Episode 16: Make it Make Sense

Decoding and Recalibrating Pain Perception for Mind-Body Wellness

In this episode of Mind Your Body, Dr. Zev Nevo delves into the intricate process of how we recognize, interpret, and respond to pain. He discusses the brain's role in making sense of physical sensations and how survival instincts can sometimes misinterpret these signals, leading to chronic pain. Dr. Nevo explains the importance of recalibrating our internal systems through mindfulness and logic to align our pain responses accurately. By understanding and re-training our neural pathways, we can reduce the impact of chronic pain and improve our overall wellbeing. The episode provides practical insights into the science of pain perception and offers strategies to correct mismatches between sensations and reality.

00:00 Introduction to Mind Your Body

01:06 Understanding Pain Response

01:51 The Brain's Role in Interpreting Sensations

03:25 The Importance of Accurate Data

08:58 Chronic Pain and Sensitization

14:52 Recalibrating Our Neural Circuits

18:32 Conclusion and Final Thoughts

This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms.

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LINKS:

• Body and Mind Pain Center
• Mind Body Rehabilitation
• Substack

Transcript

When we notice pain, what is our response? Responding to pain is made up of recognizing the physical sensations, deciding how we feel about it, and then doing something about it. But what exactly goes into these decisions that we make seemingly automatically? Today, we will dissect the step-by-step process of how we notice, interpret, react, and respond to pain, and learn to decode and recalibrate our pain response pathways. Pretty cool, right? Hey everyone, and welcome back to Mind Your Body. I'm Dr. Zev Nevo. Your source for pain and trauma-informed psychoeducation and the exploration of mind body rehabilitation.

Okay, let's jump in. When we first notice a sensation. Whether it's a physical feeling, a sound, a smell, or even an emotion, [00:02:00] our brain's first job is to figure out what it means. It's trying to make sense of our reality. In essence, we think: make it make sense. 

But what happens when the sensation we feel in the context of the reality we're experiencing doesn't match our expectations? And what if in that mismatch, our brain's survival instincts, its desire to keep us safe, end up working against us, creating a sense of dread, fear, and hopelessness? That is the essence of today's episode.

When we first notice a sensation, our response is a complex mix of conscious recognition and a rapid, subconscious emotional read. We're often hacked by a sense of dread or other strong emotion that's based on our interpretation of the sensation as a threat. [00:03:00] The actual objective danger to our wellbeing is almost irrelevant.

Our limbic system, which is the part of our brain that deals with emotions and memory, sends signals of protective and survival, thoughts, emotions, and ultimately behavior patterns based on it flagging the sensations as unsafe. To understand this. Let's think about how we rely on tools to give us objective data about our bodies.

We trust a thermometer to quantify a fever. We trust a scale to inform us of our weight. We can see inside our bodies with x-rays, MRIs, CT scans and ultrasounds, and experienced practitioners can understand certain functions of the body with palpation or noticing subtle changes externally, such as warmth, fullness, or [00:04:00] tightness.

 We rely on laboratories to analyze our blood, to inform us of our overall health. But here's a critical question. What if that data is wrong? What if you utilize a clotted blood sample, providing an insufficient sample size and the results come back all out of whack? Most likely you would just repeat the test, understanding that the information is not accurate.

What if a thermometer reads 115 degrees Fahrenheit when you feel just fine, or a scale that tells you you weigh 1.3 pounds? Or 980 pounds? What would you do? Would you be in fear that your life is in danger, or most likely just repeat the test, understanding this is not accurate information? [00:05:00] You would immediately understand there was something wrong with the device, not with your body. Why? Because the mismatch between the data and your reality is so large that your brain immediately knows it's false.

It would be so obviously unbelievable. You would immediately understand there was something wrong with the thermometer or the scale, not with your body.

 Now, what if our temperature reads a more subtle 101 degrees? Or our weight is just a five or 10 pound difference from our expected norm. The amount of variation from what is expected that is accepted is dependent on how much of a threat the results impose on our wellbeing, our safety, our health, as well as how high the stakes are regarding the data that is provided, which can differ from person to person.

Small changes in [00:06:00] body temperature, for example, can be indicative of normal variations throughout the day. Changes in hormones or compensating for environmental external temperature changes. At some point, a rise or drop below a certain number will start to cause dysfunction in our bodies. As human beings, we are a physically vulnerable species. Generally speaking, in a developed adult, changes of a few pounds are not noticeable nor indicative of something wrong. But how different is this in a newborn baby? Or think how distressing this may be for an individual with a body dysmorphic disorder. So our interpretations of the seriousness, the meaning, the stakes of the results are dependent on both actual and perceived levels of importance. The results themselves are only [00:07:00] as good as the accuracy and capacity of the device that is reading the raw data.

There's a quote that goes something like, "we shape our tools and thereafter our tools shape us." Our brain is very much a tool that is trying to measure our health, safety, and wellbeing every single second of every single day. Ultimately, our interpretations of the seriousness of the meaning and the stakes of the results are dependent on actual and perceived levels of importance.

The accuracy of the data that we receive from our nervous system is as important as the accuracy of the tools we use to understand ourselves. Just like we utilize a thermometer to quantify a fever or a scale to inform us of our weight, we get data from our limbic system, which relies on our memory and emotions and mood and [00:08:00] state of mind to inform us viscerally if we are experiencing danger or a threat. We would rather be wrong about a perceived danger and survive then be ambivalent to our surroundings. Whether that's in our external environment or interactions with others, or even with what is transpiring internally in our bodies, especially when we can't see it directly. We often can think of the worst case scenario, especially if we carry memories of loved ones who have had subliminal or poorly recognized illnesses or injuries that went underdiagnosed or that contributed to disability, negatively impacted health or even threatened their lives. We learn from these experiences and our brains then tag them as crucial survival information. 

So how does this relate to [00:09:00] pain, especially chronic pain? Well, the regions of our brain that spit out results usually at a subconscious level and relatively quickly, can often over predict danger because we are actually wired with a negativity bias towards survival that's extremely sensitive. This is a crucial inborn survival mechanism.

We are wired to err on the side of caution. We have had to become very keen to threats in order to survive as a species, and this wiring is influenced by our lived experiences. Ultimately, whatever we're exposed to as a sensation, visually, through sound, smell, taste, or touch, we access these sensations within the context of our perception of reality and state of mind.

First, we identify the sensation, but then we need to make it make [00:10:00] sense. To make it make sense, our brains need a match. For example, if you smell donuts and are sitting next to a box of donuts, all is good. If you hear birds chirping and are sitting outdoors on a sunny day, seeing birds flying around you, it just makes sense.

If you feel hot water enveloping your legs and you see that you are stepping into a bathtub, it doesn't feel surprising. In all of these cases, the sensations are not only not negative experiences, but may even be positive, pleasant, or something you look forward to Now, what would happen if the same scenarios occurred at 3:00 AM while you're lying in bed? Smelling donuts, hearing birds, or feeling hot bath water can feel terrifying if they're experienced out of context. The [00:11:00] sensations are neutral, but they become a serious problem if 

the mismatch between them and our perceived reality is large enough. With chronic pain, the regions of our brain that give meaning to sensations become sensitized. This means we have a lower threshold to classify any sensation in that area as potentially unsafe or very unsafe even when it may not actually be harming us or detrimental to our health. So what do we do when our reality doesn't make sense? When we get a mismatch between our sensations and our expectations?

You can't just tell someone that everything is fine when something feels off, nor can we just pretend or hide from those intuitive insights we get. When we feel a mismatch in what we expect, we need to make it make sense. [00:12:00] Even if the overall determination is that we are experiencing something negative, we need to first label it so and help ourselves assign causality to what we feel.

How often when hearing about someone who passes away, do people feel a need to inquire about how it happened? It's not necessarily being nosy, but rather death, illness, tragedy, injury or pain is something we desperately try to avoid. Rightfully so. However, we learn from others' experiences, as much as our own, how to avoid or prevent ourselves from walking the same path and getting hurt. For the most part, this is a crucial adaptation and strength that helps us predict and plan so we can live to see another day. This survival initiative is a muscle that grows with each experience of [00:13:00] pain. We do this to protect ourselves.

We don't wanna get burned again. A nd if it happens again and again and again, we keep moving the needle indefinitely until we become paralyzed by anticipation or fear, or just find it easier to succumb to the belief and identity that will always be in pain no matter what. We seek out less and less opportunities to lean into discomfort as an often necessary experience of healing, recovery, and rehabilitation, and get more and more accustomed to the surrender of acceptance and fatalism associated with being a chronic pain patient.

Each time we experience a physical or emotional injury, we go through an in-depth retrospective analysis of what we did right and what we did wrong, so we can never feel that again. We develop protective thoughts, beliefs, and behaviors that are our first line of defense. [00:14:00] Not to react to the cut, but to see the source of the cut before it even reaches us.

The difficulty here is that there are elements of utility to acceptance and learning to cope with discomfort, and I have addressed this before. But in the context of pain sensitization, it can become a slippery slope and weaponized to keep us stuck in the muck of fear, frustration, hopelessness, and desperation about our situation.

So we come to the final most crucial piece of this puzzle: the solution. We've talked about the problem, the mismatch between sensations and interpretations. The mind's brilliant but flawed attempt to protect us. The danger of getting stuck in this "why me?" spiral. So how do we get out? Well, to truly learn healthy habits in dealing with pain, we need to reverse engineer our neural circuits [00:15:00] that feed so insidiously and are so interwoven into our interpretation of our pain experiences.

We need to recalibrate our thermometers, our scales, our points of view, our states of mind, our awareness of our internal selves, our external environments, and our surroundings, so we can feel confident in the data provided to our consciousness by our nervous systems when we encounter sensations.

Making it make sense is always going to happen, but pausing to apply logic, reason, and mindful awareness of the current sensation we are interpreting, all the while being honest about the bias and influence of our past experiences on what we are feeling in the present moment will be the key to correcting mismatches with precision and [00:16:00] accuracy, now and moving forward.

Think of it like a fire drill. When the alarm first blares, everyone's immediate instinctual response is to panic and run for the door. This is your limbic system, your survival brain, taking over, taking charge. The pause is the conscious choice to stop, take a breath, look for smoke, and calmly assess the situation.

This pause is the moment you engage your prefrontal cortex to ask, "is this a real fire or is it just a drill?" It is not about ignoring the alarm, but it's about verifying the threat.

This pause also allows for the self-compassionate work of being honest about our biases, honoring the legacies of our past. We must gently acknowledge that our brain and its protective drive has developed a survival mechanism based on our [00:17:00] past experiences. We don't blame ourselves for this. Instead, we honor this protective response. And gently question its accuracy in the present moment. We're essentially telling our nervous system, "thank you so much for the warning.

I hear you now. Let me check the data." How we make it make sense matters. We must correct the mismatch with precision and accuracy. This isn't about ignoring the pain or simply thinking positive thoughts. It's about retraining your brain with new, more accurate data. We've talked about how our brain relies on tools like a thermometer or a scale to measure our health.

What we are doing here is recalibrating our internal measuring devices. We are consciously and consistently showing our nervous system that not every sensation in that [00:18:00] body part is a threat. We are showing it that a normal movement is just that a normal movement. We are intentionally collecting new data, data of safety, not danger until our internal thermometer begins to read reality with precision once again. This intentional act is the key to correcting the mismatch and building a new neural pathway of safety. Thank you, and I'll see you next time.​