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When dealing with any chronic pain condition, a common tool to help provide relief is recognising your DIM and SIM triggers:
DIM = Danger in Me (negative)
SIM = Safety in Me (positive)
This concept was developed by Dr. David Butler and Professor Lorimer Moseley in their leading and widely popular pain management resource 'Explain Pain'. (References to the delicious food 'dim sum' are purely a mnemonic device, designed to help remember the concept and make you hungry.)
This approach focuses on the biological, psychological and sociological/environmental causes of pain - rather than just a single cause (e.g., endometriosis tissue damage).
It recognises that pain is an incredibly complex neurobiological process, which can be the result of not only tissue damage, but also how your environment and other factors contribute to and amplify pain signals.
DIM and SIM triggers can be provoked by a variety of stimuli, including:
Things you do
Things you say
People in your life
Places you visit
Things you think and believe about your pain
Things you hear, taste, see, touch and smell
Things happening in your body
An example of a DIM trigger (negative) is hearing someone describe their pain using words like 'stabbing' or 'gut wrenching'. After hearing this, your brain may unconsciously make an association with danger - causing pain to suddenly be felt in your body.
Or, it could be visiting an unpredictable environment, like work, where your brain remembers the stress associated with this. This causes it to send a pain signal in its effort to warn you of the perceived danger - even if it’s a quiet work day and there’s nothing to address.
An example of a SIM trigger (positive) could be walking on the beach (if you enjoy that, of course!). Feeling the sun on your face and hearing the waves of the ocean creates a sense of peace and calmness in the body.
Or, it could be when hanging out with your loved ones - the feeling of emotional support and ease lets the brain know that it's safe and there's no danger that it needs to look out for.
The power of our thoughts and environment—and their influence on pain levels—cannot be overstated. Your brain's subconscious is responsible for 95% of its processing. This means only 5% is conscious thought (e.g., planning and decision-making).
This leaves a lot of room for the brain to work its magic and make assessments of situations and stimuli without your conscious input. Problem is, it makes mistakes and gets confused a lot. Even words or phrases can set it off if we don't consciously and mindfully override it.
Recognising your DIMs and SIMs is a powerful tool for creating safety in the body, which helps limit the pain response. Understanding your DIMs and subsequently overriding them with SIMs tells the brain that everything’s ok. You’re safe.
This can be as simple as piling SIMs into DIMs, like listening to your favourite podcast and doing deep breathing while commuting to the office. Or focusing on relaxed parts of the body where there isn’t pain to remind your brain what safety in the body feels like.
This neural rewiring doesn’t require a lot of time to establish, and the mere act of finding safety in the body when experiencing danger will have tremendous effects on your pain levels, as you continue to practice it.
While it isn’t always perfect, you’ll notice some pretty cool changes to your relationship with pain, just by simply rethinking how pain works and the power you can have in managing it.
If you're interested in learning more about DIMs and SIMs (beyond an aggressively oversimplified version of the topic), you can start by visiting here.
And if you want to begin rewiring your pain response through the power of neuroplasticity and mindfulness, you can check out special meditations for endo warriors here. You've got this, warrior.
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