Disturbing the pain

Earlier I mentioned that sometimes the powerless try to use anger as a substitute for power.  People also  use anger as a way to displace pain.  I do that all the time.  Because of the arthritis in my neck, I am constantly banging my head getting in and out of cars.  Because of the arthritis in my back, I tend to lift my head too quickly or swing it too widely after looking into the refrigerator or a low cupboard, again smacking my head against an edge.  I’ve learned to move more slowly and watch better for edges, but it still happens, particularly in an unfamiliar setting.  Before I understood what was happening with my body, I would often fly into a rage, partly brought on by surprise at the pain, but very much associated with shame at being so clumsy and for not paying better attention.  When I was younger, I would I often punch the offending object (note the displacement of responsibility) or a nearby wall.  If I was particularly surprised or hurt or frustrated, I would go outside and smash a big stick to pieces against a tree or a rock. I don’t do that any more, but I still have been known to beat the roof of the car with my hat after hitting my head getting out.  More often now, strings of four-letter words work for the angry displacement of pain.The release of adrenaline accompanying the anger usually makes the hurt go away, until I start feeling shamefaced for losing control.

Being upset can also distract us from other pains. David Epstein mentions a worker who was so afraid that his co-workers would think he was stupid for losing his foot in an industrial accident that he didn’t feel that pain; a woman “with a severed leg felt fine but cried because she believed that now no man would want to marry her;” soldiers with ghastly wounds in WWII, did not seem to feel pain, even refusing morphine, but complained about inept IV sticks.  According to Epstein there is a

pathway that evolved for stress-induced analgesia, in which the body’s natural opiates, such as endorphins, bind to opioid receptors in the brain and spinal cord and trigger the release of dopamine, which causes a euphoric feeling and mitigates pain.

Very often after a particularly violent outburst, I would feel that moment of euphoria.

Pain and disturbance interact the other way too.  When we are upset, we hurt; when we hurt, we are upset. Simple nerve stimulation is not enough for pain.  There also has to be disturbance.  South African scientists studied how runners can control pain when they know how far they’ve run and how far they still have to go.  When, however, the runners don’t know how much farther they have to go, upsetting their sense of control, pain takes over and they can’t run as well … until they can see the finish line.

Our bodies have evolved to be programmed to flee or fight threats.  Physical pain, however, is already within, already inside, already not! now.  We cannot flee physical pain unless we flee our own bodies. We call the various substances we use to get away from the pain “pain-killers,” but they really do not kill pain.  They stop or break up nerve signals, or otherwise interfere with the neuromatrix, so that “we” can get away from, out of our tormented bodies.  As David Epstein puts it, “The main power of some painkillers lies not in dampening the physical quality of pain but in softening the emotional response to it.”  That is, modulating the disturbance.

If they cannot do that, painkillers can at least render us unconscious, unable to attend to anything, especially physical pain … out of it.  In moments of extreme sensory overload, our bodies can do the same for us.

If we don’t have the option of fleeing or displacing the pain, then we tend to fight it.  Charlotte Delbo had a clear path to fight her thirst—get water by any means necessary.  Laura’s path to overcome her aphasia, speech therapy, didn’t work.  Her therapists were used to working with stroke victims and handicapped children.  They just didn’t know what to do with a woman with two doctorates, who may not have been able to say it, but who knew better than they did that they were lost.  So, if we cannot fight the pain or the source of the pain, we start fighting ourselves.  We start making negative judgments.  “I can’t bear not being able to say what I’m thinking.”  Then, we start believing these negative judgments.  “I look stupid.”  C.S. Lewis calls this “misery’s shadow … you don’t merely suffer but … keep thinking about the fact that you suffer.”  (1961, 9-10)

Side note about speech therapy.  When Laura was doing her best under Avastin, her tumor still kept her from performing at her former language levels.  In the course of looking for a better language therapist, Laura found that the hospital where she was being treated for GBM had a large institute for treating language disorders, including aphasia like hers.  No one on her “team” at that hospital had ever connected those dots.  She did.

Over the last few posts, we have seen how the experience of fear works very much like the experience of grief, both as pain and disturbance.  In his “new science of bereavement,” George Bonnano adds an important dimension to this interaction between pain and disturbance.  They are physical movements and they oscillate.  Grief comes in waves. (Bonnano 39-42)  To illustrate this point, Bonnano quotes from the following passage in which C.S. Lewis compares his grief to his wife’s physical pain.

What is grief compared with physical pain?  Whatever fools may say, the body can suffer twenty times more than the mind.  The mind has always some power of evasion.  At worst, the unbearable thought only comes back and back, but the physical pain can be absolutely continuous.  Grief is like a bomber circling round and dropping its bombs each time the circle brings it overhead; physical pain is like the steady barrage on a trench in World War One, hours of it with no let-up for a moment.  Thought is never static; pain often is.  (Lewis [1961] 41)

I’ve quoted Lewis in full because Bonnano does not seem to see that Lewis puts grief outside the body, into “the mind … thought.”  Bonnano seems to be distracted by Lewis’ metaphor of the bomber, which he quotes, but does not pay attention to the opening question (“What is grief compared with physical pain?”) nor the closing aphorism (“Thought is never static; pain often is.”)

As someone who described Laura’s pain as “unending, constant,” I can fully appreciate why Lewis wants to dismiss the importance of his grief in comparison with his wife’s suffering.  But Bonnano does not have that excuse.  Nor does Bonnano recognize the seeming contradictions between what Lewis says and Bonnano’s own statements two pages before (p. 40) where he calls grief a “mind and body function,” not just “thought,” as Lewis does.  If  “everything inside us oscillates, literally,” as Bonnano says, then where does that leave Lewis’ claim that “physical pain can be absolutely continuous.”

I can also understand why Lewis might have forgotten or no longer agree with the appendix to his earlier work on The Problem of Pain.  In a “note on the observed effects of pain … from clinical experience, R. Havard, MD, states that

Mental pain is less dramatic than physical pain, but it is more common and more hard to bear.  … [I]t is easier to say ‘My tooth is aching’ than to say ‘My heart is broken’. (Lewis [1944] 161)

When Lewis writes that “the body can suffer twenty times more,” he is talking about the amount of pain that can assault the body, more than the body’s ability to bear pain.  As strongly emotional as this passage sounds, Lewis overextends a mind-body dichotomy to classify grief as “thought” not “pain,” by which he means here only “physical pain.”  He claims that the grieving mind can always evade an “unbearable thought.”

This tendency to divide feeling sad from physically hurting is of a piece with Scarry’s opposition between the pain and imagination, which we will explore when we consider the aphasia of pain in detail in a later post.  For now, please recall how Dorothee Soelle criticized Jesus’ disciples for falling asleep while he was in such anguish that “his sweat became like great drops of blood falling down on the ground.”  (Luke 22:44)  Soelle felt that the evangelist was giving them a pass by offering the excuse that they fell asleep “out of sorrow,”  Not only is she apparently unaware that the original Greek apò tēs lúpēs also refers to physical pain, she treats sorrow as less significant than physical pain.  In her view, Peter, James and John “went to sleep on him like children for whom something dragged on too long.”  It is one thing to describe how this behavior made Jesus feel “betrayed, denied, and left in the lurch.”  But I think she goes too far when she ignores the physical toll of grief and sorrow and compares the disciples to “friends and acquaintances” who informed on the Jews under Hitler, or even just “slept well when the victim was arrested.”

It is interesting that Soelle seems so obtuse to the suffering of the disciples at the beginning of a very detailed and insightful analysis of Jesus’ agony in the garden during which the mental anguish of his fear of his pending crucifixion turned into physical pain.  Jesus gave the disciples more consideration: “… the spirit indeed is willing, but the flesh is weak.”  (Matt 26:40, Mark 14:62)   We will look more closely at Soelle’s section on “Gethsemane” in the next post because it deepens our understanding  of how pain and disturbance oscillate and come in waves of grief, fear, and shame.  We will also return to her treatment of the sleeping disciples in another post where shame and guilt will be compared.  Falling asleep while their leader anguished over his pending arrest was without doubt shameful, but the weakness of the disciples did not make them guilty of the indifference or outright disloyalty that Soelle charges them with.  By “weakness” I refer to falling asleep, not to Peter’s denial.  Of that he was guilty.


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