How Fear of Expressing Emotions Can Result in Physical Pain

My subconscious must have been really busy one night because very early one morning, somewhere between wakefulness and sleep, I had an ‘AHA!’ moment. It may be that what fell into place for me has been obvious to many others all along. But, just in case anybody out there is ‘not quite getting it’, I wanted to share what suddenly made sense to me, just in case this personal realisation could be helpful to others.  

My Assertion:  Our primitive autonomic nervous system is really intelligent!! It’s the neocortex* which is often stupid! (but makes the mistake of believing it is really clever!)

*Neocortex: The neocortex is the most recently evolved part of the cerebral cortex and is the centre for higher brain functions, such as perception, decision-making and language.  

As a Physiotherapist, I will describe my ’aha moment’ in terms of back pain, but you could substitute it with any pain or symptom presentation which was not due to structural damage, infection, disease or tumour. 

Is our brain really trying to protect us? 

Whilst I understand (especially following acute personal experience) how repressed emotions can present as pain or other symptoms, I was uneasy with the explanation that this was just because our primitive nervous system has chosen that it  is safer for us to have the pain than express the emotion: that it is protecting us from feeling the ‘pain’ of our emotional needs. I’m sure most patients suffering the terrible impact that their pain is having on their work/relationships/sleep/enjoyment of life would probably argue, ‘I would rather feel the emotion any day than the pain. This doesn’t make sense!’  and I would think to myself, ‘I have to agree’. 

This brings me to my ‘light bulb’ moment (does that saying make sense only in the UK?).  If, in young age we experience fear expressing our emotions and needs, we become conditioned to unconsciously repress them to survive; ok, this we understand.  This is an automatic defensive tactic, so that we don’t feel the emotion consciously, and we carry this habit into adulthood.  However, our primitive nervous system still registers the fear of experiencing or admitting to that emotion or need. This fear stimulates the stress response and the back pain, for example, is produced by the primitive nervous system as a protective output.   

This idea we know well from Professor G. Lorimer Moseley. That pain is produced by the brain in response to perceived danger, and that this can include emotional threats. Why? Not, I now believe, because the primitive nervous system decides it is safer to feel pain than the emotion but because the emotion has been automatically repressed.  The pain is produced by the nervous system to motivate the individual to pay attention and to seek help. (Cue the light bulb being turned on!).  

Example: A child’s stomach ache

This concept is more obvious when we observe how children behave.  For example, a child may report to their parent that they have stomach ache, which happens to only occur on a school day because they cannot articulate the emotional insult they experienced by a bully or an overly critical teacher. The intuitive parent will realise it is not something they ate, but something ‘eating’ them.  Therefore, the parent provides the compassionate attention to the child, so that they may feel safe enough to express whatever is upsetting them and then the parent can offer them reassurance and advice as necessary. Consequently, their pain resolves as the pain message produced by the primitive nervous system (of the child) has been correctly interpreted by the neocortex (of the adult).   

If, however, the child presents with stomach ache and the parent assumes it is a physical stomach disorder (because this is how they have been programmed in their childhood), they might take them to a doctor who may give them medication, for example. Any subsequent pain relief is therefore attributed to the medication, thus reinforcing the belief that they probably need medicine to relieve every pain in the future.  As a result of this, the child may learn that all pain messages are due to a physical or medical cause and will seek this help in the future from professionals who can offer a physical or medical solution. This treatment paradigm comes from the neocortex (of the health professional).   

(As an aside: Recently I observed through treating a young patient that ‘growing pains’ are another example of repressed emotions and that these pains, which are disregarded by the medical profession, can also be settled with a mind body approach.)  

Misunderstood messages 

The problem arises when we misunderstand the pain message from the body sent by the primitive autonomic nervous system.  For example like back pain believed to be a structural back injury (despite no incident or overload occurring) and help is sought from a back surgeon or a physical therapist. As a health professional trained to understand the mindbody relationship however, we can recognise the difference between back pain from a structural cause or from a learned neural pathway and stress disorder. It is then our role to provide, through a thorough examination and wider perspective, a solution for the pain problem by addressing  the underlying fear which is producing the symptoms. Just like the intuitive parent with the child with the stomach ache before school we can provide reassurance that, despite the often excruciating pain, their body is healthy and provide an alternative explanation for their symptoms.   

When the fear is resolved with a mind body explanation and the repressed emotions have had an opportunity to be expressed in a safe environment with support from a compassionate therapist (or privately with journaling), the message from the primitive nervous system has been delivered, understood and acted on, and so the pain often resolves. When we as health professionals have the trust of our patient, and we can explain how pain can represent repressed emotions and activation of their stress response,  they invariably agree that this explanation makes a lot of sense.  Unfortunately though no-one previously had ever presented this possibility to them before. (Cue the light bulb moment for the patient.  I love that moment!) 

The challenge of trusting the neocortex

The smarter modern society perceives itself to be, with access to so much medical information and opinion and advice on Google, I would suggest the more ignorant we have become as a society of treating pain which is not of structural origin.  Unfortunately this is evidenced by the worsening chronic pain and chronic disease incidence figures.  For most people, their neocortex trusts Google’s wisdom more than the wisdom provided by their primitive autonomic nervous system.  It is no surprise that as we have gained more medical knowledge, pharmaceuticals, surgical expertise and genetic knowledge, we have become more ignorant at solving non-structural pain problems. That is, unless, if I may boldly state, your neocortex has learned from the information provided by modern neuroscience research and training in mind body techniques.  Or if the individual has learned to listen to their intuitive wisdom, like the example of the mother above.  

So, in conclusion, instead of the concept that our autonomic nervous system is really primitive, and that is why it represses our emotions and ‘chooses’ to give us pain instead,  I suggest that we have an incredibly intelligent primitive nervous system! It is our neocortex (which thinks it knows better) where the problem lies and it must learn to become smarter by learning about the contemporary mind body concepts and evidence from neuroscience research!  However, I hope that as we proponents of the mind body approach share the information from our neocortices, we can help many more people relieve their pain. 

Thank you for reading my ramblings, I would love to hear your response. 

Irralee Andrzowska
SIRPA Trained Physiotherapist, Sheffield UK

About Irralee:

Having worked with clients with musculoskeletal pain in the private sector for 25 years, my practice has been revolutionized following training with SIRPA and implementing the mind-body approach to the treatment of pain. I am passionate about this holistic approach. If you would like to know more, please contact me via email so we can arrange a free 30 minute call to answer your questions and to see if this approach is what you are looking for.

You can find Irralee’s contact details on our Find a Practitioner page.