Guest Post: The Emotional Side of Migraines - Part 1

We are pleased to share this guest post with you from Nathan Feiles, MSW, LCSW-R.

There has long been a stigma when it comes to migraines and psychology. If someone mentions to a migraineur that mental processes or emotions could have a role in feeding their migraines, the comment is often met with disdain, anger, and annoyance that the person making the comment just doesn't get how real the migraines are, and doesn't understand that the migraineur isn't choosing to live in misery.

Do emotions play any role?

Trust me, as someone who's endured my own migraine struggle, it has always frustrated me when someone would say that "it's all in your head," or even worse, "You're bringing it on yourself." It's likely the person saying these things doesn't understand the experience of migraines, just as anyone who's never had a migraine cannot truly understand the struggle of this issue.

But what if there is a partial truth embedded in that scenario? Bear with me for a moment, if you can. What if somehow deeper emotional processes that are completely out of our own awareness can have a hand in pushing us towards and/or crossing the migraine threshold? It certainly doesn't mean that the migraines are any less real, and it still doesn't mean we are somehow making a conscious choice to cause our own migraines.

Emotions are not the cause

First, to be clear, I'm not attempting to indicate that emotional-relational processes are the cause of migraines. There are many other triggers in the migraine world that are unrelated to emotions. Rather, emotional-relational processes are a part of the picture for many people -- a contributing factor. How significant a factor varies from one person to the next.

Migraines are an incredibly complicated issue, starting with the fact that migraines can be experienced in so many different ways. It would be one thing if there were one or two identified ways for everyone to have a migraine, but the truth is that there are so many ways to have a migraine. It is an incredibly individual experience.

All the triggers

Generally, migraines are known to start with a genetic medical predisposition -- meaning that neurotransmitters and other chemical processes are more likely to respond to certain stimuli in one person versus another person who doesn't have the predisposition. Once the medical predisposition is in place, the ways in which migraines are triggered can run a huge spectrum -- from certain foods, hormonal shifts, physical exertion or tension, and weather, to things like stress, anxiety, sleep patterns, anger, and more.

As a psychotherapist and specialty coach, I've worked with many people across the world on emotionally understanding as well as managing chronic migraines. Coming from the perspective of someone who works with migraines and also has a migraine history, it is strikingly clear the impact emotions can have in the migraine picture.

In the second part of this article, I will describe in more detail the kind of emotional patterns that tend to correlate with migraines, as well as a more specific look at the types of deeper emotional-relational processes that tend to present in conjunction with migraines.


Nathan Feiles, MSW, LCSW-R is a psychotherapist and specialty coach in full-time private practice in New York City. Nathan specializes in working with people who struggle with Anxiety, Migraines, Relationships, Depression, Commitment Issues, Decision-Making, Life Transitions, Fear of Flying, and Performing and Visual Artists. Nathan has received extensive education and training in comprehensive psychotherapy and relational psychoanalysis. He is a graduate of New York University and is affiliated with National Institute for the Psychotherapies in New York City. Nathan works with people nationally and internationally via online coaching if outside of NYC. For more information about Nathan’s work, or to meet with him, visit

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