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might be effective with painby Mark Grant MA
Some of the key players of the central nervous system in pain are the thalamus, the amygdala, the anterior cingulate cortex and the frontal cortex. The Central Nervous System is also not 'hard-wired' but kept in a stable state by elaborate control mechanisms. If these control mechanisms become unstable, as a result of say prolonged stress, neurological changes can occur, producing symptoms such as those found in trauma and chronic pain.
The amygdala regulates the emotional state of the brain and mediates the fear response. The amygdala is thought to be involved in the affective component of pain (Le Doux, 1997, Lenz et al, 1997). Stimulation of the somatosensory thalamus has been reported to reproduce previously experienced pain associated with a strong affective dimension. It has been suggested that stimulation-evoked reproduction of previously experienced pain is the result of thalamic activation of 'limbic' structures that are involved in somatosensory memory, ie; the amygdala, and conditioned by the previous experience of pain. (Lenz, 1997, Le Doux, 1997) . This is corroborated by the finding that stimulation of the amygdala of patients with other pathologies, such as epilepsy, has also been found to produce associated emotions. (Halgran, Walter, Cherlow In Lenz.)
NB: Learning done by the amygdala is thought to be unconscious, as opposed to the conscious learning and memory functions mediated by the hippocampus and related brain regions. In an emotional situation, both forms of learning would take place simultaneously, but separately. There are thus two distinct forms of learning and memory, one conscious and one unconscious. This has implications in terms of how affective experience might color later reactions to pain. (Le Doux, 1997)The Cingulate gyrus regulates switching of attention from one thing to another. Problems in the Cingulate system can lead to getting 'stuck' on certain thoughts or behaviors, aggressiveness, compulsivity, which is seen in chronic pain sufferers and trauma victims.
The functions of the Prefrontal cortex include modulating concentration and attention and the ability to feel and express emotions. (Perhaps pain sufferers who are able to succcessfully distract themselves from their pain are using their Cingulate system, in conjunction with their pre-frontal cortex?)
The hippocampus regulates the stress response. Repeated exposure to a stressful stimuli appears to weaken the hippocampus ability to control the release of stress hormones.
In both trauma and pain, neurological phenomena can maintain the response, even though the original cause may be long gone.
Characteristic neurological phenomena have been observed in the brains of persons diagnosed with PTSD and persons with chronic pain, notably in the thalamus, the amygdala, the anterior cingulate cortex and the right hemisphere (lateralization effect). Both pain and trauma are associated with increased thalamic activity. (Derbyshire et al, 1997)
The amygdala is implicated in both chronic pain and trauma. (Lenz et al, 1997, van der Kolk, 1996). The amygdala has also been implicated in the production of natural opioids. (Manning & Mayer 1995).
In both trauma and chronic pain there is increased activity in the right hemisphere. (van der Kolk, 1996, Hari et al, 1997) This is the hemisphere involved in expression and comprehension of global non-verbal emotional material.
The anterior cingulate cortex consistently shows increased activity during pain (and trauma).
In both trauma and chronic pain there is usually disruption to REM sleep. In trauma at least, this is known to be as a result of too much norepeniphrine. (Henry, 1994 ) NB: REM sleep is known to be necessary for information processing.
Chronic Pain Sufferers usually experience high levels of stress. Stress is known to lower the production of Seratonin by the brain. Seratonin is an "anti-stress" chemical that inhibits transmission of nociception, low Serotonin levels increase sensitivity to pain. Chronic pain is also known to lead to over-sensitivity in spinal cord and Central Nervous System, ('Central Sensitization' Devor, 1996) and drug therapy is aimed at "turning down the volume" on that sensitization.
Trauma victims, who were treated with EMDR and given a SPECT brain scan, pre and post EMDR, showed reduction in some of the neurological abnormalities associated with their condition: (van der Kolk, 1996) Specifically, the anterior cortex of the cingulate gyrus was activated.
And there was a lateralization effect as a result of the left hemisphere (Broca's area) becoming reactivated. (van der Kolk, ibid)
Nicosia (1994) found that examination of EMDR clients by electroencephalography (QEEG) revealed a normalization in the slower brain wave activity of the two cortical hemispheres.
This tentative evidence that EMDR works to correct neurological abnormalities underlying trauma, which have parallels with pain, suggests that it might also be efficacious with pain.
The commonalities that seem to exist between neurological bases of trauma and pain, together with the neurological changes observed following EMDR, suggest that EMDR might facilitate correction of neurological abnormalities associated with both trauma and chronic pain. These speculations regarding neurological correlates of psychological processes represent a fairly new trend in psychology. Traditionally there has not been much attempt to related psychological events and/or therapy, to neurological processes. They do offer the hope of developing psychological interventions that are both consistent with how the brain processes information and demonstrably effective.
This information is provided by Mark Grant to assist you to participate actively in your treatment and cope with chronic pain in the best way possible.
Mark Grant is a psychologist, specializing in the management of chronic pain and trauma. His advice is based on many years of clinical experience working with persons affected by chronic pain and trauma.
Mark has also conducted research regarding a multi-modal approach to pain management. He is the author of two self-help tapes which use accelerated learning principles for sufferers of chronic pain and stress: Calm and Confident based on EMDR and Pain Control, based on EMDR. He has also spoken at numerous international conferences and workshops about pain management.