Your Brain Is as Powerful as Morphine for Relieving PainI have practiced hot yoga for about two decades.

A class is in a room heated to above 90 degrees with somewhere around 40 to 60 percent humidity. I went to a class today and it got to 100 degress with 61 percent humidity. It was extra humid because it was raining outside. The actual temperature depends on the studio and the weather. If it’s raining, it can get pretty steamy! Even on days when it’s not raining, it can be insanely hot and muggy.

As far as I’m concerned, the more heat and humidity, the better.

I remember a time when the yoga teacher was prepping a first-timer before entering the heated room. He instructed her repeatedly to not leave the room during class. She replied “It’s OK.  I’ve given birth twice.” With that attitude, I knew that she’d be fine — because the practice is as much of a mental challenge, if not more so, than a physical one.

In fact, that’s probably why I like it so much.

The real challenge a person faces in a hot yoga class is not contorting and twisting their body in extreme heat. It’s in accepting the adverse conditions, the heat and humidity, and even learning to use it to their benefit. I know from experience that to struggle against the conditions and focus on my discomfort only makes my experience more difficult. I’ve done it more times than I care to admit.

Learning to accept being uncomfortable in the hot room is great practice for life outside of the room I’ve found.

Acupunture has similar lessons to teach us.

I used to also do acupuncture frequently to aid in my recovery from a brain injury. (It worked. Read more here.) I quickly figured out that, once the needles were inserted, I couldn’t feel them — unless I moved. When I moved, I would feel something similar to small electrical shocks where the needles were inserted. So, I learned to do a pretty good impersonation of a statue while lying on the acupuncture table for about an hour.  Even if my nose itched like crazy or my butt fell asleep, I resisted the urge to move and tried to experience the feeling literally for what it was: a physical sensation — nothing more, nothing less.

It was my brain’s interpretation of that sensation that defined it as an itch or uncomfortable. It’s interesting to explore an itch without automatically, unconsciously just scratching it. What if my brain doesn’t define it as something that needs to be scratched? It becomes just a physical experience.

The same mindset applies to hot yoga — and any physical or mental experience. It’s my brain’s interpretation of the conditions that dictate my experience of them. Because of that, a hot yoga class, an acupuncture treatment — or anything for that matter — is a learning exploratory experience that you can influence with your mind.

Pain Is in Your Brain 

In these examples, I’m using my mind to consciouslty interpret physical sensations and influence my body. You also do this every day too — whether you are conscious of it or not. To mindfully alter the way in which physical sensations are perceived by the mind in this way is proving highly successful in management of pain. Pain literally occurs in your brain,  and you have the power to increase or decrease it there. As we know from general anesthesia, if the brain doesn’t process the signals as pain, there is no pain.

In his article in The Wall Street Journal, “Thinking Away The Pain”, Jonah Lehrer writes:

New therapeutic approaches don’t target body parts or nerves close to the source of the problem. They don’t involve highly technical surgeries or expensive new drugs. Instead, they focus on the mind, on altering the ways in which we perceive the pain itself. “

Lehrer cites a study conducted by Wake Forest University in which participants reduced the unpleasantness of their pain by 57 percent after only a few days of meditation training. That’s roughly equivalent to the relief provided by morphine. He also tells of studies at Duke University in which cognitive behavioral therapy, biofeedback, and hypnosis significantly reduced chronic lower back pain in participants.

Your Brain Is as Powerful as Morphine for Relieving PainChronic Pain Is Brain Plasticity Gone Wild

Your brain is neuroplastic, meaning it physically changes form and function based on input, mental and physical. Neurons that fire together repeatedy wire together, strengthening and increasing their connections, firing faster, and becoming more efficient. The opposite is also true. Connections between neurons are weakened and lost over time when neurons are not activated together.

Neuroplasticity is both a blessing and a curse, and it’s an important factor in acute an chronic pain. Research shows that neuroplastic changes can take place in the periphery, the spinal cord and also in higher brain centres following injury or inflammation. These changes may increase the magnitude of the perceived pain and contribute to the development of chronic pain syndromes.

Here’s how that happens:

Signals from parts of the body are processed in the brain with adjacent body areas usually represented right beside each other in the brain. When pain receptors in one body area’s pain map fire repeatedly, because of neuroplasticity, they become stronger, more sensitive, and even enlarge the brain map. This means the pain starts to be experienced over a larger corresponding area of the body. The neurons can also continue firing long after the original cause of the pain is gone. If that weren’t bad enough, pain signals can even “spill” onto other brain maps causing what’s known as “referred pain” in completely different parts of the body.

When this happens, the pain isn’t in a person’s body anymore. It is in their brain and becomes a vicious cycle of the pain reinforcing itself. Acute pain is the brain interpreting sensations originating from the body. Chronic pain is a more complex, top-down process, usually starting in the brain.

The good news is that studies suggest that the perception of pain is subjective and dependent on individual differences in physiological, emotional and cognitive states. Science shows that pain is a complex phenomenon that is highly modifiable by a person’s expectation. In other words, your mind has the ability to greatly affect your experience of pain.

Neuroplasticity Is Both the Problem and Answer

In his book,  The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity, Dr. Norman Doidge tells the story of Michael Moskowitz M.D., a psychiatrist, who became a pain specialist because he wanted to alleviate his own chronic pain resulting from a falling accident. After pouring over thousands of pages of neuroscience research, Moskowitz came up with a plan to reverse his pain.

Because of plasticity, there is always a battle in your brain for cortical real estate. You have a use or lose it brain meaning that activities performed regularly take up more space in the brain and “steal” resources from other areas, a concept known as competitive plasticity. Moskowitz noticed that the areas of the brain that actively process chronic pain also process thoughts, sensations, images, memories, movements, emotions and beliefs when they aren’t being hijacked by pain.

Moskowitz decided that when he was in pain, he would take these areas of his brain back and force them to work on other activities rather than processing the pain signals. When he felt an attack of pain, he immediately visualized the areas in his brain processing pain shrinking until it looked like a pain-free brain.  Doidge quotes Maskowitz:

‘I had to be relentless — even more relentless than the pain signal itself,’ he said. He greeted every twinge of pain with an image of his pain map shrinking, knowing that he was forcing his posterior cingulate and posterior parietal lobes to process a visual image.”

It worked. In the first three weeks, he noticed a slight decrease in the pain. By six weeks, some of his expanding pain had started to disappear. By four months, he was having his first totally pain free periods in  thirteen years, and within a year, he was almost always pain free. If he did have pain, usually from doing something to cause it, he responded with his visualization method and could make it go away in minutes most of the time.

Your Brain Is as Powerful as Morphine for Relieving Pain

The MIRROR Technique to Reduce Chronic Pain

Moskowitz started teaching his method to his patients with amazingly successful results. He coined the acronym MIRROR to detail the steps of the process:

  • Motivation – The chronic pain sufferer has to take an active role in their healing. Instead of taking a pill or turning to doctors to solve their pain, they must understand the physical process causing their pain and understand how and believe that their brain can reverse it.
  • Intention – Contrary to what you might think, the immediate intention is not to get rid of the pain. It’s to focus the mind and visualize the pain brain map shrinking. The long term reward is pain relief.
  • Relentlessness – Every time pain breaks through the consciousness threshold, it must be met with the visualizations. Self-directed neuroplasticity requires intense focus to happen.
  • Reliability – The person needs to know that they can rely on their own brain to heal and function normally. The brain always seeks a stable state, which in this case, is chronic pain. So, its unconscious preference for stability has to be consciously overridden until pain free becomes the stable state.
  • Opportunity – The person needs to view each pain episode as an opportunity to repair a faulty brain system.
  • Restoration – The goal of the process is not to mask the pain or deal with the symptoms as medication or anesthetics would, but it is to restore normal brain function.

Plasticity – Not Placebo or Pills

The end to the pain is not likely to be a placebo effect because the results are lasting. In Maskowtiz’s case, 30 years and counting and many years for his patients as well. Besides, placebos generally work rapidly with persons relapsing pretty quickly. Patients using the MIRROR method can show no response for weeks, then gradually have diminishing pain as the brain changes until they only have to do the intervention for occasional pain breakthroughs. This pattern is consistent with people who have used neuroplastic techniques to cure learning disorders and recover after stroke or brain injury. However, because results were not immediate or dramatic at first, not everyone was able to sustain the level of commitment and dedication required to successfully implement MIRROR.

Your Brain Is as Powerful as Morphine for Relieving Pain

I used my own experience-dependent neuroplasticity exercises to recover from a brain injury.  Neuroplasticity does take time, commitment, and effort, but it CAN work. Doidge writes:

What Moskowitz has added to our understanding of this ability of the mind to eliminate a particular pain is that constant mental practice is necessary to strengthen this ability and change the firing of the brain in a way that can be sustained. Unlike medication or placebo, the neuroplastic technique allows patients to reduce use over time, once their networks have rewired.”

Conclusion

One of the most important insights coming from Maskowitz’ work is the revelation that opioid narcotics, popular for treating pain, actually make pain problems WORSE because of neuroplasticity. Over time, a pain sufferer’s brain adapts to the opioids becoming less sensitive to them and more sensitive to the pain causing the person to become more dependent on the drugs. Maskowitz successfully weaned many of his patients off their opioids by lowering their doses gradually giving their brains time to make neuroplastic changes with the visualizations.

This same principle works for many uncomfortable situations in life both physical and mental, I’ve found.  Any event becomes what my brain interprets and defines it to be, and I have the power to influence that.

Now, that’s some real mind power!

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4 Comments

  1. Debbie, Thanks for writing about this topic, I worked with a pain specialist who in addition to physical therapy provided brain training. I did exercises on an app related to my particular injury. It did help. It’s not that the pain doesn’t exist. It just exists in a different place than you think once the tissue around an injury has had its time to heal – as you say in the brain. I don’t know if it works 100%, what remedy does? But it’s a worthwhile one to explore from my experience.

    • I’m so glad you found help, Sandra. As you say, I think the intent is and effectiveness comes from processing the pain differently. It also does not expand and worsen it on your brain map.

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