“Pain is physical, suffering is mental. Suffering is due entirely to clinging or resisting. It is a sign of our unwillingness to move, to flow with life. Although all life has pain, a wise life is free of suffering. A wise person is friendly with the inevitable and does not suffer. Pain they know but it does not break them. If they can they do what is possible to restore balance. If not, they let things take their course.” ~ Nisargadatta

In a recent post the Buddhist principle of “real but not true” as well as the idea of Satva (seeking of truth) was discussed. This installment will look at these two principles weaved into understanding physical pain as well a way toward releasing the suffering it holds.

The Satva of pain from the biological level
(as true as the most recent evidence demonstrates and my brain comprehends)
The human body and brain are directly connected through the nervous system. Containing 400 different nerves that if stretched end to end would extend 45 miles. These nerves sit at a resting level of excitement, ready at every moment to communicate necessary information from the peripheral system (body) to the central system (brain). Each nerve contains a series of receptor sites. These sites are specifically sensitive to change in the internal environment, such as mechanical, chemical and temperature. To the surprise of many, no nerve in the body or brain contain receptors specific for pain. Instead the nerves are armed with something called Nociceptors. Directly translated these are danger receptors. Nociceptors will fire along with the other receptors, if any of the changes detected are great enough for the body to perceive a potential of harm. The nerves will send the messages of sensation to the brain via the spinal cord. Along the way and ultimately in the brain these nerve messages are received and interpreted by a series of complex events, involving multiple cortical regions. The brain will determine if said event is indeed dangerous. The sum of these events can be thought of like a fire-work. The initial ignition of one area can send an array of embers to light other specific areas. The end result is known as a neuromatrix or neurotag  that will be unique for this particular experience. If the brain believes this neurotag does indeed represent imminent danger than a painful experience will be expressed. The brain will command the body to take action. For example, remove that splinter from your finger before it becomes infected. If the brain decides this is not a place that requires action, pain will not be produced. This might appear confusing. It is no different than the process used by all of our senses. You do not have vision receptors in your eyes. You have light receptors. What you see is a product of a neuromatrix in the brain. It is the brain that produces the visual experience not the eyes. It is the brain that produces pain not the finger. Evidence has shown that nociception is neither required nor enough for pain to occur. Neurotags can become part of our deepest memory system. When they are practiced or repeated they become easier and easier to access.

Evidence has shown us the longer pain is present (the more chronic or persistent) the less it accurately represents what is occurring at the level of the body. It is possible this particular neuromatrix has gotten stuck on repeat. This challenges the common belief that something is still wrong with the finger. The very good news is we are not our neurotags. Our brain and nervous system are plastic. Even the best-practiced pattern can be shifted with gentle attention and awareness.

Real but not true:
Let’s look at a simplified example of a runner with knee pain. He has seen doctors and therapists. X-ray and MRI were performed. He has been assured his knee is not structurally compromised. Yet, every time he runs he suffers from pain in his knee. This has led him to stop running mostly out of fear that he is damaging himself. The pain – real. Damage, disease, danger, need to protect – not true.
To be honest it is often not this simple or clear cut. MRIs and x-rays may show changes. A traumatic accident may have occurred that resulted in an injury. But, injuries heal. If pain stays past the typical healing time frame or is greater than expected for the issue seen in the tissue, than it can be safe to assume, at least in part, an element of “real but not true” is present. This scenario just takes more practice but a shift is absolutely possible.

Putting it to practice:
Bring to mind a fairly simple reproducible pain you experience. Think about the other sensory stimuli that may come along with it. Change in breathing, heart rate, movement, muscle tension, thought pattern, emotion.

Take a comfortable seat. Maybe close your eyes. Place one hand on your belly and one hand on your heart. Begin to deepen your breath.

Let yourself slowly begin to imagine a movement, activity or position that can be painful. You might start to actually feel a bit of familiar pain. Let your awareness lean into the other sensory experiences.

Can you place your attention on softening the reactions around the painful experience? Keep the breath even, slow and full. Allow the heart rate to settle. Encourage the muscles to relax. Imagine the movements as fluid and efficient.

As the fears and catastrophic thoughts begin to creep in choose not to engage. Acknowledge they are there – they are based on a real feeling – but begin to find the holes present in the truth behind them. Temper the physical and emotional reactivity to the painful experience. Repeat this visualized practice until you feel you are ready to take these same techniques into the performance of the historically painful activity.


Butler & Moseley Explain Pain

Louw & Puentedura Therapeutic Neuroscience Education