How Secondary Pain Becomes Chronic

When we experience injury or illness, the body sends raw information to the brain. We call this primary pain. The mind’s reaction to primary pain is called secondary pain. This post examines how secondary pain becomes chronic.

I’m currently engaged in a very personalized training process to become a certified mindfulness teacher. Knowing my interest in working with people who struggle with chronic pain, my mentor and coach, Sean Fargo, suggested I read the book “You Are Not Your Pain” by Vigyamala Burch and Danny Penman. So far, I’m really enjoying it.

In the first chapter, the authors talk about primary pain and secondary pain and the processes that occur as the brain attempts to process pain. I decided to write this all out for myself step-by-step to better understand the material. What I ended up with is this 12-step process describing how secondary pain becomes chronic.

12 Steps to Chronic Pain

  1. The brain zooms in on pain to process the information it contains.
  2. The mind teases apart the sensations to determine the underlying cause and find a solution.
  3. Pain intensifies.
  4. The mind begins to sift through memories, looking for similar instances of pain.
  5. Depending on what it finds, the mind may become flooded with unsettling memories.
  6. We become enmeshed in thoughts about our suffering.
  7. This creates a lot of anxiety, stress, worry, and fear.
  8. Stress and fear create added tension.
  9. Pain pathways are produced (or intensified) in the mind.
  10. The brain is now fine-tuned to sense pain more quickly.
  11. We are primed to suffer.
  12. This process happens repeatedly, trapping us in a cycle of chronic pain.

There is a Way Out

Most of what occurs in the steps above is secondary pain. Secondary pain is the mind’s reaction to primary pain–raw information being sent from the body. It’s important to understand that secondary pain is psychogenic. It results from mental processing. Nonetheless, it is absolutely real and painful.

This is the good news though. As we begin to recognize the mind’s habitual responses to pain, we can learn to handle it differently. It takes both courage and mindfulness to accomplish this, yet with insight, dedication, and practice, it’s all quite doable. Especially since mindfulness teaches us new ways to approach pain in the first place.

The takeaway? Secondary pain and chronic pain are optional. They’re both within our power to manage. So, even though some pain in life is inevitable–we are after all embodied beings with deep feelings living in a material world–that doesn’t mean we’re obligated to suffer. We can find new ways to approach pain that doesn’t entail jumping inside the 12-step spiral described above. Once we understand what we’re dealing with, we can find our way out.

Kimberly Holman

Kimberly has a B.A. in Psychology and an M.A. in Religious Studies. She has been practicing mindfulness meditation since 1996.

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