many cultures outside of our own Western culture have retained a clear understanding of the connectedness of the mind and the body, and of our mental and physical health. 

Finally, I want to state that this work can be very emotionally intense. We will be looking at events and factors in your life that may have been traumatic, and may still be causing you a lot of pain and dysregulation today. For this reason, especially if you have a preexisting mental health condition or are starting to experience signs and symptoms of serious mental illness, I do not recommend doing this work without the supervision of a mental health professional. If you do not currently see a therapist regularly, I recommend you get started finding one as soon as possible (You can find therapists who specialize in Pain Reprocessing Therapy here, and also TherapyDen and Psychology Today both have great databases where you can search for thousands of therapists in your area)