What Does Overwhelm Have To Do With Chronic Pain?What Does Overwhelm Have To Do With Chronic Pain?
The Biology of Trauma™ With Dr. Aimie
Dr Aimie Apigian explains how chronic pain is linked to overwhelm and trauma rather than simple stress, outlining the body’s survival patterns and pain loops. She shares five core nervous system skills aimed at building capacity and reducing chronic pain flare-ups.
23:19•24 Mar 2026
Chronic Pain, Overwhelm and Trauma: Dr Aimie’s Nervous System Skills
Episode Overview
- Chronic pain is framed as an overwhelm issue rather than a stress issue, changing how interventions are chosen.
- Pain and trauma are said to follow the same biological pattern, looping between stress and overwhelm when the body does not fully reset to safety.
- Survival responses such as dissociation, freeze and energy conservation can keep the body stuck in chronic pain states.
- Five core nervous system skills—feeling, shifting state, pacing, tracking and choosing—are presented as essential for those with chronic pain.
- Building capacity and moving towards a calm, “calm alive” state is described as more effective than simply managing symptoms.
“Chronic pain is not a stress problem. It is an overwhelm problem, and that distinction matters because it changes the interventions that we use.”
How do people manage co-occurring mental and physical health issues while recovering? This episode of *The Biology of Trauma™ With Dr. Aimie* looks squarely at the links between chronic pain, overwhelm, and trauma, making it especially relevant if you're dealing with pain alongside stress, addiction, or long-term emotional strain. Dr Aimie Apigian, a double board-certified physician and trauma and addiction expert, breaks down why chronic pain is rarely just about stress.
As she puts it plainly, **"Chronic pain is not a stress problem. It is an overwhelm problem, and that distinction matters because it changes the interventions that we use."** She explains how the body crosses a “critical line of overwhelm” where survival responses like dissociation, freeze, and energy conservation kick in, and how that same pattern underpins both chronic trauma and chronic pain.
You’ll hear her outline how the nervous system loops between stress (fuelled by adrenaline) and overwhelm, and why pain often shows up more intensely in the shutdown phase rather than during stress itself. She also brings in concepts like microglial activation, neuroinflammation, and neuroception to show how the body is constantly scanning for danger and deciding if it has the capacity to cope.
A major highlight is her set of five core nervous system skills for people with chronic pain: **Can I feel? Can I shift my state? Can I pace? Can I track? Can I choose?** These skills are presented as practical tools to build capacity rather than just manage symptoms, especially for those who find themselves stuck in familiar flare-up patterns.
Whether you're someone living with chronic neck or back pain, dealing with long-standing trauma, or a practitioner supporting others, this conversation offers structured, body-based strategies that might help you ask a new question: is this really about stress, or is my body telling me it’s overwhelmed?
Do you want to link to this podcast?
Get the buttons here!
More From This Show
The latest episodes from the same podcast.
Related Episodes
Similar episodes from other shows in the catalogue.