When pain becomes a cycle
Chronic pain can take over more than just the body. It can affect mood, sleep, work, and how connected someone feels to life around them. At Cova Psychology, many people we meet describe feeling caught in a loop. Their pain increases when they worry, and the worry grows stronger every time the pain flares.
This pattern is sometimes called catastrophising. It is a process where the mind jumps to the worst possible conclusion. Thoughts like “What if this never ends?” or “What if I damage myself again?” quickly turn into tension in the body and distress in the mind. Over time, that stress makes pain feel louder.
Understanding how this loop works is often the first step to changing it. You can learn more about how psychologists help manage this process on our page about chronic pain treatment in Melbourne.
What catastrophising actually is
Catastrophising is not exaggeration or attention-seeking. It is the brain’s way of preparing for danger. When something hurts, the body sends pain signals to the brain. The brain’s job is to decide how serious that pain is and whether action is needed. In chronic pain, the system becomes over-protective. The alarm rings even when there is no new injury.
This means pain is absolutely real, but the brain has learned to interpret normal signals as threats. It becomes better at producing pain, even when it is no longer helpful.
When the mind expects pain, muscles tense and the body prepares to defend itself. That physical tension keeps the alarm switched on. It is a loop that keeps pain, fear and fatigue intertwined. If you are interested in understanding this thought cycle further, you might like our article on overthinking and thought loops in CBT.
How pain rewires the nervous system
Modern neuroscience has shown that the nervous system is constantly learning. If pain lasts for a long time, the pathways that send and receive pain messages become more sensitive. This process is called central sensitisation.
It is like a car alarm that goes off every time the wind blows. The alarm is working, but it has become oversensitive. Similarly, a sensitised nervous system reacts to normal movement, light touch, or emotional stress as if there is damage.
This explains why someone’s scans or medical results might look fine, yet the pain remains intense. It does not mean the pain is imagined. It means the body’s alarm system has been trained to stay alert. For some people, this is linked with early life experiences and patterns formed long ago. You can read more about how unresolved experiences can shape our pain response in our post on childhood trauma and therapy in Melbourne.
The role of thoughts and emotions
Catastrophising keeps the nervous system activated. When pain sparks fear, the brain interprets that fear as further evidence of threat. The result is a self-reinforcing cycle.
You might notice this if your pain worsens after a stressful week or when you are particularly tired. It is not all in your head. It is your body reacting to the signals it receives from your thoughts, emotions and environment.
Therapy helps by retraining the brain to respond differently to those signals. Instead of strengthening the loop, the goal is to soften it.
How therapy helps retrain the loop
Working with a psychologist can help you identify the patterns that keep pain and fear connected. Awareness itself can begin to change the way the brain processes pain.
Different therapies can be used together, depending on what fits best for you.
Cognitive Behavioural Therapy (CBT)
CBT explores the link between thoughts, emotions and pain responses. It helps you recognise unhelpful patterns such as “I can’t cope with this” or “I’ll never get better,” and replace them with thoughts that create calm and control. Even small shifts in thinking can lower tension in the body.
Acceptance and Commitment Therapy (ACT)
ACT encourages making space for discomfort rather than fighting it. By focusing on values and what matters most, pain becomes less of a barrier to living meaningfully. People often describe feeling more grounded and less consumed by the constant monitoring of their symptoms.
Mindfulness and body awareness
Mindfulness invites you to notice sensations with curiosity instead of fear. Simple practices such as gentle breathing or noticing the edges of a sensation teach the brain that these signals are not necessarily dangerous. Over time, this reduces reactivity in the nervous system.
Polyvagal and somatic techniques
The vagus nerve is central to calming the body. Breathing exercises, grounding, and slow movement can activate this system and help the body return to safety. When the body feels safe, the brain begins to trust that safety too. For more detail on how this works, you might find our blog on polyvagal exercises for emotional regulation helpful.
Rebuilding confidence in movement
Avoiding activity is a natural response when pain flares, but it can make things worse. Muscles weaken and confidence drops, reinforcing the loop of fear and avoidance. Gradual re-engagement with movement, guided by a psychologist or physiotherapist, helps rebuild trust in the body’s ability to cope.
In some cases, therapy approaches such as EMDR can support the emotional side of pain by addressing the stress memories that sit underneath it. You can read about how this approach works in our post on who can benefit from EMDR therapy.
Compassion as part of recovery
People living with chronic pain are often very self-critical. They may feel they should be coping better or worry that others do not believe them. Self-criticism keeps the body in a state of tension, while compassion helps it relax.
A compassionate mindset does not mean pretending pain is fine. It means understanding that the body is trying to protect you, even if it has learned an unhelpful pattern. Treating yourself with patience rather than frustration helps calm the same physiological systems that drive pain.
Sometimes people think self-compassion is a soft skill, but it is actually one of the hardest parts of recovery.
When to reach out for support
If pain is beginning to take over your life, therapy can help you regain balance. Psychologists trained in chronic pain management can help you:
Recognise unhelpful thought patterns that intensify pain
Develop practical tools to regulate your nervous system
Rebuild trust in your body and your ability to move
Reduce the fear and anxiety that often accompany chronic pain
At Cova Psychology in Melbourne, we understand that chronic pain is complex. It is never just physical or just emotional. It sits at the meeting point of the two. Our role is to help you understand that relationship and begin to change it.
Taking the next step
If you have been living with ongoing pain and want to find a new way forward, you do not have to do it alone. Our psychologists at Cova Psychology in Melbourne can help you retrain the loop of pain and worry, and support you to reconnect with the things that matter most.
We offer in-person sessions in our Melbourne CBD clinic and online therapy for people across Victoria. Taking the first step towards change can feel daunting, but it is also a sign of hope.
Reach out to our team today to begin working towards a calmer, more confident relationship with your body.
Dr. Sarah Valentine
Sarah is a Clinical Psychologist and co-director of Cova Psychology. With more than 20 years of experience across both public and private mental health settings in Melbourne, she brings a calm and compassionate approach to supporting people living with chronic pain and emotional distress. Sarah works with the mind–body connection that sits at the core of many pain experiences, helping clients understand how patterns such as catastrophising and fear can keep the nervous system stuck in protection mode.
She is an experienced EMDR therapist and also integrates Schema Therapy and Mentalisation Based Therapy (MBT) into her work. Sarah has a particular interest in helping people recover from trauma and the long-term impact it can have on how the body holds pain. As a board-approved supervisor and mentor, she also supports other psychologists in developing confidence and skill in this area of practice.