The Origin of Pain

The scientific model of perception -- how we deploy our senses in order to experience life – has undergone an overhaul in the last couple of decades or so, but the revolutionary changes the overhaul has brought have gone largely unnoticed. The upshot is that the lion’s share of what we perceive, through sight, touch and other senses, is generated internally, in and by your central nervous system (CNS), your brain.

This finding has everything to do with our experience of pain, and is spelled out in our new book Dissolving Pain.

Dr. Richard Gregory, a professor of experimental psychology in the UK, wrote that the reason we experience pain when there is no physical cause, or itching when there is nothing apparently causing the itch, is because the role of our CNS is far more central to our experiences of pain than is the outer world. “Sensations of consciousness are created by the brain,” he wrote in the British Medical Journal. “Perceptions are predictive hypotheses, based on knowledge stored from the past.”

Ninety percent of perception, he believes, is based on memories.

Pain comes into the mix because emotionally charged memories lie at the root of physical pain, especially pain that seems to have no physical origin, such as chronic headaches and some kinds of back pain and phantom limb pain.

I know that it’s difficult for people who have an aching shoulder or back to accept the fact that the pain is not just located in the aching tissue but is largely in their mind and brain. Many of my patients say “it hurts so much it has to be in the muscle”, or “why would I create the pain?” Or they may feel they are somehow being blamed for the chronic pain, even though they have no idea what is going on. Or that it’s a way of saying that it’s all in their head. But it is real. The pain is very real and physical. The muscles are very tense and nerves are impacted. Muscles are just tensed for emotional reasons, not purely physical ones and often the shorted route to relieving the pain is through the CNS.

In an emotional situation, as far back as when we were small children, when we start to feel the discomfort of fear traveling throughout the body, we unconsciously and reflexively tense muscles control this fear. Muscles then stay tense to prevent the release of this emotional pain. Our minds and bodies are quite good at it. We labor to keep this pain distant from consciousness by narrowly focusing away from it. This tension related resistance eventually causes the pain to hurt more, and further activates the sympathetic autonomic nervous system, which produces increased arousal, which in turn causes more pain. Back pain or a chronic headache or stomach pain can activate the entire nervous system in this kind of loop and can go on for years.

Even pain that does have a physical cause often hurts more or longer than it might have because the brain is unstable from holding back these stressful memories. And if we narrow focus on this pain with a physical cause, the same thing happens as when there is no physical cause.

The key, as always, to dissolving physical or emotional pain, with an apparent cause or a cause that is not apparent, is to change our mode of attention from a narrow-objective one to a broad and immersed one with Open Focus training exercises.

In this expanded awareness we allow these feelings to be felt in a very mild way and are allowed to diffuse. When something is pleasant we feel it and allow it move on. Negative feelings can move on as well -- unless we pay attention to them inappropriately. If we broaden our attention, and expand our awareness, we break the loop that causes pain to linger and allow it to dissolve, and then we can go on our pain free way.

An Addiction to Video Games

A recent study in the journal Pediatrics found that children who watch as little as an hour of television and video games a day find that it’s harder for them to pay attention in school. There are other problems associated with video games – parents may notice children who play long hours of video games are depressed or anxious when they are not playing, and in a very real sense the become addicted to the thrill of playing
There is nothing per se wrong with video games played for short periods of time. Kids love the mastery and control they feel with a video game, and it can boost their dexterity and self-esteem.
Playing video games however, can become an addiction and come with other problems.
Mis-use of attention is one of the things at the bottom of playing video games. Doing something that deeply engages us is a powerful distraction, away from anxiety or depression, and away from a life that might be boring or uncomfortable. Kids may feel they aren’t that good at school work, or they worry about social adequacy, but while they are playing a game of Halo or Grand Theft Auto, they are the master of their fate, and in control, totally immersed with all other unpleasant thoughts and feelings left behind. The challenge of being in a competitive game causes a rise in adrenaline.
The addiction to video games can be addressed through the way we pay attention. The style of attention to a video game is narrow-focused immersed. Again narrow focused immersed is not wrong, but the over use of it causes the accumulation of stress and can become an addiction. After hours of play people get burned out and drained and can become depressed, or anxious and seek out more play to divert their attention.
Listening to a teacher, you can imagine, does not create the same kind of narrow immersed attention, and excitement. Their energy for paying attention is used up by the game. School has a hard time competing with the excitement of a video game. In fact much of life looks dull in comparison with the excitement of a virtual game world.
Treating video game addiction begins with dissolving anxiety and depression. Young people are often very good at finding and dissolving these feelings which may be in their stomach or chest or any one of a number of other places. When these feeling are gone, the world around that looked dull and drab now seems richer and fuller and the urge to play is often less. Then it easier to start to wind down the number of hours they play.

The Social Media Surge

In a few short years social media has radically changed our lives. From Facebook to Twitter to iPhones, with their dozens of apps, the world we pay attention to, day in and day out, has changed dramatically in just the last few years. And so has the way we pay attention. We now spend much of our day watching small screens, and pecking out texts on tiny keyboards. The changes these media have brought to our lives are fun, interesting and enhance learning. But there is a downside too – and as many readers of this blog know it has to do with how we pay attention.

Some people say they feel addicted to their iPhone or their computer. They can’t wait to leave dinner or class and update their Facebook or read their latest email or Twitter. There’s comfort to totally absorbing yourself in a task, but many people say it makes them feel uncomfortable after they are finished. In a newspaper article one woman wrote that after hours on Facebook “she felt completely numb, drained and devoid of humanity.” It’s a feeling that video gamers commonly report.

The addiction part of it comes from emotional rewards of social media. We become completely absorbed in Facebook and for that time we forget our physical and emotional pain. But as soon as we move out of the cyber world to we feel the discomfort that comes from the hours of narrow focusing on screens that ramp up our arousal and cause tense neck and face, muscles, eye strain, anxiety and even depression.

The answer to this addiction and pain is to change the we pay attention to phones and computers and other screens as we use them. We over-focus, grip the world of electronic screens with an attention style that is far more effortful than we need. We can relax the way we pay attention by gently centering our gaze on the screen in front and at the same time admit a simultaneous and effortless peripheral awareness of the environment around the screen – your work environment, living room or classroom. Admit an awareness of space between you and the screen, the space around the phone or computer, the space all around you. Try it now as you read this and you’ll find out why we say that changing the way you pay attention is the fastest way to reduce stress.

One Word of Advice

In a memorable line in the 1970s film The Graduate, someone offers advice to a young man seeking his way in the world. “One word,” the advisor says. “Plastics.” For people interested in the brain, however, the word of advice is plasticity. In the 1990s, the Decade of the Brain, the greatest discovery in the field of neurology was that the brain is malleable, not static – in other words plastic.

This is of course what neurofeedback has capitalized on since the 1960s. Neurofeedback – which is also known as brainwave training and EEG feedback -- could also be called directed plasticity. With sensors on the scalp we can read what the brain is doing, and guide it to move into realms that can mitigate or eliminate problems such as anxiety, attention deficit disorder, depression and chronic pain. In other words it teaches us to engage and use our plasticity.

A study just published in the European Journal of Neuroscience shows that just half an hour of feedback causes a lasting shift “in cortical excitability and intracortical function.” That means essentially that the brain becomes less reactive. The researchers, from two laboratories at the University of London, call for more funding for neurofeedback “to modulate plasticity in a safe, painless and natural way.”

With the Open Focus approach, we have been using neurofeedback since the 1970s to help people gain voluntary control over the plasticity in their central nervous system. But the goal is to eventually teach them to do it without neurofeedback, by changing the way they pay attention. Attention, in other words, is a powerful tool that also engages and directs the brain’s plasticity, and we can learn to mitigate and eliminate anxiety, depression, pain and host of other problems simply by learning how to use the different ways of attending that are at our disposal.

The Ways of Attending

There’s a story of a wise old fish swimming along and sees two young fish swimming toward him. “Hello boys,” he calls out. “How’s the water?”

The two young fish look at each other and say “Water? What’s water?”

We all tend to be stuck in narrow focus, what I call the emergency mode of attending. We have paid attention this way for so long, that, just like the two young fish, we don’t realize it. And we don’t realize there are other ways of paying attention, that can make us feel very different.

We are stuck in narrow focus because we have been taught to always be watching the world around us – look out for cars, pay attention to your homework or your teacher, watch out for this and that. We also spend time in this narrow objective attention because it helps us tamp down unpleasant feelings that happen to us as we grow up. Unfortunately they don’t go away -- they just stay in our mind and body, taking a toll on our physical and emotional life.

Here are the other ways of attending I have identified, and a little bit about them. Learning about them and learning to access them is fairly easy and can help us solve a great many problems in our lives, from anxiety to pain to impaired performance at work, on the playing field or on stage.
Narrow objective attention, is the one style we favor the most. It is a hyper-focus that engages the brain’s high frequencies. It is attention directed toward one or two things and which makes everything else background. Narrow focus isn’t just a way of attending visually. We can chronically narrow focus on any sensation, thought, a serious problem or a deadline, to the exclusion of almost everything else, which can cause worry and anxiety. Extreme narrow focus can be crippling, when it is overused or chronic, bringing on anxiety, panic and worry. It is the enemy of a smooth, fluid performance. A golfer, for example, who suffers what is known as the yips – uncontrollable muscle movements when putting – is hyper-focused, and the muscles are tense and in spasm.

Diffuse attention is the opposite of narrow and just what it sounds like– a softer, more inclusive view of the world, not attending to any one object or thing, as in narrow, but opening to everything, equally and simultaneously. It takes in a figure, but also includes the background. Think of attention as a beam of light. On a camping trip someone might hear a bear in a tree. Adjust the light so the beam is narrow, and nearly all of the light will focus on the bear. That’s narrow focus. But if we don’t know which tree the animal is in, we can broaden the scope of the flashlight beam so it illuminates more of the forest, as well as the bear, and not just one tree. That’s diffuse.

Diffuse brings on a multi-sensory experience, not just thinking and seeing, which are the senses that dominate in narrow focus. Walking through the forest and being simultaneously aware of birds singing, the smell of flowers, the feel of a breeze, the view of the trees and the space and the silence in which these sensory experiences occur is diffuse.

Objective attention, which we habitually combine with narrow, emotionally distances us from the object of our awareness. The combination of narrow and objective is energized and fast paced, favors the rational and linear processing skills of the brain’s left hemisphere. It emphasizes thinking and seeing, and diminishes the role of the other senses, including emotions. It tends to be organized in the left hemisphere.

Immersed or absorbed attention is characteristic of someone who enters into a union with an object or process and forgets themselves. It is usually pleasurable, and takes place in low brainwave frequencies. The effortlessness of a creative artist or performing athlete in a well learned behavior -- a dancer so immersed in her body, movement and music she loses a sense of self or where she is, for example -- is immersed attention. Both diffuse and immersed attention favor the right hemisphere of the brain.

There is also a combination of narrow and immersed attention, which is associated with a combination of low and high frequencies. Immersed is a way of attending that allows us to savor and intensify an experience. The main draw for a fisherman who forgets himself for hours as he watches a fly intently and sees nothing else as he waits for a fish to rise, is partly the physiological release that comes from immersed attention.

Stress and Vision

Stress is hard on the eyes and the muscles in the head and face that support vision. It shows up in many different ways, from eye pain to dry eyes, pain around the eyes, headaches and tension in facial muscles.

A big part of the reason is that from the time we’re very young we learn to watch for cues to our safety – we watch our parents and siblings faces for their approval, watch out for cars, barking dogs and automobiles. Vigilance is key to being safe, and we reflexively stay in a narrow, objective focus, an emergency mode of attending.

It’s especially powerful because it’s not just a physiological process – there’s a strong emotional component. The severity of the threats and our genetic make-up determine how problems manifest, but almost everyone has stress in their eyes, face or neck from paying attention so narrowly and intently.

There’s another kind of problem that affects vision – how we pay attention to work or school, even when it has little if any emotional dimension. A recent study found that myopia, or nearsightedness is much more common now then it was 30 years ago, according to researchers at the National Eye Institute. About 42 percent of people less than 54 years old have nearsightedness, versus 25 percent in the 1970s. People with myopia can see things close up but their distance vision is blurred.

Researchers think the problem may be linked to widespread use of computers, because we pay attention to a very small visual field in narrow focus much of the time rather than varying how we pay attention – looking at large vistas or other things in the distance.

It is not, however, the computers themselves. We are all guilty of hyper-focusing, that is focusing too intently on our work, or on the other things we do. We need to learn to pay attention more gently, to dial down the very effortful focus we use without thinking.

The remedy is using Open Focus exercises which can not only release tension and help mitigate vision problems including myopia, but also can help release all of the muscles that support narrow attention – in the neck, face, forehead, scalp and elsewhere.

Can you imagine becoming aware of the space between you and the computer as you read this?

Can you imagine becoming aware of all of the space in the room around you and computer as you read?

Treating Pain With Flexible Attention

"Pain is inevitable. Suffering is optional." That statement, by someone whose name is lost to history, is true wisdom. Pain is something that happens to us, and then we have choices on how to relate to it. How much we suffer is one of those choices.
It is determined by how we attend to our pain.
By learning to pay attention to pain in more than one way, we can change the suffering part of the equation.
Some pain is inevitable. We bang a shin or strain a shoulder and it hurts. But pain that endures for no apparent reason, or even a pain that endures for a known reason, can be localized and dissolved as an experience of and in the body. But pain is actually generated by circuitry in the brain.
Take the case of phantom limb pain. People who have lost an arm for example, years later report pain, often severe pain, in the missing hand or elbow. Why? Because the circuitry of the brain that represents the missing arm become active.
But it’s not just that brain circuitry is active and the pain has a life of its own, beyond on our control. How we pay attention to pain, is something within our control.
We all tend to pay attention to pain in the high arousal mode of attention, we call narrow, objective focus, which is how the attention style we habitually use fights and avoids the pain. If we let pain in, we think, it will hurt more. But the opposite is true – it’s more painful over time to try to avoid it in a rigid narrow objective focus of attention.
The strategy then is to broaden our aperture of attention with Open Focus exercises by establishing a general awareness of space. With our awareness so much larger, the pain becomes a small part of one’s experience and is no big deal. It often dissolves on its own, or we can easily dissolve it.