"Pain is inevitable...Suffering is optional"   Haruki Murakami

Pain Education:

                 Up Pain                Down Pain

                             Good Brain                 Bad Brain

UP Pain DOWN Pain GOOD Brain BAD Brain

Pain analogy to alarm system

Pain is the body’s alarm system. It has elements like a home alarm system

Alarm Sensors

A home alarm system has sensors around the doors and windows.

Your pain system has sensors everywhere in your body.

Alarm Signal Conduction System (Wiring)

The home alarm system has a dedicated signal conduction system to send the signal to the home’s alrm system control panel.

The body has a nerve system for pain (‘C’ Fibers) that is distinct from the nerve system for other motor functions. These are the UP PAIN signals

Control Panel

The home alarm system has a central control panel to receive all signals and process them and if they meet certain programmed conditions, send the alarm to the manned 24 hour Central Monitoring Station for a higher level review and analysis of the threat and at the same time sends signals back down to the alarms

The pain system uses the primal brain as the central control panel. The primal brain is the source of the fight-flight-freeze response that is our SURVIVAL response system that keeps us alive (GOOD BRAIN). The primal brain sounds the alarm and sends the fight-flight freeze response out to the body areas that need to respond (be ready to fight, flight or freeze). This is DOWN PAIN. The primal brain also sends the alarm signal to the brain’s higher level central monitoring system for a higher level review and analysis of the threat. This higher level central monitoring system has two parts: First the threat is monitored by the Emotional Brain (limbic system) and then goes to the Thinking Brain (pre frontal cortex). This is still GOOD BRAIN.

Central Monitoring Station and RESPONSE System

The home alarm’s central monitoring station is where the threat is analyzed. These are higher level reviews. First the alarm is analyzed by the stored past history and compared to previous threats (real versus ‘false alarms’) If there have been multiple false alarms from a particular sensor in the past the ‘learning system’ of the central monitoring analyses an informed decision to call the homeowner for further investigation instead of immediately calling the police. The threat is then passed to the person managing the central monitoring system with a ‘threat level’ score that they can consider when they THINK about what is the most appropriate action to take (remotely turn off the alarms as the threat level is false alarm, call the homeowner for further investigation, call their own level one response team to investigate, call the police, call the fire department, call EMS)

The Brain’s system for FIRST analyzing a current threat against past threats is processed in the EMOTIONAL BRAIN where memories are stored and coded as to how threatening they were. The emotional brain codes past threats based on how threatening they were in childhood when most of these survival memories were first formed then built on over a lifetime of experience. So it is then passed on to the THINKING BRAIN with a THREAT LEVEL code

The Brain’s system of next analyzing a current threat and developing an ACTION PLAN is in the THINKING BRAIN. This is the highest brain function that can fully analyze the response to take. For example if the ALARM SENSOR pain signal was from a hand holding a VERY HOT POT and primal self preservation brain told the burning hand to let go of the pot BUT the THINKING Brain possessed more information and detected that the hand was holding the hot pot for a few more seconds to avoid that hot pot from falling on a child then the THINKING BRAIN overrides the primal brain for higher level purpose. This is still GOOD BRAIN and DOWN PAIN


‘First generation’ Home Alarm systems in the past were notorious for false alarms. " As you have seen in this analogy most false alarms can now be over-ridden by the analysis in the Central Monitoring station through learning, further investigation and analysis. In the past police were called so frequently for false alarms they started ignoring some calls and also fining homeowners for false alarms.

The primal brain and the emotional brain are like first generation older alarm systems. The primal brain sends out an alarm without any analysis if the threat is real or perceived. The emotional brain can miscode the threat level as it is using really old data from childhood when threats were much more challenging. Unfortunately in CHRONIC PAIN is like constant false alarms. The responses that made sense for acute pain do not make sense for CHRONIC Pain, whether the pain site has fully healed or is an ongoing medical problem pain. In chronic pain the primal brain has taken over and keeps sending the fight-flight-freeze signal as DOWN PAIN regardless of the THREAT LEVEL regardless of a higher level response that might be planned. Then body’s response system starts to turn against the constant alarms and gets pain fatigued. The immune system turns against itself and instead of be anti-inflammatory it becomes inflammatory. Just like the fines police invoked for false alarms. The emotional brain takes over and does not involve the THINKING BRAIN very much.