Dr. Kate Truitt & Associates

Related Resources

For Thriving Through Pain

Tools for Stress & Pain Relief: Self-Havening and CPR for the Amygdala

In this video, Dr. Kate shares a personal experience regarding an injury she experienced that is in line with her journey of chronic pain. She explains how this experience was quite insightful for her, and was a perfect example of the concepts she intends to discuss. For example, she notices a clash between self-care and obligations/desires, which leads her to conclude that it is important to notice when it’s your body that’s getting in the way. An instructional video on CPR for the Amygdala may be found at this link.  Other concepts she introduces are where the pain “lies,” either on top of you or below you, the idea of a “steel blanket” weighing you down, and how “mind over matter” means that your amygdala plays a key role in the suffering you experience.

Living With the Pain and the Stories We Tell: Why We Fear Pain and More

Have you ever noticed a sensation of pain or tingling when you recall an injury of the past? This is “Amy,” the amygdala, reacting to even the memory of a threat. In this video, Dr. Kate explains to you why this function exists in our brain, how pain and trauma are related, and why this is important for the healing process.

You may find that your experience of pain is associated with a symbol, anchor, or sensation. If this is the case, you can use that symbol as an anchor to treat your pain. In this sense, the way that pain and trauma are connected allows you to treat your pain the same way you treat trauma, using that anchor as a guide. Find out more by watching the video above.

Self-Havening Meditation to Reduce Tension, Ease Pain, & Create Safety

Counterintuitively, by leaning into your body’s experience of pain, you can reduce painful sensations by signaling to our body that you are safe. In this guided meditation, Dr. Kate will lead you through a series of steps to help you do that in a calm, stress-free manner. Join Dr. Kate as you envision a safe place that is all your own. Using self-havening touch, your senses, and the imagination, Dr. Kate will help you find your way to a state of comfort and relaxation in this meditation. 

Havening Guided Color & Breath Exercise for Reducing Stress and Enhancing Calm

This is a guided meditation for expanding your mind and body’s ability to be in a healthy relationship with both positive and difficult experiences. In this exercise, Dr. Kate utilizes a tool called “Breath Color Titration,” which capitalizes on the brain and body’s willingness to intentionally move among different feelings in order to progress toward a state of being that we would like to experience more often. She invites you to scan your entire body for feelings of stress, tension, worry, or concern. Instead of ignoring or fighting these feelings, she encourages you to welcome them in as helpful information that you can bring to the forefront of your attention. After realizing that this data can be helpful to you, she asks you to extend gratitude towards your mind and body for making you aware of it.

Guided Practice for Cultivating Self-Care & Resilience with Rebecca Turner, LMFT

This practice is based on the Creating Possibilities Protocol and takes advantage of neuroplasticity to support creating and strengthening new neural pathways to help you build the brain you want to navigate the world with. Use this practice after CPR for the Amygdala or the Guided Practice to increase calm and reduce tension to plant and grow the seeds of resilience.

Thriving Through Pain

By Dr. Kate Truitt

Do you have chronic pain? If so, you are not alone: One in five people live with chronic pain. Medical trauma and chronic pain have consistently been all too common for many people around the world but never more so than now in the wake of COVID-19.

The experiences of physical pain and psychological trauma go hand-in-hand. In order to create empowered change and self-awareness around chronic pain, we need to explore the connection between the mind and body. In this connection there is a powerful opportunity to use some of the same “healing in your hands” tools we use for the mind to ensure these physical pain experiences don’t become long lasting.

Mind-Body Connection: Experiences of Emotional and Physical Pain

Let’s take a moment to look at the similarities between physical and emotional pain. When you find yourself in a moment of nervousness or anxiety, do you ever notice that you feel a certain sensation in your body?  The reason there are similar sensations in response to pain, whether it be physical or emotional, is because the same areas of the brain are involved in processing those experiences.

This may seem obvious when it comes to emotional pain, like that of a broken heart, but the same is also true with physical pain. Don’t believe it? If true, then we ought to be able to take a couple of Tylenol to help ease our heartache, right? It seems we can. One study found that acetaminophen, the active ingredient in Tylenol, can be effective in both headache and heartache, pointing out the connection between the emotional pain of social rejection and physical pain. (DeWall, et. al, 2010).

DeWall et al. gave half the participants in their study doses of acetaminophen and the other half a placebo. They found that among those who received the acetaminophen, the daily doses reduced the pain of social rejection. Then they did another experiment, in which they performed functional magnetic resonance imaging (fMRI) on the subjects. In this second study they found that, “acetaminophen reduced neural responses to social rejection in brain regions previously associated with distress caused by social pain and the affective component of physical pain (dorsal anterior cingulate cortex, anterior insula).” 

The Connection Is More Real Than You Might Think

Notice the mention of our friend the insula, connected to the vagus nerve—the true mind-body connection. The insula is a lobe deep inside our emotional, mammalian brain, and it connects our minds to our bodies. Neurofeedback authority Sebern Fisher (2014) explained its function well: “The insular cortex, among its many functions, serves interoception, the perception of information that arises from the interior of the body and contributes to the felt sense of being. It functions as well to inhibit the firing of the amygdala.”

The vagus nerve (see the diagram) is a major connection between the mind and the body. Running from the brainstem through the thorax and into the abdomen, the vagus nerve provides two-way communication between the brain and the gastrointestinal system—forming the “brain-gut axis” of our bodies. The main function of the vagus nerve is to transmit information to the brain from our organs, including the heart, lungs, liver and those of the gut. (Breit, Kupferberg, Rogler, & Hasler, 2018).

That’s how real the connection is in our brains between emotional and physical pain. It’s very easy to set aside medical trauma as a non-entity in these experiences. This is especially important in this age of navigating the coronavirus pandemic and with so many people experiencing post-COVID syndrome, where they have survived the initial infection but are now experiencing long-term respiratory issues, autoimmune system effects, and problems with brain functioning. All these medical experiences are also representative of traumatic pain.

When we step back and take a look at a traumatic encoding being part of our developmental neurological experience, we can see why physical pain, which can ultimately result in chronic pain, can easily be a component in developmental trauma. As we know, developmental trauma, PTSD, panic, and anxiety are just experiences of your brain and our body doing the best they can to keep us safe in the moment.

The Conflict Between Pain and Self

As humans we are taught to hide pain because we believe it makes us vulnerable. This goes far back in time to our early human development. If we go back to the caves or the savanna, showing weakness could be deadly, because in tough times those who showed weakness and vulnerability were often left behind to fend for themselves for the greater survival of the community.

This creates a conflict between how we are supposed to present ourselves to the outside world and how we are actually feeling on the inside. Our emotions and physical sensations are connected intrinsically, and our brains are programmed to feel vulnerable and weak when we feel pain.

If you ever find yourself in those situations where you feel weak, scared, anxious and vulnerable, you need to check in and acknowledge this connection. The difficulty comes in when our friend Amy the Amygdala starts telling scary stories about our safety, creating narratives about the world around us and our interaction with it.

According to the widely researched and accepted Fear Avoidance Model of Pain, illustrated below, the #1 thing that shifts us from being in acute pain to chronic, or traumatic, pain is an experience of fear, and this is the territory of Amy. She can start to impact our confidence and our even our sense of capacity to tackle the daily experiences of life—our ability to just get things done. Exposure to these emotions for long periods of time can lead to feelings of depression, anxiety, and hopelessness.

UnDerstanding How Our Brains Look at Pain

How does the brain make sense of pain? In both emotional and physical pain, our brain sends us an alert that it has received a stimulus telling it something is wrong in our system—it could be a broken bone, a car accident, an illness. The initial experience is simple: You cut your finger, and you immediately experience pain. In the longer term, the cut starts to heal, you may feel a little itching as it heals, but then the pain dissipates.

Sometimes though, the pain and illness stay with us or they recur. Why does pain sometimes not just dissipate once the wound has healed or the illness passes?

If you have ever had a broken bone and you reflect on the experience of having broken it, you may notice a little twinge, also known as a phantom, of the pain you once experienced in that area where the bone was broken. If you think about the pain you felt during a migraine, you might get a little twinge of pain in your forehead. That is your amygdala tuning into anything she might perceive as a threat and reacting to it. Amy records and remembers sensations tied to difficult moments in our life.

The Fear Avoidance Model of Pain

To understand how acute musculoskeletal pain can develop into chronic pain, I would like to introduce you to the Fear Avoidance Model of Pain (Lethem, Slade, Troup, & Bentley, 1983). This is a well-researched paradigm that explains the critical role fear plays in prolonging our relationship with pain. The model’s central concept is fear of pain, and the two extremes of how people might respond to that fear are “avoidance” and “confrontation,” as shown in the figure below.

As you can see in the figure, avoidance is not the path we want to be on. What happens on that path is that our brain starts to tell us stories around the wound we have experienced. We call this “brain catastrophizing,” which in its most basic form is guarding behavior to protect our body, like holding your former broken arm into your side so it doesn’t get hurt again, or hunching over to protect your stomach from pain.

As this progresses, our brain, with a little help from our friend Amy the Amygdala, starts to put on what I call “pain glasses” that keep us from participating in our lives as we normally would so we can create a felt sense of safety in the guarding behavior. The problem is that this begins to cultivate deeper pain-related fear as more and more pain stimuli get tapped and brought into the narrative of the pain catastrophe.

One example of this is having a migraine and remembering how bad the pain felt when you had to look at a computer screen during the migraine, and then starting to avoid computer screens out of fear of creating that level of pain again. In this example the brain is taking the pain narrative a step further by bringing in external stimuli that were not related to initiating the original pain experience, and creating generalized avoidance, making the pain narrative deeper and more complex, and leading to avoidant hypervigilance.

This all puts Amy on constant alert, hypothesizing and sowing stories of fear to guide us into a narrower and narrower set of choices about what is safe to do in our day-to-day lives. Although this may make us feel “safer,” it often leads to disuse, disability, depression, and even panic about the possibility of going out and living our lives, lest we be exposed to something that could cause us greater pain. But the opportunity is that, although Amy can be a fear and pain junkie, we also have tools that can put us on that “confrontation” path toward recovery and healing.

Putting Pain Into Perspective

If you have physical pain symptoms like migraines, or back pain, or those of post-COVID syndrome as I mentioned above—whatever your pain story—I would like to invite you to do some journaling. First, identify whether there is fear tied into your pain story. If there is, this is traumatic pain. Your brain is holding a trauma story tied into the physical experience of fear. This is not a good situation to be in, but it gives you an opportunity for self-healing.

This is crucial to remember when you are living through ongoing experiences of pain. Acknowledging this connection can help you overcome the stories your amygdala might be telling you about yourself and the world around you.

Again, pain and trauma go hand in hand. The opportunity here is that we can use many of the same tools we use to treat trauma to also work on physical pain. Our goal is to create a new pattern of pain and healing, which includes:

  • Recognizing that an injury happened without getting stuck in the spiral of pain stories and catastrophizing and false narratives around the injury.
  • Realizing that after a pain experience there will be times when things flare up again. Tell Amy you love her for alerting you to the stimulus but let her know you are going to confront it without living in fear.
  • Practicing brain care exercises, like CPR for the Amygdala, The Water Fountain of Healing, and other exercises in the sidebar to this article to create a relaxed calm, rather than guarding against the pain experience.
  • Keeping the focus on healing and release and stepping into recovery.

In the sidebar to this article, I have chosen several videos from the 19-part series on our YouTube channel titled, “Thriving Through Pain.” If you are suffering from chronic pain, I invite you to try some of these meditations and exercises. If you find them helpful, please visit the entire series by clicking here.

References

DeWall, C. N., MacDonald, G. Webster, G.D., Masten, C. L.. Baumeister, R. F. Powell, C. …Eisenberger, N. I. (2010). Acetaminophen reduces social pain: Behavioral and neural evidence. Psychol Sci  2010 (7):931-7. doi: 10.1177/0956797610374741. Epub 2010 Jun 14. PMID: 20548058.

Fisher, S. F. (2014) Neurofeedback in the treatment of developmental trauma: Calming the fear-driven brain. New York: W.W. Norton. https://doi.org/10.1080/14746700.2015.1082869

Lethem J, Slade PD, Troup JDG, Bentley G. (1983). Outline of fear-avoidance model of exaggerated pain perceptions. Behav Res Ther. (21):401-408).