The Brutality of Pain

what doesn't kill us won't always make us stronger

Our society tends to a rather macho attitude towards pain. "What doesn't kill us, makes us stronger," wrote Nietzsche, who, himself, suffered a great deal from chronic pain. Such a philosophy may be a comfort to those who are in pain and can't find relief. But sadly, there is much that is false in this credo.

Three Types of Pain

Pain differs not only in intensity but in kind. From the most benign to the most malignant, they are:

• somatic pain. Pain in the skin, muscle and bone
• visceral pain. Pain originating in the internal organs, particularly the stomach, intestines and bladder, has a more agonizing quality. It is caused by inflammation, distention, or pressure on tissues. It's often experienced as generalized so it can be difficult to locate in terms of a specific part of the body. Visceral pain signals are processed by a different area of the brain, the limbic system. Because of the part of the brain involved, this kind of pain has more emotional content.
• neuropathic pain. Pain left untreated can actually cause physiological changes in the body. Nerves that have become traumatized may produce pain indefinitely even after the cause has been removed. The level of this pain can be agonizing. Hyperalgia occurs when the organ responds with high levels of pain to relatively mild levels of stimulation. If this pain isn't treated, the repeated pain signals sent from the organ may cause changes in the dorsal horn of the spinal cord which can then perpetuate the pain signals to the brain independently of cause. This is what causes "phantom pain" of a missing limb or bladder.
• emotional pain? Oddly, this is not listed as a type of pain. Is it a property of the limbic region of the brain? If so, is it, too, ultimately physical in nature. Does it come from the mind acting on the emotion centers of the brain? The difference between emotional and physical pain touches on the whole body/mind dichotomy which people don't all agree on. Is the mind, emotional, and spiritual function independent, separate from and qualitatively different from the physical? Does matter produce spirit? Does spirit produce matter? Are they just separate and co-existing entities which come together in physical life? Why is emotional pain often a signal for judging the person, which seems to mean the more emotional, the less morally upright. What of a mother's pain at the death of her baby? Isn't this kind of pain as agonizing and as natural as any physical pain? The fact that people will sometimes subject their bodies to physical pain in order to dull emotional pain certainly suggests that it can be.

Burn the Witch

For all the sexual libertinism in our society, we are far closer to our Puritan roots than most of us realize. This Puritanism finds expression in such abominations as the "war on drugs," which is really a euphemism for a war on people. While the recreational use of drugs may cause social problems, particularly in the context of drug-war repression, the "cure" is, in this case, worse than the disease. Drug addicts have been consigned to third class citizenship where they lead lives of physical and social degradation. Advocates of the drug wars speak of addicts as people having little importance as human beings, the dregs (which the very war has made them) who deserve to suffer for trying to "escape reality."* While most people who can be ever so callous to the sufferings of drug addicts don't realize is that other people are being harmed as well - the sufferers of chronic painful diseases, for example. Because of the war on drugs, people who need opiates for the control of pain often have a hard time getting enough to do the job. Dr. Daniel Brookoff says, "Patients in bad pain don't get high or euphoric. They use meds to get back into their lives. Patients not in pain take the meds to get euphoric. Current research demonstrates that the risk of addiction is minimal for chronic pain patients. I find it significant that the risk of addiction is even considered more serious than the risk of permanent nerve damage due to untreated severe chronic pain.

Mind Over Matter?

Perhaps the greatest blessing of mortality is that life is only temporary. The greatest pain will end if only in death. If the terrible things our bodies can do to us rightly terrorize us, we know it's not forever. Even the most intractable chronic pain has its valleys and peaks. A good day can be received as a blessing. Life changes as the sun moves across the sky. Nothing in this mortal life is total. Goethe wrote in a scientific treatise that color is the result of the struggle between light and darkness. Our lives are lived between the two. Yes, it is a frightening thing to know that pain, itself, can cause spinal damage. It is no wonder, we try to think we are independent, able to rise above physical pain. It is a fearful, dreadful thing to contemplate the degree which our spirits are held hostage of the body.

I have never suffered from agonizing, chronic, visceral pain. My pains have been, for the most part, the ordinary kind. Yet they hurt and I have worked on strategies for overcoming them with my mind. I try to isolate the sensation of "pain" in my mind and ask myself what about this sensation is "bad." What happens is, the more I focus on the sensation of pain, itself, the more it recedes. From this experience, I have developed a theory that what we call "pain" is a result of not accepting a sensation; of fleeing from it. Fleeing towards pain seems to make it vanish, at least in my limited experience of pain. Pain seems to be closely related to fear. What makes all my pains worse is a mental idea connected with them. Perhaps our mortal bodies produce pain to trigger fear in order to motivate us to protect ourselves from harm. Our bodies were designed to deal with crisis as "flight or fight." They were never designed for long term pain which couldn't be stopped by any action of our own. Chronic pain and anxiety are the price we pay for our civilization which spared us the need to hunt our dinner daily and which prolongs life far beyond what it can be in a state of nature. Now that we have reaped our "blessings," let us learn to make them truly blessings. Let us discard outmoded and inappropriate Puritanism and guarantee to chronic sufferers a life of dignity and comfort within our ability to achieve it.

• American Society for Action on Pain. If you love America, pray to end the drug war.

home
Hole in the Infinite