How Do You Retrain Your Nervous System When Pain Has Become Automatic?

What understanding pain, a dog on a lead and a Formula 1 car can teach us about changing established responses.

You can understand everything there is to know about your condition, read all the books about pain and the nervous system, and still experience exactly the same difficulties.

Because information doesn't necessarily change how we experience something.

We can understand why pain occurs, what the nervous system does and how the brain processes information. But knowing all of that doesn't automatically change what our nervous system has learned to do. Particularly when those processes have become so efficient that we're no longer consciously aware of them. And that's where the actual work begins.

The difference between understanding something and changing it

In an earlier episode of Shift the Field, I talked about the two floors: what we consciously understand and what happens automatically, often without our awareness.

We can consciously recognise that a particular movement is safe, for example, yet still experience hesitation, tension or an immediate protective response when we attempt it.

The body may begin preparing for something unpleasant before we've even consciously considered what's happening.

These are felt, experienced states. We don't necessarily change them by acquiring more information.

A different interpretation may help. Reassurance may help. But the automatic response itself may still be operating.

The nervous system is constantly processing information about our internal and external environment, drawing on previous experiences and anticipating what may happen next.

And much of that happens before we have the opportunity to consciously intervene.

Think about how many things you do every day without having to work out every individual movement.

Walking, reaching, maintaining balance, adjusting your posture.

The nervous system has become extraordinarily efficient at coordinating these activities.

But efficiency isn't always helpful.

A protective response that was useful in one situation may become repeatedly activated in circumstances where that degree of protection is no longer necessary.

And the more familiar a response becomes, the less conscious attention it may require.

What an F1 car can teach us about efficiency

Think about a Formula One Car.

You can change the tyres, the oil and its' components but if you miss running the diagnostics you may miss the faulty sensor that explains why the car won't accelerate and why the brakes don't work. It's the difference between looking simply at the external parts hoping that explains everything whilst missing what's actually going on within the system. The former won't change what is only accounted for by the latter.

The same is true of the body. We keep expecting everything externally to make sense by what we can see on a scan, assess movement , treat the tissue and improve how the body moves but the way the body feels is where real change lies. That can be shown temporarily in treatment but it won't permanently override what's running it underneath; unconscious automated responses we perform without thinking because those responses have become learned, efficient, repeated time and time again until they are automated. To retrain those we must first become aware of them and then consciously override them with repitition so the original response becomes less and less efficient.

The dog who won't stop pulling on the lead

Imagine you've got a dog who pulls.

He wants to get to the sounds, the sights, the smells and all the exciting things happening around him.

And as far as he's concerned, pulling is the most efficient way of getting there.

You can tell him to stop pulling, but that won't make him stop.

So you tighten the lead and he pulls harder.

Now you're both pulling against one another, rather like stretching a tight elastic band.

The dog wants to go forwards. You pull backwards. He resists.

When we're experiencing pain, continually fighting against the experience can sometimes create a similar struggle.

But what happens if we train the dog differently?

Rather than pulling back, you change direction completely.

You turn him around and then begin walking forwards again.

And he's probably thinking, why is she turning me around all the time? This is so annoying.

So he pulls again.

And you repeat it.

Eventually the dog begins to realise that pulling is thoroughly inefficient.

He's actually getting where he wants to go more slowly.

The more he pulls, the more arduous and inconvenient the journey becomes.

Whereas walking without pulling gets him there much more easily.

We've changed his experience.

The response that was previously so efficient has become less useful, while the alternative has become more rewarding.

And through repetition, he begins learning something different.

The point isn't that the nervous system learns exactly like a dog.

It's that we haven't simply instructed the dog to behave differently. We've changed the conditions through which he learns.

What happens when protective responses become automatic?

When you've experienced persistent pain, your nervous system may become increasingly sensitive to certain movements, sensations or situations.

You might begin bracing before bending forwards, hesitating before getting out of a chair or anticipating discomfort before an activity you've previously found painful.

Some of these responses may happen before you've consciously recognised them.

And they're not necessarily deliberate.

The nervous system is continuously evaluating information, including previous experiences, physical demands and potential threats.

It doesn't wait for us to finish thinking before it begins responding.

And if certain protective responses have become familiar, they may be activated very efficiently.

This is where the motorway analogy becomes useful.

Imagine travelling the same route thousands of times.

Eventually, you barely have to think about where you're going.

You know the turns, the exits and the quickest way to get there.

Now imagine establishing another route.

Initially, it requires attention. It's unfamiliar. You have to think about where you're going.

And the original motorway is still there.

But as the alternative becomes more familiar, it can become easier to access.

When we're retraining automatic protective responses, we're working towards something similar.

We're not trying to erase every protective mechanism. We need those mechanisms.

We're trying to help the nervous system become more flexible and better able to distinguish when protection is necessary and when a different response is appropriate.

Because a nervous system that responds to everything as though it requires the same degree of protection isn't necessarily serving us particularly well.

It's not simply about changing how you respond to pain

We often hear advice about changing our relationship with pain, thinking differently about it or responding more calmly.

Those things may be useful, but they're only part of the picture. That's too simplistic.

What about the response that's already happened before you've consciously thought about it?

The muscles that have already tightened.

The movement you've already hesitated over.

The expectation that's already influenced what you're about to do.

What about the deeply familiar internal narrative that immediately tells you what you won't be able to manage?

These aren't always responses we consciously choose.

And if we're going to retrain them, we have to do more than decide to behave differently.

We need to recognise what's happening and begin introducing different experiences, repeatedly, so that those established protective responses are no longer the only efficient option available.

This doesn't mean forcing yourself through pain or ignoring what your body is telling you.

It means developing greater flexibility in how the nervous system responds, while respecting the physical condition and the body's actual capacity.

How a few seconds in the morning can influence the day

Imagine waking up and immediately feeling the pain.

And you're like, I won't swear, but essentially, crap.

Here we go again.

What am I supposed to do now?

And suddenly your entire day floods into your mind.

Well, I won't be able to do that.

And there goes that thing I had planned.

That millisecond of experience has started deciding the entire day for you, because that has been your experience before.

Now, I absolutely love my first cup of coffee.

I'm a bit like Goosy Lucy, my female runner duck, who behaves as though she's never seen peas in her life, even though she's had them a thousand times.

She squeals with excitement every time. It's the cutest thing.

I'm like that about coffee.

So when I wake up, I'm thinking about that first cup.

And whatever it is for you, it can be useful to introduce something you actually want to do into that first experience of the morning.

Perhaps you have dogs to feed. Perhaps you want your coffee.

You may still need to take your time getting up.

But as you begin doing something you want to do, you're creating movement and giving your attention somewhere else to go.

It's remarkable how the desire to do something can interrupt, even momentarily, how we feel about ourselves and what we believe we'll be able to manage.

We're beginning to change the familiar sequence that can develop around the experience of pain.

And it's something we can practise repeatedly.

Why pain returning after treatment doesn't mean you're back at square one

This is something I see frequently in clinic.

Someone has treatment and feels considerably better.

Suddenly their whole mind opens up.

Perhaps they could go back to the gym, take a longer walk or do something they haven't managed for quite some time.

And then the pain returns.

Immediately, it's here we go again.

I'm right back at square one.

That must be difficult, particularly when you've experienced such an improvement.

Because you've now experienced feeling better. But this matters because it shows what is possible.

But physical loading, inflammation or other factors often need further attention or treatment, especially when the condition has been long standing.

But we can also consider what happens within the internal system when symptoms return.

How quickly do we begin anticipating the worst? Because that is such a natural response.

What happens to our movement?

Are we immediately restricting activities we had begun feeling more confident about?

And are some of those protective responses happening automatically?

We can't always control whether symptoms return.

But we can begin learning how to work with the responses that develop around them, including the ones we haven't consciously chosen.

After fourteen years of treating people in clinic, I've become increasingly interested in what happens between treatments.

Because treatment can make an enormous difference. I see that regularly through acupuncture, auricular needling and manual therapy.

But what happens when somebody goes home and the symptoms return?

What can they actually do?

And how do we help somebody move beyond understanding their condition towards influencing the internal processes that may be contributing to their experience?

That's why I developed Shift the Field.

It's a practical method for recognising and working with those established internal responses, including the automatic processes that operate beyond conscious awareness.

It's to begin changing the experiences through which the nervous system learns, so that familiar protective responses don't remain the only route available.

Because treatment is only half the story.

And what happens between treatments deserves just as much attention.

AMDtherapie | Chronic Pain Treatment & Shift the Field

Explore the Shift the Field method at AMDtherapie.com.