Coregulation and Pain


Coregulation is really a phenomenon of human existence. We share feelings, emotions, thoughts, physical interactions and unconscious energy when we are in the same place.


Measuring Coregulation

The physiological measurements of co-regulation is a recent area of study. The activity of the autonomic nervous system; cortisol, oxytocin, vagal tone (an activity of the vagus nerve which is involved in heart rate regulation) has all been measured with respect to co-regulation.

We Affect Each other

When we are in any place together each of us is actually having an effect on someone else and they have an effect on us. More so if we have a caregiving or long-term relationship. When the people around a chronic pain sufferer are fatigued and upset, then the person in pain is affected. This coregulation is the beauty and the difficulty of human interaction.

Who is in your circle?

It can seem like an impossible task but when we are in pain – especially chronic pain – we want to be very careful whom we have in our close circle. Pain lessens when we are at ease and when we have fun, play and laugh. So the joy of coregulation is that we feel better around people who are positive and help us to be positive. And we are happier in familiar environments.

What if you are in an institution?

Physical therapy on a leg
LANDSTUHL, Germany (Oct. 16, 2008) Physical therapist Lt. Cmdr. Mitchel Ideue, Officer in Charge of Inpatient Services at Landstuhl Regional Medical Center, in Landstuhl, Germany, gives Army Sgt. Charlie McCall a physical therapy treatment. (U.S. Army photo by Michelle Barrera)

It is very difficult to coregulate in a hospital or nursing home setting with roommates who are depressed or drugged. Therefore, if at all possible go home quickly to heal or find a beautiful place to gain strength and decrease pain. If we are faced with low energy from others and are not around energizing people than the suffering stays the same.

What makes a positive difference?

Proven to make a difference: children and support animals visiting nursing homes lessen the pain of residents. And how do they accomplish that? Coregulation. We need to recognize that we are regulating other people and they are regulating us.  We energetically share the same space.smiling boy

So even without words when other people are tense then the pain sufferer will naturally tense, which increases pain.  


Our bodies pick up what is available from others. A calm and happy interaction is much more healing.

Move away from the people that are feeling depressed and anxious when in pain. And move towards people that have the opposite effect. 

The mammalian nervous system finds two cues extremely important.

Labeled by science lethal cues, one is restraint and the other one is isolation. Either one will increase pain.


Isolation is a problem for most pain sufferers especially the bed-bound. Texting as communication can be looked at as a metaphor of being isolated. We can not get the healing cues of a hug or kiss or handhold by text.

Face to face

We need to have face to face connection. So the issue of where we are and how isolated we are makes a big difference in healing and reducing pain. When we’re not isolated we can have positive reinforcement and lessen our fear of abandonment.


Restraint is the other cue that is problematic for chronic pain sufferers. Anxiety can be high in certain group settings and if one person is in pain that does affect others. For example, one crying baby in nursery affects all the babies and they all begin to cry.

L0000384 Credit: Wellcome Library, London.
Extremity of pain: Painting, Sir Charles Bell  Published: 1806
Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0

Although restraints used in healthcare settings are decreasing because of lethal outcomes, various settings use physical restraint as a measure designed to protect both patients and staff.

Restraints not therapeutic

The extent to which restraints can be classified as therapeutic interventions is questionable: their efficacy as therapeutic measures has not been empirically demonstrated. And when in pain the sufferer will only feel an increase in pain from restraints in the long term.

Cascade of stress chemicals

When a person is restrained, there will be a cascade of stress chemicals, which may temporarily seem to end pain (we don’t want to notice a pain in the foot running from a tiger) but that does not mean that the foot is not signaling. Using restraints on a pain sufferer does not help with feeling safe and calm. Those feelings are the ones that in the long term create a pain-free life.  

Positive coregulation can make all the difference

Very few chronic pain sufferers are able to self-regulate enough to separate a pain signal from suffering. But coregulation by a positive loved one can make all the difference.  This, in fact, can create greater resources for the sufferer to self-regulate.

create a support system
Support is vital for a healthy life


When we are all consciously aware of this fact of human existence then there can be a big step forward to lessen pain and empower our self healing.


Butler, E. A., & Randall, A. K. (2013). Emotional Coregulation in Close Relationships. Emotion Review, 5(2), 202–210. 

Coan, J. A., Schaefer, H. S., & Davidson, R. J. (2006). Lending a hand: Social regulation of the neural response to threat. Psychological Science, 17, 1032–1039

Leerkes, E. M., & Wong, M. S. (2012).Pain free at last . Infancy, 17(5), 455–478.

Sbarra, D. A., & Hazan, C. (2008). Coregulation, Dysregulation, Self-Regulation: An Integrative Analysis and Empirical Agenda for Understanding Adult Attachment, Separation, Loss, and Recovery. Personality and Social Psychology Review, 12(2), 141–167. 

Children and the elderly

The Effects of Preschoolers’ Visits to a Nursing Home Carol Seefeldt, PhD The Gerontologist, Volume 27, Issue 2, 1 April 1987, Pages 228–232,

What happens when a nursing home and a daycare center share a roof?

Less pain for seniors




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