Alan G. Overcoming conditioned responses

[rileshoops]

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Question

Hi there, I was wondering if you could give advice about chronic pain symptoms that occur every morning. I have chronic daily headaches and they happen in the morning. For the past four years or so I've had a headache pretty much every morning when I wake up. And it's because they occur when I wake up that I feel stumped. I also get migraines and back pain at other times of the day (during stressful times usually) and for these I can use somatic tracking or meditations or journaling to lessen or get rid of the pain, so I definitely see the power of this work and how it can help me. But when I'm sleeping I don't have a chance to notice the pain coming on or do anything about it. And once I'm awake it's hard to be motivated to do somatic tracking or a meditation or journaling because I'm sleepy. In fact, somatic tracking or a meditation will just put me back to sleep. And the more I sleep in, the worse I feel. I love the new podcast, but it feels that most of the people you work with have pain when they do a certain activity like sitting, moving their neck, etc. And that makes sense to me that you can try out that activity and remind yourself you're safe and eventually re-train your brain. But how does this work when you're not conscious for the activity ie sleeping or just waking up? I've read the books, listened to the podcasts, use the Curable app, did Dr. Schubiner's workbook "Unlearn Your Pain," and have a therapist who specializes in MBS/TMS/neuroplastic pain etc. And still these headaches persist. I feel I have the tools to help myself at other times of the day but in the morning I feel helpless The most success I've had in dealing with my morning headaches is to go to bed and wake up at the same time every day and do yoga, meditations, and journaling at least once if not twice a day each. But this is 1) not sustainable and 2) creates fear around straying from this schedule at all and 3) still doesn't give me any tools to deal with the pain right when it happens. These headaches definitely feel like a habit formed in my brain that I need to break, but I'm not sure how to break the habit when I'm sleeping/just waking up. Any advice?

 

[Alan Gordon LCSW]

Answer

Hi Riley,
The morning head pain is just a conditioned response. There is nothing objectively dangerous about the morning. It’s just like how some patients develop an association between pain and sitting or pain and typing, for you it’s just a time of day instead of a position or activity.

The goal is not to prevent the pain from coming on, but change the way you respond when it does. I’m guessing that each morning you wake up and have pain, you feel fear or frustration or despair. But this kind of energy just further reinforces to your brain that the pain is dangerous.

Each time you have a headache, it’s just another opportunity to create a new association. Practice attending to positive sensations and giving yourself messages of safety.

If you can get to a point where you’re in a positive emotional state WHILE feeling a little pain, that’s even better than not feeling the pain at all. Because your brain will eventually learn those sensations are safe, and the pain will eventually fade.

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