Have you ever experienced pain? The obvious answer to this question is yes. We have all experienced pain at some point in our lives. Some of us may even be in pain as we read this. Do we understand pain though and what it is really? The current definition set out by the International Association for the Study of Pain (IASP) is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

What may be surprising to see in this definition is that pain is associated with “actual” or “potential” damage, meaning that pain may occur without any damage at all. Pain is therefore associated with threat and not necessarily damage, which has or has not taken place. If you think about it, this actually makes pretty good sense. It’s a protective, self-preservation system designed to get you to change what you’re doing to avoid harming yourself. It would be a pretty terrible protection system if it only ever told you when something had actually broken.

The next thing to notice is that it is “sensory and emotional”. They have not separated the two because you are not a mind and a body separately. You are a beautifully complete and complex human being who has a mind and body which function together. Physical pain is real and by virtue of it being unpleasant, it is an emotional experience. Emotional pain is real and if you’ve ever felt anxiety, stress or heartbreak you can probably agree that these emotions can be felt very physically. It is therefore impossible and possibly even misguided to try to separate them from each other.

So if pain is physical and emotional, and doesn’t only happen when something is actually damaged, then we really should start looking a little bit further away from your hand, foot or chest to find its source. This is where things get really interesting… The way I understood pain based on my childhood was that the brain just received the pain and I then felt sore. This makes no sense then for someone who has phantom limb pain in an amputated foot (which is clearly no longer on the end of their leg). How are they experiencing pain in something that is not there? It simply doesn’t make sense unless you change your understanding and learn more about how pain is created. These people are absolutely not crazy. They are not faking it and they are not imagining it. The brain receives information, this is true, but how it processes this information is what will influence whether or not it generates pain. It is not a one-way system, it is vastly more complex than that

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