How restoring a sense of safety in the nervous system supports healing and evidence-based pain treatment
Written by Anna Katherine Black, PhD
Licensed Clinical Psychologist
GI Psychology
For many people living with chronic pain, the body doesn’t feel like a safe place. Pain can feel unpredictable, overwhelming, and exhausting—especially when medical tests don’t fully explain the intensity of symptoms. Decades of research now point to a clear starting point for healing and sustainable pain relief: safety.
Creating a sense of calm in the nervous system isn’t about “ignoring” pain or assuming it’s psychological. It’s a core component of evidence-based treatment for chronic pain conditions, including gastrointestinal (GI) disorders and functional GI disorders. When the nervous system feels safer, pain often becomes less intense, less frequent, and more manageable.
Why the Nervous System Matters in Chronic Pain
The nervous system has two main branches that shape how we experience pain:
- Sympathetic nervous system: the “fight, flight, or freeze” system. It prepares the body to respond to threats.
- Parasympathetic nervous system: the “rest and digest” system. It supports recovery, digestion, and healing.
In chronic pain, the sympathetic nervous system is often stuck in a high-alert state. The body behaves as if danger is constantly present—even when it isn’t. Over time, this state of vigilance amplifies pain signals and interferes with pain relief.
Simple definition:
When the alarm system of the body stays on too long, even safe sensations can start to feel painful.
Central Sensitization: When the Volume Gets Turned Up
One key concept in modern pain science is central sensitization.
Central sensitization means the brain and spinal cord become more sensitive to pain signals. The “volume knob” on pain is turned up, so sensations that were once neutral—or mildly uncomfortable—can feel severe.
Central sensitization plays a major role in conditions such as:
- Chronic abdominal pain
- IBS and disorders of gut–brain interaction (Rome Foundation)
- Fibromyalgia
- Chronic pelvic pain
- Migraine and tension headaches
Importantly, central sensitization is reversible. One of the most effective ways to reduce it—and support long-term pain relief—is by increasing a sense of safety in the nervous system.
How Creating Calm Reduces Pain
When the parasympathetic nervous system is activated:
- Muscles soften
- Digestion improves
- Inflammation markers decrease
- Pain signaling pathways quiet down
This is why interventions that promote calm—such as gut-directed hypnotherapy, cognitive-behavioral therapy (CBT), mindfulness-based approaches, and other psychological treatments—are now considered first-line, evidence-based options for chronic pain and disorder of gut-brain interaction treatment (Mayo Clinic; APA; Rome Foundation).
These approaches don’t eliminate pain by force. Instead, they send the nervous system a new message:
“You are safe enough to turn the alarm down.”)
Practical Ways Patients Can Support Nervous System Safety
Here are a few gentle, research-informed strategies patients can try:
1. Slow the body first
Before trying to “fix” pain, focus on slowing breathing or grounding the body (e.g., longer exhales, feeling your feet on the floor). This directly supports how to calm a nervous digestive system and the parasympathetic response.
2. Reduce threat-based self-talk
Thoughts like “Something must be terribly wrong” can unintentionally activate the sympathetic nervous system. Replacing these with more accurate, compassionate statements can support pain relief over time.
3. Use predictable routines
The nervous system likes consistency. Regular sleep, meals, and gentle movement help reinforce safety.
4. Work with trained providers
Psychological treatments are most effective when delivered by clinicians trained in pain science and functional GI disorders, particularly for GI-related pain.
Why This Approach Is Not “All in Your Head”
Pain is always real. Pain is a biopsychosocial experience, involving interactions between the brain, body, and environment. Treating the nervous system does not invalidate physical symptoms—it directly addresses one of the most powerful drivers of ongoing pain.
This is why leading medical institutions now integrate psychological care into comprehensive pain and GI treatment programs focused on durable pain relief.
Key Takeaways
- Chronic pain is often driven by a nervous system stuck in threat mode
- The sympathetic nervous system amplifies pain; the parasympathetic nervous system helps quiet it
- Central sensitization explains why pain can persist without ongoing tissue damage
- Creating a sense of safety is a foundational, evidence-based step toward pain relief
- Calm isn’t a luxury—it’s a biological intervention
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References
American Psychological Association. (2023). Clinical practice guideline for psychological and behavioral treatments of chronic pain. APA.
Mayo Clinic. (2023). Chronic pain: Symptoms, causes, and management. Mayo Foundation for Medical Education and Research.
National Institutes of Health. (2022). NIH pain research strategy. U.S. Department of Health and Human Services.
Rome Foundation. (2016). Rome IV diagnostic criteria for disorders of gut–brain interaction. Rome Foundation.
Tracey, I., & Bushnell, M. C. (2009). How neuroimaging studies have challenged us to rethink: Is chronic pain a disease? PAIN, 142(1–2), 1–8.
Williams, A. C. de C., Fisher, E., Hearn, L., & Eccleston, C. (2020). Psychological therapies for the management of chronic pain. Cochrane Database of Systematic Reviews, (8).