By Alex Klassen MSW, RSW
Our brain is a learning machine that quickly develops associations, meaning we connect conditions and responses as we move through the world. To understand how this works, we can think back to Pavlov’s research on the brain and learning, where he experimented with dogs. Right before feeding his dogs, Pavlov started turning on a clicking metronome. After a few trials, he noticed the dogs started salivating from the sound of the metronome alone. The dogs developed a conditioned response1.
The condition: the sound of a metronome
The response: salivation
When we’re experiencing chronic pain, it’s easy for the brain to make an association between an activity or stimuli (the “condition”) and pain (the “response”). For example, imagine a woman notices her back pain increasing when sitting in her computer chair. Naturally, her brain asks the question, “Why does my back hurt?”. And the most obvious answer might be, “It’s this stupid chair!”. If there was a problem with the chair and it was hurting her back, this association is helpful. She might fix the problem by adjusting the chair, buying a better one, stretching more, changing her posture, getting a massage, or avoiding sitting for long periods of time.
Making associations is essential for learning and survival, but the brain can make mistakes. Let’s imagine instead this woman’s pain is neuroplastic, meaning it is caused by her brain mistaking safe nerve signals from the body as dangerous2. In this scenario, the trigger of her back pain is actually a stressor like her job, or some other cognitive or emotional problem occurring2,3. In this case, the conditioned response connecting her pain to the chair is unhelpful. Rather than helping the woman address her stress and emotions, the pain sensations may send her down the wrong road, fixating instead on problems with her chair and back.
The condition: sitting in the computer chair
The response: back pain
If the woman believes the chair was the cause of her pain, her brain is more likely to generate more pain the next time she sits in it. This is because pain is a danger signal, it’s job it to protect you from things it believes to be dangerous2. This can lead to the conditioned response growing stronger and stronger.
Conditioned responses can happen all over the place, including foods, weather, time of day, stress, emotions, smells, environments, and certain movements and activities. This often leads to more and more avoidance behaviours, increased fear in our bodies, and life getting smaller and smaller. It’s a nasty feedback loop, but it’s possible to reverse it.
When working with our clients, we gather evidence for physical safety, while providing education on how neuroplastic pain works. Through this process, our clients often realize their brain is being over-protective, producing pain in many conditioned responses where it doesn’t need to. Recognizing how neuroplastic pain is occurring as part of a conditioned response allows our clients to feel safer and make changes. Step by step, we can teach our brain that our body is a lot safer than it used to think, changing our beliefs and gradually re-engaging in activities and environmental stimuli. Over time, this leads to less pain and a fuller life, which are the goals we work toward with every client.
Book a free 20-minute consultation with one of our therapists and begin your journey out of chronic pain today.
Rehman I, Mahabadi N, Sanvictores T, et al. (2023). Classical Conditioning. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Gordon, A., Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC.
Crofford LJ. Chronic Pain: Where the Body Meets the Brain. Trans Am Clin Climatol Assoc. 2015;126:167-83. PMID: 26330672; PMCID: PMC4530716.