Where pain comes from
When was the last time you experienced pain? I’m sure we can all remember that! Just last night for me… I had a headache that felt like someone was grabbing a hold of the back of my head, and refusing to let go. One of my middle of the night musings was to marvel at my own personal experience since I was exploring pain this week.
Did you know that there are actually two steps to our pain experience? I found this 2019 research study finding fascinating:
“If you step on a tack, neurons in your brain will register two things: that there's a piercing physical sensation in your foot, and that it's not pleasant… While painful stimuli are detected by nerves, this information doesn't mean anything emotionally until it reaches the brain.”
This sounds just like the two arrows parable in Buddhism which has been around for at least 2500 years. I guess the research is just getting caught up to prove what many have known for centuries.
Both sources refer to the negative emotions of pain. Let that sink in for a moment. Pain is an emotion? Just like frustration, anger, disappointment, fear, worry, doubt, and anxiety?
What’s even more interesting is how our emotional response to pain can be both for real and perceived pain. That is, we definitely will feel the tack we just stepped on, and we might also feel the pain of someone else when expressing empathy, like when we say “I feel your pain”. This perceived pain is referred to as ‘empathic distress’ though – we are actually feeling our own pain!
If pain is an emotion, we need to think differently about pain in order to feel differently.
That means we are back to looking at ways of managing negative thoughts and emotions.
I want to take a closer look at the RAIN approach originally created by Michele McDonald, adapted by both Drs. Raymond Prior and Tara Brach, and adapt it again for pain relying on other helpful research I have found from Drs. Ellen Langer, Ron Siegel, Marti Laney, Tara Swart, and Phil Parker.
You might remember how Tara Brach referred to the acronym RAIN as “an easy-to-remember tool for bringing mindfulness and compassion to emotional difficulty.” That is why I think this is a good approach to explore pain with.
Let’s jump in!
Recognize: It doesn’t take too much to recognize the painful stimuli detected by our nerves, does it? Unless you have a really high pain threshold. Then it might take you a while. Funny enough, Marti shared the findings from a study on pain in which extroverts complained more about pain, but seemed to have higher tolerance than introverts. Once we recognize it, we need to move quickly to accept it.
Acceptance: We need to accept the painful stimuli and not try to push it away. In Ron’s words, avoid avoidance. Because this just makes the pain hurt more. Raymond tells us that acceptance is what gives our primitive brain enough time to understand that we’re not actually in danger so it can calm down and allow our new brain to stay in control – so we can move on to investigate it.
Investigate with curiosity and compassion: This is an opportunity to explore where and how much it hurts. Ellen talks about applying a mix of attention to variability and general mindfulness. Ask yourself questions like:
Where do I feel the pain right now?
Where does it hurt the most?
How far does it reach in every direction? Follow it up and down, then left and right, as far as you can go.
Is it more or less than the last time?
What happens to that pain if you focus on something else non-pain related intently?
Where do I feel tension in my body?
Now you are ready to move on to nurturing.
Nurture now: There are three things to consider to nurture ourselves when we are in pain.
First of all, in order to influence our thoughts, we have an opportunity to move from focusing on the desire to be “pain-free” (because our brains are simple-minded and only hear the ‘pain’ part – not the ‘free’ part) to visualizing how we want to feel when we will be healthy. Do you remember how Tara Swart helped me further my own practice of visualization? I’ll include her quote here again because I think it is a very helpful description of what all it entails:
“Visualization is not just about creating an image of what you want but also about imagining what it would feel like if you were really in that picture. Everything from the taste in your mouth (the taste of success), the smells around you (the fresh paint of a new home, food-related smells in a certain career, your favorite perfume for special occasions), what you are hearing (applause, congratulations, music) and, hugely importantly, the physical feeling in your body of achieving this (how does happiness or confidence actually feel?). The more we practice this, the more likely we are to start noticing when it is happening, or the things that are associated with moving us closer to that ideal.”
Secondly, release any tension you feel in your body. One of the most amazing experiences I have had in the past few months has been learning to release tension on my own. Last night I focused on removing every finger on that hand that gripped my head. Others might find guided imagery to be more helpful: https://www.verywellmind.com/use-guided-imagery-for-relaxation-3144606.
Thirdly, follow this up with some nurturing using only the senses which give you that “ahhhh!” feeling – touch, smell, sound or sights – because, as my trauma counsellor told me, when our bodies are hurting, we need our bodies to heal that hurt. You can read about my nurturing approach here: https://www.tammybrimner.ca/my-journal/listening-to-the-rain.
I would also add another step here:
Reflection: Take the time to reflect on what positive changes you experienced. Because that will confirm you are making progress, and that you are not letting your emotions get the best of you.
Perhaps I will need to change this acronym to RAINR – which would make it a verb. Time to RAINR, one could say. Ha ha!
You know what the best part of this RAINR approach is for me? It is completely drug free, and it is completely within my control to remove the added layers of emotion which make the pain hurt more. Does that mean I never take pain meds? No, sometimes I need some additional help — like the Tylenol and Advil I eventually took last night. In fact, we might need that additional support when the pain is so overwhelming, making it hard to think of anything else. I might also want to check in with one of my meaningful connections to ensure my mindset remains strong and resolved.
So, let me ask you now. Do you feel better about pain? I sure hope so. Just remember this is something we need to practice regularly to help our brain’s neural pathways find a healthier approach. In fact, I would strongly recommend you come up with a vision of yourself wrapped in well-being when you aren’t in pain – so you can more readily access that vision when you are in pain. Practice that too!
My wish for you (and the world) is that you can lean into your own ability to help manage your pain and a vision of what your life can be.
Resources
Brach, Tara. Access February 13, 2025: https://www.tarabrach.com/rain-practice-radical-compassion/
Laney Psy.D., Marti Olsen. The Introvert Advantage: How Quiet People Can Thrive in an Extrovert World. Kindle Edition.
Langer, Ellen. 2024. The Mindful Body: Thinking Our Way to Chronic Health. New York: Ballantine Group.
Parker, Phil. Get the Life You Love, Now: How to Use the Lightning Process® Toolkit for Happiness and Fulfilment. Hay House. Kindle Edition.
Prior, Raymond. 2023. Golf Beneath the Surface. Dallas, Texas: BenBella Books, Inc.
Siegel, Ron. Accessed February 13, 2025: https://www.praxiscet.com/posts/how-mindfulness-works-avoiding-avoidance/
Swart, Tara. The Source: The Secrets of the Universe, the Science of the Brain. HarperCollins. Kindle Edition.
