all in your headache

[estimated reading time 5 minutes]

when someone tells you the pain you feel is all in your head, they’re being dismissive — it’s imaginary. but they’ve inadvertently told the truth. it is all in your head but it’s not artificial and it’s not thought. we’ll get to that in a moment but this raises a very important issue. the brain is often talked about having three parts from different periods of evolution. they’re roughly termed the lizard brain (reptilian, too), the emotional brain and the rational brain. the first is associated with animals, the second mammals, the third human.

well, this is two problematic things — misleading and untrue. it’s fake news in the most severe and dangerous sense. that’s not how the brain works and it’s not how evolution happened or could even possibly have happened. nothing in your body developed then stayed the same. especially not something as complex as your brain. so we should probably look at a better brain model before we get into pain and its mental basis.

a better way to look at the brain is in terms of three systems — the sympathetic nervous system, the parasympathetic nervous system and the conscious thought system. these interact constantly but they are somewhat discrete and can be discussed independently. our bodies go through transformations on an ongoing basis. the sympathetic nervous system functions in tension and the parasympathetic nervous system stabilizes us. when they are in balance, our bodies work properly — we call this homeostasis. the other piece, our conscious thought, runs on top of these all the time and it’s what we’re aware of.

there is another division that’s useful but less physically-present. it arises from how the brain works rather than what the brain actually is in reality. we can call this the conscious-subconscious-memory division. in much the same way, our active thoughts run like an app on the operating system below that links subconscious bodily function with memory storage and retrieval. it is often confusing to make an explicit link between the brain and a modern phone but it’s useful in this way — the memory is like your photos. they are stored there all the time and can be added to, edited and retrieved as necessary. the problem is they aren’t very stable. our brain’s memory, unlike a phone’s, is constantly fluctuating. but the function is analogous. the subconscious is where people go off the rails making this comparison. it’s both the operating system and all the apps running in the background. it does both jobs. all the things under the surface like keeping your heart and lungs working, pushing blood and chemicals through the body as needed. the conscious is like only the app you currently see on the screen. it’s what you’re doing right now. what you’re aware of. as you can imagine, memory is significant, unconscious processing is absolutely massive and conscious thought is a tiny fragment of what your mind is doing at any point. it’s not just the tip of the iceberg — it’s the grain of sand trapped at the top of the tip of the iceberg.

what does this have to do with pain, though? more than you might think.

the body is an open-loop system. it interacts with its environment and that environment often causes it harm. sometimes it hurts itself but usually that damage comes from the outside world. let’s say you drop a rock on your foot. what happens?

the impact is picked up by the nerves in your foot (mostly the ones near the surface but the depth of the damage depends on the weight of the rock and from what distance it fell) and that signal is sent to the brain for processing. the subconscious determines it’s not a typical sensation (like the subtle rubbing of your sock against your foot that can be ignored — these nerves pick up everything but your subconscious filters most of that information out) and sends a signal to your active conscious process something like “hey, something just happened down there and you should know about it”. the conscious mind responds immediately by treating this signal as “pain”. that might be the end of it. but there could be inflammation. there could be damage. if you broke your toes with that rock, this could go on for quite a while. as the subconscious continuously gets a stream of feedback from the foot about how much inflammation and damage there is, it sends blood (among other things, usually in the blood) to that area to start the repair. as the inflammation continues to exist, it updates your conscious mind saying “it’s still happening! you should notice! i’m fixing it but pay attention already…” and again this is received and translated to pain. remember, these are informational signals from the perspective of the subconscious. but when you experience them consciously they’re pain. the pain isn’t in the foot. it’s in your brain. that doesn’t make it less painful. but it does tell you how it works.

when you take a painkiller (let’s use ibuprofen as an example), it can take away some of the inflammation. that means less signal is transmitted to the subconscious so it doesn’t feel the need to send that to your conscious mind as much and you can get on with your day. if you take a narcotic (codeine, for example), it does something very different. it doesn’t deal with your foot or the inflammation. it shuts down at least some of the information flowing not from the foot to the brain but the subconscious to the conscious. just as much information comes from the foot. but it doesn’t hurt as much because your conscious mind isn’t getting nearly as many signals about it so it doesn’t have to pay as much attention.

this is why people feel so good when they take narcotics and why they’re so easy to become addicted to. the addiction itself is a chemical thing, a dependency from longterm exposure to a substance. but it immediately (or at least close to immediately) stops the conscious and subconscious minds from communicating as much. is something bothering you? troubling memories? painful thoughts that keep coming back? sadness? physical pain? it’ll turn those signals down — often, like in the case of morphine or diacetylmorphine (also called heroin), it will realistically mean none of those signals get through. you’re living in sensory absence and that’s as close as a human can generally experience to bliss. it’s very dangerous, though. the body can be very badly hurt but you won’t be aware of it. walk on glass? no problem. punch a wall hard enough to break your hand? definitely possible. this is not a place you want to go. but if you have a gunshot wound in your chest and you’re waiting for surgery, being able to shift away from the pain is a good thing and this is why we use such strong drugs. they have their places. but their places are in hospitals, as you’re likely well aware.

of course, this is only the beginning and pain has many other components — we can create artificial pain, for example, just from our minds and we can overcome pain through meditation or even the power of suggestion in some situations. but i hope this brief introduction will have sparked your interest in a topic that has fascinated me since i was a child — i fell off a fence and my mother distracted me as she cleaned my rather severe wounds and somehow they didn’t hurt nearly as much. when she explained how it worked, i was blown away. i was six. i’ve never stopped being amazed by the power of the mind to hurt and to stop hurting.

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thank you for reading. your eyes have done me a great honor today.