The psychology of pain: Is it all in your head?

When you’re a child, you’re asked to point to a series of frowning faces to rate your pain. As an adult, you rate your pain on a scale of 1 to 10. The truth is, pain is subjective. But is pain real, or is it all just in your head?

In reality, pain is all in your head—but by no means are you making it up. One of the most damaging preconceptions in our culture is that pain must not be real. It’s as real as stubbing your toe or falling off a cliff.

Let’s dive into the psychology of pain so we can understand it a little better.

Pain is both physical and psychological

When you stub your toe, for example, your body will generate an automatic response, stimulating pain receptors at the source of the injury. Neurotransmitters send messages along your spinal cord and up to your brain, saying, “Ouch! That hurts!”

Pain, therefore, really is in your head. Or rather, your brain.

Understanding chronic pain

But chronic pain is more than the pain experience of simply stubbing your toe. It’s often wrapped up with emotions, anxiety or depression, which can exacerbate the pain experience.

Your thoughts, emotions, predispositions and opinions can influence and worsen your pain. A health psychologist can help you work through your thoughts and feelings to help manage your pain.

A lot of people are very nervous when their doctor suggests that they see a psychologist or mental health expert to help manage their chronic pain. They think, “My God, my doctor thinks I’m crazy.”

But please hear this—chronic pain doesn’t mean you’re crazy. It means that there’s a psychological component to pain that sometimes we don’t think about. Addressing the psychology of pain can do a lot to help you manage your pain.

How cognitive behavioral therapy (CBT) can help

With cognitive behavioral therapy, we help you realize that stress and your mental state contribute to your pain experience.

Working with a psychologist can:

• Help you understand that your pain shouldn’t control you
• Help you understand that your pain doesn’t have to go away before your life can continue
• Teach you relaxation and distractive techniques
• Guide you in changing your thoughts in order to change your emotions in order to change your pain experience
• Train you to challenge your thought distortions to change your thought patterns, perspective, emotions and pain experience

Ongoing pain management

We can’t make any promises about making the pain go away. The focus is on management. We can help you find ways to go on with your life without the pain impacting how much you can function or enjoy your life—that’s when the pain leads to suffering.

What I try to do is help you get out of that. The pain may still be there, but the suffering doesn’t have to be.

Need helping coping with chronic pain? Find care near you.