The morning my husband put his back in the garbage.
It had been a rough night with our sick 2-year-old. It had been a rough week of nights. I was fumbling around the kitchen in a sleep-deprived haze when my husband comes upstairs and announces:
“I threw my back out.”
My poor husband. I imagine a compassionate response in this moment would have been: “Oh, man, I’m sorry – that sucks. What happened?”
But that is not what he got from me.
Instead, exhausted and anxious, I’m thinking about myself: “Does my own husband seriously not understand what I do? Does he not understand how pain works? How have I failed to convey that it matters how you speak about your body?”
I muster up an ounce of patience, try to take it less personally, and offer: “At work, I try to coach people not to use language like that.”
As my husband walks towards the door, he follows up with: “There is something mechanically wrong.”
And in this moment, I believe he believes that and I’m speechless because my brain isn’t processing fast enough to offer a compassionate, helpful, and authentic response. The unhelpful response on the tip of my tongue is: “Are you kidding me?”
Fortunately, before I say anything, my husband turns around with a smile on his face and says, “I’m joking!”
I furrow my brow a little. Not funny.
Okay, a little funny.
Those of you who haven’t dabbled in pain neuroscience might be a little confused at this point. I probably lost some of you with my lack of sympathy for my husband throwing his back out. But let us really pause there for a moment.
What does that even mean? “Throw out”. Did he put it in the garbage? Toss it out the window?
No. Of course not. It means he is experiencing pain in his back.
But – and this is the key piece – he is using language that implies a structural problem or weakness in his back. Language that suggests something went wrong, that something is out of place.
You might be thinking at this point, “Okay, I hear you, but what does it matter? It is just an expression. We know what he means.”
Here is why it matters:
Pain is a protective response. It is like a built-in alarm system for your body. If your brain believes your tissues are under threat, it will sound the alarm.
Contrary to popular belief, the alarm itself is not a reliable representation of what is happening in our tissues. Countless variables influence whether or not your alarm will trigger, but the one that matters with respect to this story is your thoughts.
What you think (and what you say) plays a significant role in your brain’s perceived need for protection. This is not airy-fairy yoga talk; this is neuroscience.
If you speak of your body as broken, fragile, or weak, you are contributing to the cues that you are in need of protection. Using language like this will increase the likelihood of a protective response. It will increase the likelihood of pain.
So, how do we think and speak about pain in a way that will decrease the likelihood of a protective response?
Use language that is as precise as possible. Use language that describes the actual experience you are having, not an attempt to explain why you might be having it.
Take my husband’s back as an example: what did he know that morning?
He knew that he started experiencing pain in his back. “Wow, I am feeling some pain in my back.”
He could probably tell me which part of his back was painful. “Right in the middle of my back.”
He could have used words to more richly describe the sensation. “It’s pretty sharp and sudden.”
What else does he know in this moment? Not much. And it is a good idea to respect that.
When you are in pain, practice using language that focuses on describing your immediate experience of the pain. Let go of language that attempts to provide an explanation for the experience because that language will inevitably be less precise.
Even the best physician, physical therapist, or neuroscientist won’t be able to tell you exactly why you are experiencing pain. Pain is far too complex to be reduced to a singular mechanism.
But the more we start to respect this complexity, the more empowered we are to influence our experiences of pain in new and significant ways. Independent of other factors, how you think and speak about your pain will influence this protective response.
When you speak to your experience of pain, stick to what you know and hold to this truth: human bodies are strong, resilient, and adaptive. Human beings are strong, resilient, and adaptive.
You are strong, resilient, and adaptive.
Moseley, G. L. (2007) Reconceptualizing pain according to its underlying biology. Physical Therapy Reviews 12: 169-178.
Moseley, G. L. & Butler, D. S. (2015) The Explain Pain Handbook: Protectometer. Noigroup Publications: Adelaide.Understanding Pain