I just popped in today to see what you’ve been writing and – as usual! – found this intriguing gem. And once again – because I tend to interpret things through the lens of a heart attack survivor – there is much familiar wisdom here. For example,

“…anxiety and fear develop (the amygdala is over reacting to perceived threat) increasing the overstimulation. Then a low tolerance for pain develops….”

This precisely describes the nightmare of the heart attack survivor. Our cardiologists can patch us up, stent us, bypass us, zap our flawed electrical circuits and then pat us on the head and boot us out the doors of the Coronary Intensive Care units as if we are just another acute medicine case. But we’re not.

It’s pervasive among heart circles to heart patients report that every subsequent chest twinge or bubble produces extreme anxiety and fear responses. “Is this something? Is it nothing? Should I call 911?” Absolutely exhausting and overwhelming and terrifying. No wonder we’re anxious and fearful! Unlike other forms of pain, chest pain to a heart patient means only one thing: death. It’s like walking around with a ticking time bomb. In fact, I’ve heard many survivors observe that having a heart condition feels like your body has “betrayed” you, that what you’ve taken for granted your whole life (your heart beating) may at any moment be taken away in a spectacularly traumatic fashion.

That’s why folks like Dr. Stephen Parker (a cardiac psychologist in Alaska, but more importantly, a heart attack survivor himself) says NO WONDER up to 65% of heart attack survivors experience depression. “A heart attack is a deeply wounding event”, as he likes to say. “The meaning that pain has for ourselves” is tremendously powerful – for all patients suffering pain. Our meaning, as I said, is interpreted a fatal warning.

I’m very interested in your brain observations on sensory and somatic sensitization – isn’t that what’s at work for all of us who interpret every pain signal as intensely meaningful?