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The emotional mechanisms  involved in triggering chronic pain

What are the emotional components identified in many chronic pain patients?


The story of each patient is unique and, therefore, the weight of the events at the origin of the appearance of a chronic pain syndrome at a given moment in a person's life, generally a break, a loss or failure, are on a case-by-case basis.

In this sense, the same event, for example a road accident, may not generate the same emotional traumas in two individuals. Everyone lives and integrates the vicissitudes of existence according to their personal history. The emotional traits listed in the extension are therefore not necessarily present in all people who suffer from fibromyalgia or chronic pain.

Due to this, the processBiodanza & chronic pain proposed consists of exercises that go in the direction of identifying the human potentials that may have been shaken or repressed after a painful event, in order to restore them with the aim of regaining a balance in life.


Take the example of courage. After an accident, this life force that comes to us from the heart, this potential,  has been able to fade or disappear, leaving pain to take up more and more space, even all the space in our lives, preventing us from overcoming the ordeals to which pain subjects every human being. During the realization of this process, this strength, the courage, can be found, greatly facilitating the overcoming of chronic pain by the implementation of new life strategies, aiming for example to reduce the pain by focusing more on the pleasure.

You could say that courage will be a strength that will allow us to flourish in the desert!


Some chronic pain personality traits

Who is this painful and this chronic pain on which the algologists of the world are researching?

Dr. Benezech builds on the work of Dr. Massimo Zoppi (1), to outline some characteristics of fibromyalgia patients that could be extended to other individuals with chronic pain:

  • catastrophic view of life

  • Hypersensitivity

  • Alexithymia

  • Incessant activity since always and need to be supported

  • Lack of autonomy

These  The characteristics listed may not all be present in all individuals, these are the characteristics identified showing a profile of the person suffering from fibromyalgia. You may not feel identified with all of these characteristics.

Pain, anger and feelings of injustice

Anger is a pervasive trait in people who suffer from chronic pain. The situations experienced at the origin of the appearance of the chronic pain syndrome may have been experienced as unfair, this feeling feeding, like an unstoppable loop, the anger in the body.

All the studies show, in fact,  that chronic pain subjects thought-feed anger, disrupting the opioid circuits that regulate these states in the body.

Freeing our body from suppressed anger is certainly the surest way to overcome chronic pain.



During my professional activities, I am often surprised at how difficult it is for interns to even recognize that anger lives in them. It seems that this emotion, yet so widespread and an integral part of our emotional states, is shameful.

In psychology, anger is considered a secondary emotion linked to a physical or psychological injury, a lack, a frustration. This is generally characterized by a strong reaction generally resulting in physical or psychological manifestations on the part of the person concerned, which can however be contained or even concealed.

We will see how muchConcealing anger for people with chronic pain can be deleterious and maintain pain in an infernal vicious circle.

Anger as a component of pain

For the ancient Greeks, pain was an emotion: the negative counterpart of pleasure. These complex links between pain and emotion led in the 20th century to the integration of one of these two terms into the international definition of the other, as one of its components. However, like the sensory and cognitive dimensions, knowledge of the emotional functioning of pain is still in its infancy.

Anger is one of these “adjustment behavior disorders”,often negatively connoted with sadness or fear. It is however the guarantor of our encroached territory, defense of our physical or psychological integrity flouted (voluntarily or inadvertently) by an individual, an event or a system...anger refuses what is experienced as an injustice.However, its forms have evolved so much, compared to its functioning in the animal world, that we have difficulty always recognizing it in society, and sometimes using it wisely.

This notion of the “misuse” of anger, of its ability to turn into pain if restrained, has been mentioned by several authors in psychological and psychiatric circles in recent decades.Scientific studies show that chronic pain patients who fail treatment report the same frequency of angry feelings as the control group (patients who have suffered a lot in the past from their illness) but are more likely to inhibit  their expression. The notion of self-punishment emerges significantly from the questionnaires and the authors link this notion to the difficulty in expressing anger to others.


Other studies have focused on exploring this expression, but also the patient's awareness of this anger. The authors do not find any difference in the expression of anger between two groups (one from a pain treatment center and the other ordinary pre-surgery),but a very significant difference in the awareness of this anger, which turns out to be less perceived for chronic pain patients. The latter are therefore in denial of angry feelings and aggressiveness.

Internalized anger, externalized anger

The angry character is distinguished from the transient emotion-anger, and even more from the way in which anger is manifested, internalized or externalized.


In algology, studies make the link between “suppressed, repressed or at least unexpressed feelings of anger” and pain. For R. D. Kerns (2) the suppression of anger could hypothetically compromise the regulation of the central opioid system and thus promote pain.

This reflection on endorphins serves as the basis for the study conducted by S. Bruhel et al. in 2002 (2), in 44 chronic low back pain patients and 45 control people without pain who received in 2 randomized sessions (said of a clinical trial where the treatment is drawn by lot for each patient, the draw is usually done between the usual treatment and a new treatment that is considered equal or superior to the usual treatment) a placebo or 8 mg of naloxone (antagonist, neuroleptic  or  antipsychotic, opiate  used in therapy), before undergoing two tests - pain. They first answer the pain and depression-anger questionnaires.


Analysis of the resultsshows more pain in low back pain, associated with a greater depressive component and anger traits, with no significant difference for the expression of anger between the two groups.


However, the comparison between the placebo test and the naloxone testhighlights the fact that the participants who report the most externalized anger do not modify their pain under naloxone, as if their endogenous opioids were already blocked beforehand under placebo.

Thus, externalized anger would modify endorphins. There would therefore be two forms of expression of anger, both having an impact on pain, but only “externalised” anger would be regulated by the opioid system.

These authors believe that externalized anger acts as stress, which via its adrenergic component is suspected to be the etiology of pain via the opioid system.

Could anger be the cause of the onset of chronic pain? by the disruption of our hormonal system, the one intended precisely to relieve it?

The link between internalized anger and chronic pain is well established. Dr. Benezech published this article in 2008




IIt is necessary to put in place means to express, in total safety for the integrity of the Self, this emotion so deleterious for our body., responsible for the appearance of many diseases.

An essential aspect of this harmful emotion for the body is to understand: behind anger hides sadness.


When we express anger very strongly we always end up crying, as if once the colossal energy of anger is released it leaves room for the origin of the anger, the sadness felt by the  feeling of unjustified loss that lives in us.  

The feeling of injustice takes its source where we find that painful, even traumatic events have taken place in our life in an accidental or irresponsible way or by the negligence of others or by the lack of conscience, it is i.e. in situations that could have been avoided,  would have saved us from suffering.

With time and work  on ourselves, on our life and on the events that marked it, this feeling of injustice can acquire another connotation, giving it another meaning. But after the accident, the emotions are there, experienced in their raw state, without elaboration to lessen its effects on us and our organism.




After my accident I felt a great anger that I could never express to anyone. Being very young at the time (19 years old), I had no awareness of the effects in my body of such an emotion. In addition, no one around me, neither in the medical profession nor in the family around me,  did not attend to my emotions or my feelings following such an accident, all knowing perfectly well the circumstances in which it had taken place.

In my case for example, when I realized that my reckless comrades had called for help and that, finding myself the closest to them, I could not refuse them  to help (I felt obligated, even though in my head I was annoyed by their irresponsibility), and that this situation had brought me an accident that had turned my life upside down, my anger welled up with a dull violence inside Me.

My anger  se  turned first against them and their lack of conscience - and prudence - and, secondly against me for my inattention, because I had not checked the position of the nail and the attachment of the rope which connected me to this one during my descent with my back to the void. My climbing partner had not reacted appropriately either, I had insisted on going down myself to rescue our comrades. In short, in such a critical situation, stress had been omnipresent, the lack of vigilance had cost me dearly.

The  Details of these various scenes of a few minutes were constantly turning in my head in the hope of finding the element that could have spared me this terrible suffering, in vain. Everything was frozen, almost flabbergasted in my memories, nothing could have happened otherwise, static bodies and minds waiting for the planned unfolding, almost programmed by an improbable fate a few seconds before.

The years passed and each moment when the memories came back - immutable - my anger grew and the fear of my 35 meters in free fall, like a disarticulated puppet, tore tears from me with a mixture of anger and sadness.

And I was thinking about my story and the millions, even billions of people who experience traumatic situations, most often without their knowledge.

How many traumatic situations take place every day through our lack of caution, attention and awareness? How many of these situations leave indelible traces on the bodies of the victims?

We have all been subject to tantrums. People who suffer from chronic pain have experienced traumatic situations with a very violent feeling of injustice, followed by a feeling of anger that could literally take up all the space in the body, repeatedly, completely disrupting the normal functioning of the body. 'body.

This suppressed anger must leave our body if we want to overcome our chronic pain. Its crystallization in our psyche results in a permanent feeling of  stress due to heightened alertness. This is perpetuated by a constant and growing muscular tension, feeding a vicious circle in the body which ends up disrupting our neuro-hormonal circuits.


Freeing the body from anger allows us to gradually regain this organic balance so necessary for good health where chronic pain is stopped.


Biodanza and more specifically the "Biodanza & chronic pain" process, is intended to release the emotions so long crystallized in our brain and our body that chronic pain or fibromyalgia have appeared to remind us of it!

(1) Mr. Zoppi, Mr. Maresca. Reumatismo. Firenze: Department of Medicina Interna, Section di Reumatologia, Università degli Studi di Firenze, 2008.

(2) Benezech, Jean-Pierre. Chronic pain: a hidden face of resilience. s.l.: Sauramps Medical, 2005.

(3) Benezech, J.P. [Online]

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QA few years after my fall and my accident, I started to feel very angry. EThey took me without me realizing it, they were stronger than my will to remedy it. I could explode beyond measure with the object of my anger, I often felt overwhelmed by this emotion, it took up all the space in my body. During these episodes of anger, my chronic pain returned with incredible force, the more anger I felt, the more my body suffered.

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“  Anger is an emotion found in many people with chronic pain. The more it is present, the more pain there is.


It participates in the patient's depression, in particular through anger against oneself.


Current research identifies the notions of internalized or externalized anger, which would act by different modes of action (opioid system for externalized pain) on different painful pathologies.The acceptance of the painful reality, and not the ineffective refusal, could be a path to explore in the therapeutic approaches of the future” (3).

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