25% of adults in the US experience chronic pain. This causes disruption in careers, relationships, and general happiness in life. We explore the natural ability of the mind to direct the body to create states of reduced suffering and increased inner balance. We discuss:
- What are pain and chronic pain
- How pain is typically diagnosed and treated
- How Mind-Body approaches can help with Chronic Pain
This information is for educational purposes and not intended to diagnose or treat any mental or physical conditions. Please consult your physician before beginning any mind-body intervention.
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Welcome to Soul Sessions with CreativeMind with Debra Berndt Maldonado and Dr. Rob Maldonado of CreativeMind. Join us each week for inspiring conversation about personal development based on Jungian philosophy, Eastern spirituality, and social neuroscience. Spend each week with us to explore deep topics in a practical way. Let’s begin.
Debra Maldonado 00:28
Hello, welcome to another episode of Soul Sessions with CreativeMind. I’m Debra Maldonado. I’m here with Dr. Rob Maldonado. We are continuing our series. This is the last episode in the series on mind-body health, mind-body wellness. We are so excited to introduce our last topic. But before we do, I want to remind you please, if you want to not miss an episode, click on the button below if you’re watching our YouTube channel, or if you are listening on Spotify or iTunes, make sure you subscribe to our podcast so you don’t miss another episode. So what’s today’s topic, Rob?
Rob Maldonado 01:14
Let’s dive in. It’s an important one. We’re talking about how to transform pain. Specifically, we want to talk about chronic pain, physical pain. Pain is so universal. When you think about human suffering, you think about pain. Physical pain, as well as emotional pain. We’ll talk about how they are connected. Because that’s really what we’re talking about in the mind-body, that the mind and the body are one.
Debra Maldonado 01:53
Continuing what we talked about last episode, our approach is an East-West approach. We have the Eastern philosophy that tells us there’s this material world that is the physical body, the mind, what we’re conscious of. Then there’s something more to us, that’s unconscious, the consciousness that holds us together, creates this experience of life, that spiritual element which is so important. If you’re talking about mind-body, you have to transcend the mind-body in something beyond it in order to work with it in an effective way. So what is pain? How would you describe physical pain, why do we have it?
Rob Maldonado 02:42
The body has this incredible mechanism to make sure we don’t damage our tissue, skin, bones, blood vessels. It’s an alarm system essentially. Whenever there’s a danger of us hurting ourselves, our hand is too close to the fire, it’s gonna get burned, it would destroy the skin, the pain sensors, receptors shoot a message to the brain and say “Pull back your arm.” A lot of it, of course, works unconsciously, automatically. We don’t have to think about it.
Debra Maldonado 03:36
It’s almost instinctual. Even as babies, no one has to tell us that fire is bad, we could feel it. It’s something that we automatically feel or we learn the hard way. Until we have an experience of it, we start pulling away. It’s a good mechanism to have, we don’t want to numb that pain receptor.
Rob Maldonado 04:01
There are children that are born without pain sensitivity, they get into trouble really quick because they start to hurt their eyes, hurt themselves because there’s no pain telling them “Don’t do that. Don’t rub your eyes hard to where you damage your eyeballs” because they can’t feel it. They just feel an itch and scratch it. But it’s not healthy. Pretty soon the children have to be restrained somehow, or some kind of apparatus has to prevent them from touching their face in a harmful way.
Debra Maldonado 04:45
If we do have pain, it’s there for a reason. But we also need to understand what it’s like to have regular pain, which is a headache, or you break your arm and have a temporary pain until they set it. You lift something, you have a little backache. You work out a little too hard and your muscles ache, you eat something wrong and your stomach aches. Those are some signals, maybe you stressed your body out too much. Those are all great indicators of “Be careful, slow down, don’t do that, adjust.” But then there’s this concept, which is turning into an epidemic and a really big issue in the world, chronic pain. 1.6 billion people on the planet experience chronic pain. Chronic pain is pain that lasts more than three months. It’s over a long period of time, it’s not just a couple days or a week, it’s ongoing.
Rob Maldonado 05:51
An incredible amount of human suffering comes from injuries, from work-related stress, from activities, sports, sports injuries.
Debra Maldonado 06:10
Autoimmune disorders, they have chronic pain, the doctors a lot of times don’t know exactly how to treat it. You see retired sports people having to deal with their lifelong punishment of their bodies, extreme intensity of an activity. It’s a big problem, but also exacerbating, all these other chronic pain situations where it’s not about an event, it’s just what is happening, maybe high-stress environment, long-term illness that doesn’t go away, you’re dealing with it. There’s biological factors, psychological factors, social factors, and spiritual factors to pain.
Rob Maldonado 07:18
Let’s start with the biological ones. Of course, we spoke about how the body has this sensory system that includes pain sensors, to give us a heads up as to when we’re about to damage our body tissue. If they’re not evenly distributed, that’s an interesting part of it, that different parts of the body have more pain receptors than others.
Debra Maldonado 07:44
I noticed that when I get my eyebrows done, it’s really bad. They say around your lips is really sensitive. Then your fingertips. But other areas of your body aren’t as sensitive, maybe there is more fat? Or just certain areas need to be more sensitive?
Rob Maldonado 08:06
It is different than the touch sensory system. Touching, for example, is not painful to us. It just feels like a little pressure. But pain receptors are distributed in a different way. The back is very sensitive. That’s why if somebody touches your back, any injury to the back persists for a long time.
Debra Maldonado 08:34
What about tickling? We get sensitive to tickling. Is that because it is very sensitive?
Rob Maldonado 08:43
Those are sense receptors, not so much pain receptors. Pain receptors are different. They’re nerve endings specialized for pain.
Debra Maldonado 08:59
Where’s the greatest concentration of that in your body?
Rob Maldonado 09:04
The back and the arms, also parts of the face, but the nose is low on the scale, it doesn’t have that many pain receptors. The thumb, they say, is probably one of the least. You can put pressure on it, it doesn’t really hurt that much. I guess because we use our hands a lot.
Debra Maldonado 09:37
The biological factors, the receptors in the body, then it feeds back to the brain. The brain interprets that sensation and decides how you should react to it.
Rob Maldonado 09:51
That’s one of the incredible things about the body that although it appears to us that we’re feeling it in the area where we feel the injury or the burn, it’s really happening in the brain. The signals have to reach the brain. Then the brain interprets that as the experience we know as pain. It feels hurtful to us. Painful burning, sharp, dull, aching, all those discomfort, that subjective experience.
Debra Maldonado 10:35
It’s different for everyone. Some people have a high tolerance and some have a low tolerance, I think you can also learn to not feel, desensitize yourself or hypersensetize yourself. That’s when we go into the psychological part of it. A lot of time pain is not actually the cause. There’s a deeper cause, the pain is the effect of some psychological and emotional event, then it shows up in the physical body as pain.
Rob Maldonado 11:17
It’s an interpretation. The brain-mind interprets that experience, those impulses coming from the body, as pain. Then it tries to determine, what is the level of pain I’m experiencing? Is it intolerable? Is it tolerable? Is it mild? What is the quality of it? Is that a sharp pain? Is it a dull pain? Is it persistent or chronic, or acute, meaning it’s going to disappear as soon as I move my hand away from the pain stimuli? Psychological factors have to do with that interpretation, the emotion and cognition around it.
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Rob Maldonado 13:11
We know if we’re depressed, we tend to experience higher levels of pain than when we’re not.
Debra Maldonado 13:21
It’s like a story we’re telling ourselves about it. The idea is that it’s not getting better, it’s getting worse.
Rob Maldonado 13:30
One of the factors we know in depression is that people feel they’re being punished for something, some guilt they have in their past.
Debra Maldonado 13:45
It’s like God or spirit has abandoned you, and you’re left here, some karma that you’re trying to pay off from this, beating yourself up for it. That makes it even worse. Or even anger at at your body. We found out when I worked with people on pain, the angrier they were about their physical condition, it made them hate their body, then the body creates more pain. It’s that feedback between the mind and the body that’s constantly communicating even on a psychological level, not just that mechanical, biological level from brain to body, but the mind itself.
Rob Maldonado 14:39
And then there are feedback loops. For example, if I experienced pain, especially chronic pain, and I’m thinking God is punishing me, or life or the universe is punishing me for something I did, that creates a feedback loop, like a circuit that keeps running automatically, so that I find it hard to break that cycle.
Debra Maldonado 15:05
Even this idea, that feedback loop of “I don’t deserve it, I’m bad because I have this”, that feeling of defeat. Because a lot of times people have chronic pain, they’ve tried so many things to deal with it. Then they get defeated, they start to believe they’ll never be out of pain. That also creates never being out of pain, they’re stuck in that loop.
Rob Maldonado 15:32
These are just small examples, because it’s a long list of emotions that play into the biopsychosocial model of pain. The social part, of course, is “Do we get secondary gains from being sick or being in pain?” Often, especially as children, we might get rewarded when we’re sick or when we’re in pain.
Debra Maldonado 16:00
When you get home from school, you get to stay home from school, Mom nurtures you, she brings you a little soup. But after school, everyone stays to play, and you can’t play because you’re sick, you took off from school. Even if you skinned your knee, Mom kisses your knee and makes it better, or gives you a little treat. We learn that when we’re in pain, we get a treat. Especially elderly people, sometimes the only time they get attention from their family is when they have a medical issue. Everyone is around them, they can rally around them. When they’re feeling better, it seems they’re not getting the attention. There’s a lot of research around creating symptoms, so that they can get attention. There’s a secondary gain. In chronic pain, people can get used to not working. Socially, economically, a lot of people who have chronic pain are on disability and can’t work. But you’re so used to getting the disability check that unconsciously you may think “If I get out of pain I’m gonna have to go and get money for myself.” This is not conscious but there could be a secondary gain from that as well. Your body and mind get into a pattern. It’s almost like the familiar is always better than something new, fear could get worse, so let me just manage my symptoms the way it is. Also socially, people with chronic pain have relationship issues. A lot of times that feeling of not fitting in with society, if they can’t work, feeling they’re not contributing or not playing, they can’t do social activities like everyone else, that can be very isolating.
Rob Maldonado 17:53
Then spiritual elements of it. Again, the sense of being punished by a supreme power, God, or the universe, or life in general, however you see life. But we also know, faith, spirituality, spiritual practices have a protective effect on chronic pain, meaning it protects the individual from those experiences. When it does happen, it helps them overcome the chronic pain.
Debra Maldonado 18:35
It can be a source. Biology can work against you or for you. Psychology can work for you or against you. Social issues can work for you or against you. Spirituality can work for you or against you. It’s based on how you explain it.
Rob Maldonado 18:56
You asked earlier about genetics. Everything has a genetic component because the body is a genetic expression essentially, everything has some genetic component to it. In research, the variance is considered high or low, some have a higher genetic component than others. Sometimes it’s broken down into percentages. But in general, everything has to have a genetic predisposition for how you’re going to react to it.
Debra Maldonado 19:32
As long as you have a body, there’s biological elements. Then we also learn from our family, how other people dealt with illness culturally — you can’t be ill, or it’s part of the culture to have suffered. Maybe a family thing that happens to everyone in the family, conditions that happened, I know a lot of people have Crohn’s and IBS, and a lot of times it’s in the family line. You feel like this is a part of our lot. Especially when it’s chronic, we feel powerless. The impact mentally on a person who suffers from chronic pain, it’s not only the pain itself and the discomfort but the mental anguish of having to deal with it. It can be depressive, some people are even suicidal from it, they can’t live with the pain. We need other ways to work. Everyone knows about the opioid crisis, “take a pill”, but it’s addictive. It’s not the safest route, just taking a pill, we have to look at the whole person.
Rob Maldonado 20:46
We mentioned in our previous podcast how modern medicine is good at treating infectious diseases and emergency traumatic situations but it’s not very good at treating lifestyle problems. Chronic pain is certainly one of the lifestyle problems, it’s about the patterns of your life, how you’ve been living your life. To make those changes, it requires some effort, it’s not going to be a one pill solution.
Debra Maldonado 21:21
What it does is just diminish the perception of pain, but it doesn’t really heal the body.
Rob Maldonado 21:31
It doesn’t get at the source of the problem. Where is this pain arising from? It’s usually a multifactorial, meaning a lot of factors are meeting in this one place. It’s expressing itself as physical pain.
Debra Maldonado 21:50
But there is a way out of pain. One of the things I discovered in my early training of pain management is that pain is an interpretation of the mind.
Rob Maldonado 22:02
That’s what saves us a lot of the times. That it is a subjective interpretation we’re making about an experience. Of course, we know it’s real, we’re not saying it’s all in your mind. Everything is in the mind essentially, everything we experience is a mental experience. But it’s very painful, it’s hurting us, it’s causing us anguish, distress, it’s demoralizing us. When we’ve experienced chronic pain, it starts to wear us down to where we start to feel hopeless, helpless.
Debra Maldonado 22:45
We don’t feel like we’re in control of our bodies anymore. And if the doctor doesn’t have the answer, it’s really defeating. This expert of the body is not able to treat us, maybe numbing the pain or coping with the pain, but a lot of times, it’s something you’re gonna have to live with. I think there is another way. There’s a way out. Even in the hospital, when we talk about perception of pain, the reason why the doctor always asks you, on a scale of 1 to 10, how painful that is, because there’s no way they can measure it. They can look at your body and assume this looks like an intense situation, it probably feels this way. But each person will label the same biological response like a nine, or a five, or a four.
Rob Maldonado 23:38
Here’s the definition of guided imagery, which is one of the approaches we recommend for chronic pain. Guided imagery is the treatment of chronic pain that aims to enhance relaxation, as well as unhooking attention from the pain and the mental elaboration about it through the use of peaceful soothing and symbolically therapeutic mental images. This part is interesting. First of all, relaxation. We know the relaxation response has an incredible beneficial effect on the mind-body, including somebody in chronic pain. It’s going to help them feel better. It’s going to release a lot of endorphins, a lot of feel good stuff in the body, they’re going to feel better. The other one is unhooking the attention from the pain. Here’s the important word, we’re hooked into that pain. We’re focused on it when we have it, the mind naturally goes there. When you have a toothache, you can’t stop thinking about it.
Debra Maldonado 25:00
You have your tongue there, touching it all the time. It’s really designed that way, the brain is saying, pay attention to this. But as we pay attention, the blood flows there, it gets more intense. My clients that I worked with on migraines, I’d always tell them, when you have a migraine, you have this big, heavy block on your head. Find a part of your body that feels calm. Most of the time I tell them to focus on your feet, imagine your feet in warm water, the blood will naturally flow to the feet. Even if you’re not in warm water, you can imagine it, it starts to pull the pressure away from the head and move it to the feet. It relieves the pain. There’s, of course, many other imagery scripts I have for that but that’s an example of how powerful it can be to be able to direct your mind. The important thing about this is that when people have chronic pain, or any kind of pain, they feel powerless, they feel they’re reacting to their body, they go to a doctor, or take aspirin, or pain medication to deal with it. But they feel like they’re a prisoner in their body. Guided imagery and these other interventions help you get back the power.
Rob Maldonado 26:26
The third one is symbolically therapeutic mental images. Here we can make a connection to the spirituality that we’re talking about. Because the mental images, almost like Jung talks about these numinous images that appear through dreams and visions, when a person is able to observe them through guided imagery, either somebody else guiding them or themselves practicing a guided meditation. They’re able to hold their mind on these important numinous images within the mind. They have a powerful transformative effect that plays into the healing system within the body.
Debra Maldonado 27:19
The power of faith, when my dad was going through chemo, I told him to imagine the white light. He’s Catholic, so I told him to imagine Jesus here with you, he’s putting his beautiful golden healing light in you, his healing powers go through your body, dissolving it of all the cancer. He used visualization, and that spiritual power, I really do believe, has such an impact, medicine doesn’t talk about it enough. But the belief and faith in something bigger than you is really mind-blowing, how it can impact a person’s state of mind. Then there’s comfort in knowing they’re not alone, that feeling of connectedness to something greater, that spiritual nature.
Rob Maldonado 28:12
The other one I wanted to mention is biofeedback. Here we see the power of understanding the connection between the mind and the body, meaning that your thoughts, and not only the conscious thoughts, but your mind’s ability to observe, and the reaction in the body is one, it’s connected. We think our mind and thoughts are separate from our body. They’re not. Biofeedback’s been around for a long time, since the 70s. It’s still around and being researched and developed. Essentially, what it is, is that we use technology and external apparatus of some kind to give us feedback on our bodily function. Here’s a simplified example. Let’s say I want to reduce the blood flow because blood flow is connected to inflammation. I injured my thumb, it’s swollen, how it swells up when you spray part of your body. There’s more blood flow going to that area and causing the inflammation. Let’s say I want to reduce that inflammation. I might wrap a little sensor around it that measures the blood flow, how much blood that area on my body is receiving. There’s a little screen that shows me the numbers associated with blood flow, let’s say from 1 to 10. I wrap it around my thumb and observe the needle, it says 10. There’s a lot of flow going into that area, and rightly so, the body’s trying to heal itself. But I want to reduce it because I know if I can reduce the blood flow, it will reduce the swelling, it will reduce the pain sensation I’m feeling. Now all I have to do through biofeedback is observe the needle. I don’t even have to understand how I’m doing it or how my body is doing it. As soon as I start to see the needle go down a little bit, my mind-body is learning, whatever it did, whatever drives it, there was a correlation, the needle went down. Consciously I’m not even aware of what I did in my body, or what my mind-body did. We’re just focusing on the screen, whatever moved the needle in the right direction, it keeps on doing it. Sure enough, the needle starts to go down to five, to two, to one. Your thumb got better, pain leaves, inflammation went down. This mechanism, of course, works in many different ways. But the basic idea is that your mind-body, just by observing what is the correlation between what the mind-body is doing and an external measure, allows your body to learn how to do it, how to reduce that pain.
Debra Maldonado 32:11
It’s like the observer mechanism, when you observe and become aware that you can actually activate some deeper intelligence. But if you’re just unconscious, just reacting to pain, not consciously observing in this way, where you’re looking at the number and you’re distracted a little bit.
Rob Maldonado 32:34
It’s an incredible, nobody really understands it completely. But the mechanism is experimentally verifiable. It works most of the time it’s applied, if it’s applied in the right way.
Debra Maldonado 32:52
We have so many tools our mind can provide that can help us with this, because modern medicine is pretty new. What did the ancients do with pain before? There must have been mechanisms. Even childbirth, we’ve been giving birth to babies for thousands, millions of years. How did they deal with it without pain? I did a lot of childbirth hypnosis when I was young and starting out. One of the things they taught us is that when you go into a hospital, psychologically, your mind goes into this place of sick people. There’s a lot of stress and tension, all these machines. We didn’t have all that when we were natural humans, it was just part of life. I wonder, if we could measure and talk to someone from a million years ago who had birth, what their perception of pain was versus someone who’s having a modern birth today. We have all these interventions that interfere with the natural birth process and actually make birth harder.
Rob Maldonado 34:12
It gets to that idea that pain is not bad. It’s simply saying “Pay attention.” If we’re willing to pay attention, we’ll be okay. Most of the time, we’ll be fine. We’ll find the way. It’s when we ignore it, or cover it up with medication, then we’re increasing the likelihood of us getting into trouble because we’re not paying attention to what the mind-body is telling us to pay attention to.
Debra Maldonado 34:41
I think what I’d love to leave everyone with today is this idea that within your own body-mind, within your unconsciousness, personal consciousness, there is the answer to alleviate your pain, and you have to find that answer. There’s going to be trial and error. But try these alternative techniques of guided imagery, hypnosis, yoga, biofeedback, relaxation. Be open to this idea that you will find the answer, that this is not a life sentence for you. Trust in your deep intelligence self, the answer’s within you. If you don’t approach it that way, if you have a defeatist attitude where it’s never going to change, it’s going to be hard to even receive it. But try, even if it’s 1%, have a little bit of faith in your own divine intelligence to find the answer. Maybe it’s by accident running into someone who has a technique that works, or it’s a friend of yours who says “I tried this.” Just try and be open to things working. You finding the solution is the most important thing.
Rob Maldonado 36:06
Would you like to give us a little hint on how to work with headaches?
Debra Maldonado 36:12
I did talk about moving your attention to your feet, but I’ll give you another one, which might be nice. One of the greatest things about guided imagery is that you actually can leave your body. Mentally, you get a little distance from your body. You can do a deep, head to toe relaxation, just picture yourself in a beautiful place. A place that makes you feel happy, because that’s also very important for healing, a calm, happy, beautiful place. Imagine that place has a healing pool, if you’re afraid of wild things, it can be a regular, spa pool, but if you like nature, maybe it’s a watering hole. The water is whatever temperature you want it to be, either really cool, or really warm. You sit in this, imagine it’s your healing bath. If you have a headache, and you’re sitting with your head outside of the water, and the rest of the bath is heat, it will pull all that energy from your head, imagine the cool air around your head. You can really just experience that healing. This is also great for chronic pain. If you have a pain in your body, imagine being in that really deep, amazing bath. When we were in Jordan, we went into the Dead Sea. It’s very salty and heavy, you can float in it. If you want it to be that salty, nutrition-filled healing back, you can create the states. You’ll find that your mind takes its attention off the physical body. There’s this mind-body, this etheric body, an image of your body that you’re actually working with and giving yourself a little space. It’s profoundly healing to do that type of work. It doesn’t have any side effects, which is the best part. Wonderful to share all this information. We hope you got something out of this today. Or you have a friend suffering from chronic pain, maybe have them listen to this episode. Be open to something changing, be open to a miracle in your life and trust that deep within you there is powerful intelligence that wants you to be healthy, wants you to have returned back to perfect health. Hope you have a great rest of your week. We will see you next week on Soul Sessions.
Rob Maldonado 38:58
Thanks for watching. See you soon.
Debra Maldonado 39:00