Safety & Danger in the Context of Health

When we experience pain; it is an expression of an inherent sense of danger. Understanding the spectrum of pain in terms of internal danger and safety can be key to addressing it.

We will experience pain when our credible evidence of danger related to our body is greater than our credible evidence of safety related to our body. Equally we won’t have pain when our credible evidence of safety is greater (Moseley and Butler 2015, p. 14)

Mosey and Butler introduced the idea of DIMS (Dangers in me) and SIMS (safetys in me) in their book Explain Pain Protectometer, 2003. This concept can be very helpful in understanding pain and a point of departure to its effective management. Once we understand our innate experience of safety or danger, we can work to a) reduce danger and b) increase safety.

According to Mosely and Butler there are 7 types of DIMS and SIMS:

  1. Things you hear, smell, taste, touch (HSTT)
  2. Things you do
  3. Things you say
  4. Thing you think and believe
  5. Places you go
  6. People in your life
  7. Things happening in your body

Perception will determine DIMs & SIMs

Both DIMS and SIMS can and do exist in the same realms. This is because our perception plays a role in determining if something is dangerous or safe. For example; if we are generally well, the idea of going to hospital may be a DIM. However, if we are unwell, the knowledge that a hospital may support our recovery will categorise hospital as a SIM. We categorise DIMs and SIMs based on our personal experience, which may also alter over the course of our lives.

The Protectometer

In their book, Moseley and Butler explain the ‘Protectometer’ which is in effect a scale for identifying and labelling our level of danger/safety. When DIMs increase the indicator moves up; when SIMS increase the indicator moves down. At a certain level of danger; danger becomes pain. Therefore, the more under threat we feel, the higher our  propensity to a pain experience. Similarly, increased danger can compound or worsen the pain experience. Inversely, the safer we feel, the lower our pain indicator. Experiences of safety can also decrease our pain experience.

    Recovering from Pain via DIMs and SIMs

    Put simply, this theory suggests that to recover from pain, we must a) reduce DIMs and b) increase SIMs. Part of the work is identifying our DIMs which can lurk in all aspects of our experience: physiological, psychological, behavioural and social/environmental. In a more complex sense, recovering from pain may include exploring core bodily functions (immune, nervous system and other physiological aspects) as well as complex psycho-emotional responses that underpin our personal experience.

    Once DIMs are identified we can work to reduce and deactivate them with a complex, integrated approach.

    Treating Chronic Pain at Soma Clinic

    If you are coming in for physical pain that is chronic, and you suspect it is more than just the usual type of body pains, let us know. At Soma Clinic, we are able to help you delve deeper, in line with the DIMS and SIMS model, with the core goal of achieving a felt sense of safety. Our approach to pain includes:

    Pain Mapping Using Biopsychosocial Model

    For those who request, we will take time to understand your pain, from its point of origin until its current manifestation and how it presents across physiological, psychological,and social aspects of life. Through understanding access points and triggers, we develop appropriate strategies and craft a personal approach to pain management.

    Down-Regulation

    One of Soma Clinic’s key therapeutic approaches to pain is to incorporate down-regulation which works to deactivate our neurological fight or flight response and restore a ‘rest and digest’ function that enhances sense of safety and well-being.  

    Integrated Approach

    Working with both a top-down approach (mind-based) and a bottom-up approach (neurological/somatization) allows clients to address the distress-cycle that is commonly associated with pain and work to change the internal experience. 

    Contact Us

    Are you suffering from situation of chronic pain? Get it touch with us if you are ready to treat it from a layered approach.