Emotion, Pain and Movement
Understanding how pain, emotion and movement intersect in the Pilates studio.
Pain is a complicated beast. We know from the invaluable research of Lorimer Moseley and the noigroup that pain is complex and chronic pain specifically can be very tricky to work with. If you have not looked into Moseley’s work, I encourage you to tap into some of the fantastic resources available including the book Explain Pain, Moseley’s Why Things Hurt Ted Talk and The Noi Group Institute. What I discuss below is heavily rooted in a pain science context and it can be useful to understand where that research comes from.
In the Pilates studio we work to approach pain from both a physical and a physiological perspective. Being careful not to discount someone’s very real experience of being “in pain”, we work to educate that client about where pain comes from as a way to help them understand and better work with their pain. We know that pain is the result of messaging or signalling from the body, known as noicieption which is essentially activated when the brain perceives something as being unsafe. This means pain is not always an accurate measure of injury or tissue damage, rather a signalling process to avoid danger. We use catchy terms like “the issue is not in the tissue” to remind clients of the significant role their brain is playing in trying to keep them safe. We teach clients about sensation and touch, to highlight how we can modulate pain by changing the imput sensation to the area. Most importantly, we work hard to create a holistically safe environment for people to move in so that they are able to experience movement and exercise successfully, without or with minimal pain and reinforce new neural pathways to help combat that chronic pain cycle.
As a Somatic Movement Therapist, as well as working with the physical and physiological components, I must also consider the psychological component of pain, and in particular, the relationship between emotion, pain and movement.
People who are experiencing chronic pain, which is considered any pain that has persisted for 12 weeks or more, feel inherently unsafe in their nervous system and therefore in their body. They may not consciously think they are unsafe, because the part of the brain responsible for high order thinking is not the same part of the brain that processes emotion. Nevertheless, their nervous system has decided, for whatever reason, that it needs to be on high alert to keep them safe. It therefore will keep firing off all kinds of information to present signs and symptoms (nociception) that their brain then interprets as pain.
There are physical and physiological “hacks” we can apply here to assist with down regulating their system and moving them closer to homeostasis, in order to modulate or soothe the pain. This part is easy. The bigger challenge (for both the therapist and the client) is addressing the psychological component. Without this psychological component - the unconscious belief patterns and thoughts running on auto-pilot below the surface - we are potentially missing the full picture of why the nervous system felt unsafe to begin with?
A person suffering with chronic pain will often also experience a disconnection from their physical and emotional self. Sometimes this disconnection might be attributed to a specific, severe trauma, such as a sexual abuse episode. At other times, it is not as traumatic - more of an accumulation of multiple stressors that have built up over a lifetime. For example, continually overworking, poor dietary choices, poor sleeping habits, lack of exercise and emotional stress. This disconnection is a form of dissociation either away from their body or from their mind, and is usually a way of coping with their situation, or for their nervous system to keep surviving. Again, this is not always conscious. We process emotion in the subcortical area of our brain (the middle layer, often referred to as our mammalian brain) where as our conscious thoughts, higher mental functions, ability to analyse, rationalise, imagine and construct language, all occur in our cortex - the outer layer. This means that often emotional traumas and their effects can remain in the subconscious areas of the brain, wreaking havoc and remaining undetected for many years. These emotional episodes are mapped into our nervous system as “somatic markers”. Our body remembers and holds them, even if our brain doesn’t fully understand them. Sometimes we won’t even remember them cognitively if they occurred before we developed our ability to talk, but our body still remembers. By suppressing emotions that are overwhelming, confusing or difficult to process, a person can also suppress their ability to experience sensations. What can be felt instead is feelings of ‘numbness’ or ‘emptiness’ or varying levels of pain from a ‘dull ache’ to ‘sharp stabbing’ pain.
Why?
Studies have proven that “affective feelings” (emotions) and “tactile-kinesthetics feelings” (sensations) are experientially intertwined. This means certain neurological and physiological responses will produce certain sensations. Certain postures and movements will correlate with certain emotions. This is proven through the work of Nina Bull. Her hypnosis study looked at how emotions are shaped by motor attitudes and postures. She determined that postures or stances are not only related to emotions but can generate emotions. For example, even when prompted, subjects were unable to experience a designated contrasting emotion such as pleasure, if they were locked into a posture of fear. Through this we understand that changing postures or stances can have a significant impact on the individual’s emotional experience. This has even become fashionable recently in corporate settings with TEDtalk by Amy Cuddy regarding “the power pose.”
So how does that relate to pain?
If we are struggling to understand or process emotion, there is a chance we are suppressing our ability to experience sensation, as the sensation is likely to evoke the old emotion. This comes back to the coping/survival strategy of the nervous system. In place of sensations, we then experience numbness, ...or pain. Pain is a myriad of sensations (temperature, texture, pressure) all mashed together. When we are disconnected from our body we are unable to decipher the sensations and the messages our body is attempting to give us through these sensations. Instead we lump it altogether as the experience of ‘pain’ or in terms of the nervous system’s experience ‘danger’. Pain is the body’s way of screaming out for re-connection.
Why Somatic Movement Therapy?
In Somatic Movement Therapy we use the body, movement and touch to address and unpack what may be occurring subconsciously below the surface, sensationally and emotionally - the two are inextricably linked. The body holds the wisdom of every experience a person has lived through and it doesn’t lie. So once we start moving, it will reveal things - thoughts, images, beliefs, memories, emotions etc. Sometimes it can be intimidating to move initially, because the body has held onto so much for so long. As a practitioner, I may invite or encourage certain movements, and they may be accompanied by renewed sensation and unexpected emotions. This can be confronting at first, as it is a re-awakening of what it feels like to truly be connected to oneself. Over time, if the person is willing, the experience of re-connecting and learning to listen to the body becomes more organic. As sensation, perception, movement and touch all begin to feel more integrated, the pain begins to fade away.
References and further reading
Sheets-Johnstone, M. (1999) Emotion and Movement: A Beginning Empirical- Phenomenological Analysis of Their Relationship. Journal of Consciousness Studies.
Hanna, T. (1988). Somatics - reawakening the mind's control of movement, flexibility and health. Da Capo Press
Rothschild, B. (2000) The Body Remembers - The Psychophysiology of Trauma and Trauma Treatment. WW Norton and Co.
T, Fuchs and S.C Koch (2014) Embodied Affectivity: on moving and being moved. Frontiers of Psychology https://www.frontiersin.org/articles/10.3389/fpsyg.2014.00508/full