It hurts: the elusive nature of painIt hurts: the elusive nature of pain
All In The Mind
Chronic pain. Gnawing, throbbing, aching. Like a rotten apple at the core, razor blades down the spine, barbed wire coursing through the body. Talking about it is difficult enough, but does how we think about pain actually change the nature of pain itself? Many of us still consider pain as solely biological, with major implications for the treatment we seek and receive. This week—a philosopher, a top pain psychologist and a young man who understands the intimate interplay between mind and pain better than most.
30:14•30 Sept 2006
Why Pain Feels So Personal: Brains, Bodies and Chronic Hurt
Episode Overview
- Pain is not just a biological signal; emotions, beliefs and the brain strongly shape how much it hurts and how limiting it feels.
- Chronic pain can persist long after tissue healing, and its cause may differ from what keeps it going.
- Heavy reliance on opioids often reflects untreated distress, yet these drugs tend to work least well in highly distressed patients.
- Cognitive behavioural therapy for pain focuses on accepting ongoing pain, reducing distress and rebuilding valued activities rather than chasing a cure.
- Feeling disbelieved or dismissed can deepen depression and self-harm, while understanding and support help people regain a sense of control.
“"What if you could have this pain and not be bothered by it? How would that feel?"”
How do people cope with the challenges of staying sober when pain is screaming at them day and night? This conversation on chronic pain pulls together science, philosophy and raw personal stories to show just how slippery pain really is – and why our beliefs about it matter. Host Natasha Mitchell talks with pain psychologist Professor Michael Nicholas, philosopher of mind Murat Aydede, and people living with long-term pain, including Richard, Rob Lomax and Linda Sinfield.
Their descriptions are unforgettable: pain like "rusty, hot barbed wire", or "an animal pouring away inside me". You’ll hear how invisible pain can leave people feeling dismissed, doubted, and pushed towards self-harm, heavy medication or alcohol just to get through the day. Professor Nicholas challenges the simple "broken part equals pain" model, explaining that pain is "not just a sensation" but also emotional, and shaped by the brain and nervous system.
He questions heavy reliance on opioid medication, noting that "there's increasing evidence that opiates are being used for distress rather than for the pain" and that they often work least well for the most distressed. Richard’s story shows how changing his thinking changed his life, even though his pain stayed. After a three-week cognitive behavioural therapy program, he shifted from trying to kill the pain to asking what he could still do "despite" it.
He describes the joy of coming off multiple medications and simply being able to smell flowers and home cooking again. For anyone in recovery, or supporting someone who self-medicates because of chronic pain, this episode offers a different frame: what if you could have pain and "not be bothered by it" as much? And what might your life look like then?
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