Research conducted by Kascakova et al. (2020) suggests that if we experience emotional abuse as a child this significantly increases our risk of suffering from a chronic pain condition as an adult. But why should this be?
According to Talley et al., (1998) one possibility is that childhood trauma increases the risk of individuals developing neuroticism and depression, both of which have been shown to be associated with somatization. Somatization refers to expressing emotional distress and mental anguish through bodily complaints and is mediated by the mind-body connection (i.e. the mind’s ability to affect the body).
Childhood trauma is also known to be linked to muscular tension (see muscle armouring) and hyperventilation (both of which may increase muscle pain. Another very common result of childhood trauma is hypervigilance – such hypervigilance may lead to exaggerated concerns and focus upon internal physical stimuli, this, in turn, may alter the way pain is processed,
McEwen (2003) has conducted research that suggests the quality of the mother-child relationship in early life may adversely affect the way certain genes express themselves leading to an impaired stress-response system, and resultant neurobiological changes, that make the individual more vulnerable to being affected by chronic pain in adult life.
More prosaically, it is also known that childhood trauma increases the individual’s likelihood of developing unhealthy addictions such as binge-eating, smoking, and drinking alcohol in an attempt to reduce levels of emotional distress which, in turn, make them more vulnerable to suffering illnesses (e.g. see the Adverse Childhood Experiences (ACE) study and, of course, the physical pain that can be associated with such illnesses.
Childhood trauma is linked to a much higher than normal risk of suffering mental illness and research conducted by Bondesson et al. (2008) has shown that patients suffering mental illness and emotional distress are twice as likely as average to report suffering from chronic pain Chronic pain has also been shown to be associated with a tendency to ‘catastrophize‘ (‘catastrophizing’ is a kind of error in thinking that involves the individual perceiving situations and events as much worse than they actually are. Ii is a term often used in cognitive therapy),
Those who have developed a sense of having an ‘external locus of control’ are also significantly more likely to report suffering from chronic pain, research suggests. (Bolger et al., 2001). This, too, is frequently linked to childhood trauma and refers to an individual’s belief that what happens to him/her in life is out of his/her control (and is, instead determined by such factors as bad luck, fate, bias, injustice, and prejudice), In contrast, a person with a sense of having an ‘internal locus of control’ takes the view that s/he is in control of his/her own life through his/her actions and behavior). Having a perpetual sense of an ‘external locus of control’ is closely connected to the psychological concept of ‘learned helplessness.’
Adverse childhood experiences have also been shown to affect certain areas of the brain associated with the processing of pain. These include:
- the limbic system (adverse childhood experiences can make it hypersensitive to threat)
- the prefrontal cortex (adverse childhood experiences can impair its connectivity to the limbic system that, in turn, makes the limbic system harder to regulate)
- hippocampus (the hippocampus, research suggests (Tahmineh Mokhtar et al., 2020) may play a part not only in depression but also in chronic pain. Adverse childhood experiences may reduce its volume which is related to reduced plasticity and neurogenesis in chronic pain).
Given the link between childhood trauma and adult, chronic pain, it is important that those working in mental health are trained to understand this link so that they may be able to help their clients more effectively.
Bondesson E, Pardo FL, et al. Comorbidity between pain and mental illness – evidence of a bidirectional relationship. Eur J Pain
Bolger KE, Patterson CJ. Pathways from child maltreatment to internalizing problems: perceptions of control as mediators and moderators. Dev Psychopathol. 2001;13(4):913-940
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