When you think of pain, you might think of injury, inflammation, or some kind of dysfuction. But the truth is that while pain can indicate tissue damage, in reality, it is much more dynamic than just a physical issue. This is especially true for chronic pain, which often coincides with chronic stress and unresolved trauma.
Understanding chronic pain
Pain is a protector
Pain is, at it’s core, a message generated by the body in response to perceived danger. It is essentially the body’s alarm signal; it’s trying to protect you based on it’s predictions about danger and safety.
Research shows that pain can be present with no injury. And that injury can be present without pain. (So, basically, correlation is not causation).
Pains is a predictor
When something or someone hurts us - whether physically or emotionally - the body essentially takes a snapshot of that moment and puts it in a reference book that it uses to predict and prevent danger. These snapshots help the body build an understanding about what’s dangerous and safe.
Take the example of a hot stove. Somewhere along the way, you probably learned that putting your hand on a hot stove would hurt. Perhaps you accidentally did so as a kid (or maybe you continue to each time you try that one recipe) or maybe an adult warned you about the danger. Now, as an adult yourself, you probabaly aren’t intentionally going around touching stoves because you know it would hurt and you don’t want that (unless that’s your kink, in which case, do you!).
Your body might also send out pain signals as warning. If you just think about touching a hot stove, if you see someone else do it, or if someone tells you that they did so, you may experience pain.
How chronic pain develops as a result of trauma
When you encounter threats that are relatively reasonable (meaning, you don’t feel totally and completely in danger) or you are able to effectively protect ourselves you can continue with life with ease, feeling relatively safe, because you know how to protect yourself and you know you can protect yourself.
But when you live through repeated or early-life trauma the constant state of stress keeps the nervous system stuck in high gear. The body’s pain receptors deploy amplified warnings whether the danger is physical, emotional, real, or perceived. In this cycle, the pain isn’t just an output indicating injury, it also becomes an input - a potential source of danger - further feeding the body’s ongoing prediction of danger.
The thing about complex trauma is that it often occurs when someone is helpless or dependent, such as during childhood. As such, there is often no relief or protection from the danger. As a result, these learnings become deeply embedded. The earlier and more frequently you experienced the trauma, the more foundational it becomes to your worldview and the more imminent the threat seems. So the body often gets “stuck” in an incomplete protective response.
Because it feels like the danger is everywhere, even inputs from the body (such as muscle tension, temperature shifts, heart rate changes, emotions, etc.) can be interpreted as signs of danger; it can just generally feel unsafe and uncomfortable to be in your body.
The call is coming from inside the house: Pain and emotions
This kind of trauma shapes not just how you behave (e.g. not touching a hot stove), but how you feel about life and how you view the world.
As kids, we need help making sense of and regulating our emotions. Our bond with our caregivers helps us learn to regulate our nervous system, and as we develop we learn to make sense of our emotions. With early and repeated neglect or abuse, however, we are often left to our own devices. It can become especially overwhelming and confusing for kids because their sources of safety and protection are also sources of danger.
When we don’t have emotional support - and especially when we experience emotional neglect or abuse - emotions themselves become scary. You might feel overwhelmed by them all the time, and feel like your anxiety or sadness will never end. These emotions can end up being repressed, whether consciously or not, because you don’t know what to do with them.
Chronic pain in everyday life
Emotions are essentially energy in motion. But without knowing how to manage your emotions, or even being afraid of them, the body will often brace to hold them back or hold them in. This can cause chronic tension patterns that further amplify the experience of discomfort and pain. This can make it especially difficult to relax; the body stays in a state of dysregulation.
It can also be common for people with chronic pain to disconnect or dissociate from their own experience. With complex trauma in particular, the lack of safe connection and protection during the traumatic events can cause the body to hyper-fixate on obtaining the connection it always longed for. As a result, you might find yourself succumbing to perfectionist or people-pleasing tendencies as a way to secure connection. Or, you might be on the opposite end of the spectrum where you completely isolate yourself and avoid experiences where you might be emotionally harmed.
That avoidance can show up in other realms of life too - when all movement seems risky it is common for people with chronic pain to avoid doing things such as exercising.
Healing chronic pain
Hit the brakes
In somatic therapy, one of the first things we have to do is help you learn self-regulation techniques to calm your very active nervous system.
That starts with learning to track your nervous system activation. In somatic therapy we practice noticing signals like tension, an increased heart rate, spiraling thoughts, and more. These are signals that arise from a sympathetic nervous system state - basically your body’s fight-or-flight mechanism.
As you notice those signals, we can start to experiment with techniques to counter balance them such as deep breathing, shaking to discharge energy, orienting to safe things in your environment, and so on. In doing so, we are activating your parasympathetic nervous system, which helps your body to slow down and rest. This acts kind of like a car brake for your gassed-up nervous system.
As you develop trust with your body in your ability to self-regulate, this also helps you develop a greater capacity for stress, meaning that when you feel stressed or have pain it won’t feel as overwhelming. This helps to reduce to the spiraling cycle of pain-anxiety-pain-anxiety.
Getting the support you never had
The chronic tension that often accompanies chronic pain can make it really hard to relax. You might resonate with the sense that your energy is always moving up and out, making it difficult to settle and feel grounded. It might also be difficult to actually receive support when it’s given to you.
Difficulties with this can come directly from the experience of chronic pain and feeling unsettled and unsafe in your body, but they can also be reverberations from early life experiences of being unsupported, of having nowhere or noone where you felt you could really be held, where you could sort of surrender. Missing those fundamental experiences, it can be hard for your body to really receive support - whether physically or emotionally - because it can’t trust it or it feels unfamiliar.
Using techniques such as mindful grounding or NeuroAffective Touch, we can also help your body practice “letting go.” In somatics, we call this yielding and it is a state of relaxed alertness and receptivity to support - whether feeling the ground underneath you or physical or emotional support from another person. This isn’t “releasing” or bypassing your emotions, but rather feeling into a soft landing place instead of bracing and holding it all in.
Our bodies, being social creatures, are wired to find safety in connection. This is actually another nervous system state called the ventral vagal state. This can be complicated and hard to access as a result of experiences of being harmed in connection (as happens with complex trauma), but can be relearned and repatterned in your body with practice.
Giving voice to your pain
While reducing the amount of pain you experience is definitely a goal, recognizing that the pain may reflect repressed emotions means that it’s also important to allow some of those emotions to come to the surface to be expressed and released.
In somatic therapy, we often explore the stories your pain wants to tell. What is it afraid of? What is it protecting you from? What emotions or memories have been too much?
In doing so, we are building the muscles you need to be able to notice, express, and move through emotions as they arise. Emotions have a lifespan; they will always end if we allow them to do what they need to do without bracing against them. This is a way that you can start to build trust with your body and start to feel safer in your skin.
Doing instead of avoiding
Because chronic pain touches so many aspects of your life, it can be common to avoid doing things where you anticipate experiencing pain. This is very common when it comes to exercise, for instance.
Often, people with chronic pain will avoid walking, exercising, dancing, or doing other things that may have brought them pleasure in the past. As long as you have the OK from your doctor, it can be therapeutic to reintroduce movement and activity into your life.
In doing so, you can help your body relearn that these activities are safe and that they are not causing more damage. This isn’t to say you will not feel pain while doing them; it will take time for your body to reassociate these activities as painless. Some strategies for getting back to your normal or desired activities include:
Pacing, such as going for a short walk instead of trying to hike 20 miles, and making sure you have space to take breaks and rest.
Integrating pain-relief tools such as ice packs, heating pads, or a tens machine during or after the activity.
Exploring what also brings you pleasure, whether that’s swimming, music, or anything that complicates the persistent narrative that “it hurts!”
Conclusion
The journey is not about silencing pain — it's about rewriting the relationship between body and mind, from one of fear and avoidance to one of safety and connection.
Pain is not the enemy — it’s the signal that the deepest parts of you are still waiting to be heard.
If you're ready to listen to and support your body in all the ways it's been longing for let's talk. I offer free 20-minute consultations for therapy.
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