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Emotional and physical pain are linked through dissociation

It’s not an accident that the word “pain” is used to refer to both physical discomfort and emotional discomfort. The way I think about pain is that people will feel it physically if they don’t – or are unable to –  feel it emotionally.

People that experienced developmental trauma (meaning neglect and abuse as children) often aren’t fully aware of their emotions because they chronically dissociate. This may be a new word for many people, so let me define it.

Dissociation occurs when people block their awareness of their emotions. Everyone has the ability to dissociate. Being able to dissociate is valuable to children that experience developmental trauma because it allows them to not feel the full extent of their abuse.

The habit of to dissociating, when used heavily during childhood out of necessity, can handicap people later in life because they will lack the ability to tune into their emotions.

When people lack the ability to feel emotional pain, I have observed that they will often experience physical pain. Things like muscle knots in their necks or upper backs. Tension headaches. Low back pain. Gastrointestinal pain.

I’d like to share a couple observations about the connection between emotional pain and physical pain that I have made from working with people in chronic pain. My first observation, which is well-documented, is that emotional pain causes physical pain to increase. Not surprisingly, the converse is also true. Physical pain causes emotional pain to increase.

You can substitute words such as “anxiety,” “fear,”  “stress,” or “worry” for the words “emotional pain” in that last sentence because anxiety, fear, stress and worry are words that are commonly used instead of the words emotional pain.

This inter-relationship between emotional pain (or anxiety, fear, stress or worry) and physical pain creates an endless loop that drives both emotional pain and physical pain upwards. If I use more general words, the observation made in the last sentence is that as emotional pain increases, physical pain increases and vice-versa.

The second observation that I want to share is that different people handle the same degree of physical pain differently. Let’s imagine two people that have both had the same physical injury. What I have noticed is that one of these individuals will go on to experience debilitating physical pain over the longer-term, resulting in what is referred to as “chronic pain,” while the second individual will develop effective coping skills and will be able to function without being debilitated.

Maybe the difference between these two people is that the one that can feel their emotional pain can also self-soothe and thus step out of the emotional pain – physical pain spiral, while the one that cannot feel their emotional pain cannot self-soothe and thus becomes stuck in the emotional pain – physical pain spiral, which escalates ever upward.

I have noted that people in the first category will often report that they had a healthy childhood, while those in the second category will often be aware that they experienced developmental trauma.

My conclusions, drawn from these two observations, is that (1) people that had a healthy childhood and are able to feel their emotions are better able to develop effective coping skills to manage physical pain, while (2) those that experienced developmental trauma and dissociate to block an awareness of their emotions are less able to develop effective coping skills to manage physical pain and are more likely to experience physical pain.

Dr. Patricia Turner, Registered Psychologist, Calgary, Alberta 

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