Its all in the mind

back-pain-woman-holding-backIt is peculiar how reluctant we are to grasp the unity that is mind and body. Take the experience of pain. How tempting it is to lay aside its subjectivity. We experience suffering and pain in our own unique way, and in our particular context. Yet we so often focus on diagnosing a single physical component: the aching head, spine, limb or organ.

Long term chronic pain is substantially derived from what pain consultant, Charles Pither, terms, ‘psychosocial variables, such as mood, stress and the social situation’. ( He proposes a combination of psychological and physical therapies to address common conditions such as back pain.

We naturally react against this sort of statement. We are defensive about the robust qualities of our minds, and bristle when it is suggested that our back pain is anything other than a direct fault in our spines.

To help make sense of Pither’s assertion, we should consider phantom limb syndrome. This experience of acute pain appears to be located in a missing limb. Here the brain’s role in mediating pain is unrelated to any external physical mechanism. The response of the brain seems to emerge from past habits or patterns. These continue despite the disconnect with the removed limb.

This is suggestive not only of a problem of absence but also the problem of presence. Where pain does emerge from a clear physiological cause, the mind still brings to bear its patterns and habits. These interact with the new source of pain. The subjective experience of pain thus has a number of layers.

Basic biology tells us that the brain mediates pain. We cannot separate mind and body. Yet our system of medicine is inadequately geared up to treat mind and body in such an integrated way. We reach first for the analgesics.

If pain demands more attention to ‘pyschosocial variables’, then we are drawn once again to the personal, relational and communal contexts of our health. We may well benefit from professional psychosocial support, but so much of what makes us well emerges from the context in which we live. We would benefit from adopting more robust relational and communal approaches to health.


For more detail, check out the pain section of the Wellcome Trust website:

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