By Alex Klassen MSW, RSW

One of the amazing things about the human brain is how quickly it makes associations that help us survive.  From childhood, we connect conditions and responses through daily experiences, learning what actions feel safe or positive (repeat these!), and what actions feel unsafe or negative (avoid these!).

To understand how conditioned responses work, we can think about Pavlov’s research on the brain and learning. As an experiment, Pavlov started turning on a clicking metronome right before feeding his dogs. After a few repetitions, he noticed the dogs would start salivating from the sound of the metronome alone. The dogs developed a conditioned response.¹

In this example, the condition = the sound of the metronome, and the automatic response = salivate.

How Conditioned Responses Develop With Chronic Pain/Symptoms

When we’re experiencing chronic pain or symptoms, the brain also makes associations between an activity or stimuli (the “condition”) and pain/symptom (the “response”).

For example, imagine you notice back pain increasing when sitting in your computer chair. Naturally, the brain asks, “Why does my back hurt?”. And the most obvious answer might be, “It’s this darn chair!”. If the chair is physically hurting your back, this association is helpful. Your brain viewing the chair as dangerous could help you increase physical safety by adjusting the chair, buying a better one, changing posture, or avoiding sitting for too long.

From what we eat, to how we move, to how we socially interact, learning associations between causes and their effects is essential for our wellbeing and survival. Conditioned responses help us anticipate and avoid danger and move toward safety.

Sometimes the Brain Makes Mistakes

Let’s look deeper at the back pain example from above. It's possible the pain you're experiencing isn’t actually caused by sitting in the chair. It could be neuroplastic, meaning it’s caused by your brain mistaking safe nerve signals from the body as dangerous². In this scenario, the actual cause of back pain could be anxiety from your job or some other stressor leading to nervous system dysregulation and a sense of tension^2,3. But you feel more pain when sitting, so you mistakenly conclude that something's wrong with your chair, posture, or back, when everything’s physically ok.  Your brain has now made a new association:

The condition = sitting in a work chair, and the automatic response = back pain

When conditioned response forms, your brain is more likely to generate pain the next time you sit in this chair. It's like Pavlov's dogs, but rather than salivating, the anticipating brain activates pain. This can happen because pain can happen without any physical injury or damage; pain is a danger signal trying to protect you from what it believes to be dangerous².  Neuroscience shows us that the level of pain we experience is not an accurate measure of your physical/tissue health, it's a measure of how much danger the brain senses^2,4. Over time, a conditioned response can grow stronger and stronger; a brain that expects, protects, leading to more pain/symptoms.

Conditioned responses can happen in many different areas of life, including foods, weather, time of day, relationships, smells, environments, movements and activities. Unfortunately, the longer pain or symptoms have been around, the more conditioned responses it may form. The brain mistakenly believes different conditions are causing pain/symptoms, leading to more fear, avoidance behaviours and pain/symptoms. It’s a nasty feedback loop, but it’s possible to reverse it!

In the Somatic Safety Method Course, you'll start by gathering evidence for physical safety and understanding how your neuroplastic pain/symptoms work. Every person is unique, meaning your symptoms and conditioned responses are unique to you. Through education, nervous system regulation practices, and brain retraining tools, you can identify and break conditioned responses.

References:

1. Rehman I, Mahabadi N, Sanvictores T, et al. (2023). Classical Conditioning. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

2. Gordon, A., Ziv, A. (2021). The way out: A revolutionary, scientifically proven approach to healing chronic pain. Sony/ATV Music Publishing LLC.

3. Crofford LJ. Chronic Pain: Where the Body Meets the Brain. Trans Am Clin Climatol Assoc. 2015;126:167-83. PMID: 26330672; PMCID: PMC4530716.

4. Moseley, L. Tame the beast: It's time to rethink persistent pain. https://www.tamethebeast.org/