There are two types of neurological circuits associated with pain that become memorized.  One category is the negative thoughts we all have about life, especially those associated with chronic pain.  The other is the actual pain impulses repetitively fired at the brain.

In dealing with chronic pain, it’s easy to become demoralized. Months go by, your pain won’t go away, and no one seems to know why. You can’t help but have negative thoughts, which then become repetitive, just like the repetitive pain signals running through your body. Both are continuous negative sensations to your central nervous system.

This process is what I call memorization of neurological circuits, and it is the next phase in the chronic pain experience after pain sensitization.  The brain becomes so focused on the negative thoughts associated with the pain experience that the thoughts are “memorized,” creating new neurological pathways, aka “circuits” in your brain. “The surgeon screwed up my back.” “I can’t get out of bed.” “The pain is ruining my life.” These circuits can take on a life of their own, running on a constant loop. If left unchecked, they turn into a serious obstacle to recovery, one that’s not a psychological issue as much as a “programming” issue. (More on this in upcoming chapters.) You become programmed to think the same thoughts over and over again.

You can develop tools to break the cycle of negative thinking, but first you have to conceptualize how the brain works. This will allow you to develop the tools to deal with negative thoughts and patterns of thoughts.

Neurological connections associated with pain will often continue to function, even if the offending stimulus is removed. A classic example of this is “phantom limb” pain. It occurs in patients who require an amputation, usually because blood supply to the limb is compromised by vascular disease. Common causes are diabetes or atherosclerosis, when there is not enough blood to sustain viability to the limb. Prior to the amputation, lack of oxygen causes the limb to become very painful. After the limb is removed, up to 60% of patients feel the pain as though the limb were still there.  Almost 40% of sufferers characterize the pain as anywhere from distressing to even more severe than before. (4)

There is not a more definitive operation than removing the entire source of the pain by performing an amputation. The nervous system does not even know the leg is gone, and it still feels the same sensations and pain. From those of us who have the visual experience of performing these amputations, this is a dramatic example of the power of the nervous system. It is also a reminder that the brain also is an extremely complex sophisticated computer, which is programmable. To “de-program,” it takes much more than will power.

Another example of a situation where a stimulus was removed, but the brain couldn’t be “de-programmed,” was a major reconstructive spine surgery that I performed in my third year of practice. Brad, the patient, was a 27 year-old athletic banker who had a moderate “hunchback” deformity called kyphosis. He was experiencing a lot of pain in middle of his back associated with it.  The deformity was about an 80- degree forward curve (the highest normal value is around 55 degrees).  I was hesitant to perform surgery, as it is a major five to six hour procedure with significant risks.  The surgery went well, however, and his curve was reduced to 50 degrees.  Post-surgery, it became clear that his body image had been his major issue, and unfortunately, it did not change at all.  His pain also did not improve.

There are many examples of negativity. However, the point is that once the nervous system becomes fixated on one specific negative thought pattern, it is not going to stop on its own. It’s possible to break the circuit but it takes very specific techniques.

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