It is a powerful word that triggers strong emotions such as pain, fear, helplessness, panic and even grief. If you are one of the millions of patients struggling with pain as you read this sentence, you are definitely not alone. Two-thirds of people today live with significant amounts of pain for more than five years. The highest percentage of all doctor visits are made in search of relief from pain. But this salvation is often not easily found.
In its purest form, pain and suffering are part of our natural survival system; It warns us that something is wrong and makes us pay attention to our body. So, pain is first and foremost a signal that tells us that we are injured or sick. Pain also results from tension and discomfort related to how we respond to a stressor or threat. When we are threatened physically, emotionally or mentally, our nervous system automatically activates to protect us from injury and harm.
When it comes to pain, we can talk about three basic pains; physical, emotional and post-traumatic. Physical pain is caused by an injury or tissue damage. Emotionally based pain results from strong, unresolved emotions; We store these in our bodies and cannot express them in a healthy way. Finally, post-traumatic pain arises from the stronger reactions we develop to sad, frightening and painful events. While these three classifications have apparent differences, one of the keys to coping with pain requires recognizing that these three basic types are intertwined. Therefore, pain is multidimensional.
You may be surprised to discover that emotional and physical pain work the same way in the brain. Functional brain scans (MRI) measure the activity of the brain and have shown us that when the pain signal reaches the brain, three specific areas light up simultaneously: the limbic system (emotional center), the sensory cortex (governs the senses), and the cerebral cortex (regulates thought beliefs). That is, ongoing pain has an emotional component, a sensory and physical ache/pain, and thoughts and beliefs that hinder healing, and these often increase the pain.
Solving the pain puzzle requires sufficient thought. What remains unresolved is unresolved trauma in the body. According to research, physical pain/pain occurs not only as a result of a physical injury, but also as a result of stress and emotional problems. Post-traumatic stress disorder (PTSD) patients are prime candidates for developing chronic pain.
There are many theories about what trauma is. Many definitions focus on the traumatized individual encountering one or more real (or perceived) events that threaten his or her survival or physical integrity, and the individual's reactions include strong negative emotions such as fear, helplessness, loss of control, and/or terror. Traumatic events are simply of two types; a single event (an accident or injury) or multiple, ongoing events, such as those who experienced emotional, physical, sexual abuse and/or neglect in childhood.
The difference between wild animals and humans, in terms of trauma, is that animals complete their flight or fight response and thus either fight the threat or run away and move away from the source of threat. Then, they get rid of the effects of stress residues by shaking and shaking movements. We humans, by contrast, generally cannot run or fight, and we are conditioned to not give our bodies time to “ejaculate” after the threat. That's why we often freeze. When the remnants of fight-flight or freeze responses are not discharged from the body, they leave us in that elevated and inhibited physiological state. We suppress our need to fight or flee in order to reintegrate into society (society often tells us “get over it”). This avoidance creates further physiological blockages and psychological detachment, which are the basis of much pain.
An important aspect of trauma is the threat response. The threat of danger calls us to action and activates the classic flight-or-fight systems we mentioned earlier. If that threat is potentially lethal or impossible to escape, our third natural response to the threat is to freeze. When we are stuck in this situation, we feel stuck in our lives, unable to move forward. Detachment does not eliminate fear or pain, but it erects protective walls so that we do not feel them. This is our ability to feel pleasure and experience it clearly. It also reduces our capacity to think. Disconnection prevents us from being in the here and now.
When working on chronic pain, it is useful to look at the interaction of trauma with pain in two main ways. One is to focus on the trauma that may have started with the pain problem; This could be an accident, injury, attack or illness. The important thing here is to realize that pain itself can be traumatizing, which is the second important way. One of the worst things about the human experience is pain, and the associated fear can be endless and very disturbing.
So how does normal, necessary pain turn into chronic pain?
Self-regulation, after the three major trauma responses of flight, fight, and freeze, occurs through the following mechanisms: cannot be achieved with:
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Disconnection
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Anxiety, fear and panic
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Helplessness and hopelessness
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Anger, rage and irritability
In our experience, dealing with pain and trauma The first antidote for people who experience anxiety is to learn how to regulate emotional and sensory experiences and to minimize the effects of these emotions on their bodies by allowing the limbic fear and anger systems in the amygdala to calm themselves, that is, by regaining their self-regulation skills.
So how do EMDR and chronic pain intersect? I would like to start this with a brief explanation of the EMDR process.
Eye Movement Desensitization and Reprocessing is one of the therapy methods that has attracted a lot of attention in recent years. EMDR is an innovative therapy method that facilitates information processing processes and enables the integration of traumatic memory fragments. EMDR is an innovative therapy method that brings together different well-known approaches such as psychodynamic, cognitive, behavioral and client-centered approaches. It is shown among the first-line treatments for PTSD in various guidelines.
By applying the Adaptive Information Processing model with EMDR, the disrupted processing of memories is overcome, and the integration of traumatic memory fragments is facilitated by facilitating the information processing processes. This is achieved and the situation causing psychopathology is corrected.
The Adaptive Information Processing model is based on the non-functional storage of unprocessed information in the brain. Information remains unchanged in the 'frozen' memory system; It was stored without connecting or adapting to any other information at the neurobiological level. The aim of this process is; It is the coding of previously experienced traumatic experiences by associating them with the current problem.
Since Engel (1959) stated that traumatic experiences are permanently recorded as pain memories in the person's body, it has been accepted that pain and trauma are related. Successful EMDR studies have been published, especially for phantom pain in war veterans (Wilensky 2006). In studies conducted on war veterans, the improvement of PTSD symptoms and pain, as well as the recovery of loss and grief, have been emphasized (Schneider J 2008).
The trick to healing pain is possible by understanding body reactions and working with them. . By cultivating body awareness and maintaining your sensory-based focus, you learn to become familiar with and move through trauma-based sensations. Because those struggling with pain and trauma often view their bodies as the enemy, this “familiarity” is an important capacity—it also provides opportunities for continued vitality. Embodiment creates connection, reducing your need to disconnect and escape from your body.
Trauma is considered the fourth path to enlightenment after meditation, sex and death. When we are released from the clutches of suffering and trauma of past events, we regain all instincts and energies that have been trapped in the prison of restriction and collapse are released. Healing from trauma means rediscovering lost parts of ourselves that allow us to feel more complete and whole; perhaps we discover this for the first time. Then we come alive and begin to struggle, freeing ourselves from the pain of being broken.
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