Pain is a Funny Thing

Pain is a funny thing. It pervades our daily existence more than we might realize. We talk about physical aches and pains like headaches, stubbed toes, and paper cuts. We talk about the emotional pain that comes from unhappy life circumstances. Countless poems, plays, screenplays and books have been written about emotional pain related to love in particular. Make a trip to the self-help section of a bookstore looking for books about having a happy (read: painless or at least pain-minimized) emotional existence and you’re unlikely to come out empty-handed. Society is obsessed with dealing with emotional pain, because most humans understand these types of pain. We know what it feels like and we don’t like it one bit. Chronic pain is whole ‘nother ball game, but we’ll get back to that in a minute.

Overall we consider it a bad thing, right? If you hear someone is eliciting self-inflicted pain, the societally-programmed impulse is to worry – and to judge. We have medical specialities that specifically deal with minimizing pain. But pain has an incredibly important evolutionary role. Pain helps us to learn – especially as children – which things are dangerous and should therefore be avoided. The fact is, while we may all experience pain, science doesn’t really understand it. Sure, we can talk about certain types of nerve fibers and which parts of the brain are active when we’re in pain. From an emotional perspective we have psychology versus psychiatry – and, of course, all different camps of different theories within them.

Still, we know it’s important. Many medical professionals consider it one of the vital signs that should be collected from each patient. I once heard two professors debate whether the pain scale should be 0-10 or 1-10. On mics. In front of the class. (The argument being that doesn’t a score of 1 imply that you have some pain? So people with no pain should be able to rate their pain at 0.) And, yet, how can we understand what other people are going through when different people perceive the same pain-causing stimulus to cause different levels of pain? An 8 on the pain scale for me might be a 4 on the pain scale for you. We all perceive it differently, and then we deal with it differently too. And both perceptions and coping abilities adapt when we keep dealing with pain over and over. There’s no magical formula for it. What works for me probably won’t work for you and vice versa. But I think the key to learning to deal with the pain is to understand that while everyone might not be able to understand what it’s like to be in pain all the time, pain really does pervade our existence. We can’t escape it any more than we can escape ourselves.

So where, in all of this, does chronic pain fit in? Well, chronic pain - perhaps because of its inherent chronic nature – is both physical and emotional. To put up with chronic pain for so long is stressful on the mind. It’s a daily frustration, and most of the time people don’t even realize that you’re in pain. Even if they do realize that you’re in pain, they really can’t fathom what it’s like to always be in pain. Without that perception, they can’t gain full understanding.

So, to recap... First we deal with the constant physical pain. Then we deal with the emotional pain that it causes. Then we deal with the fact that nobody gets it. (Relax, I’ll spare you the what doesn’t kill you makes you stronger speech.) I think what it comes down to is realizing that pain has a purpose. How much pain my joints are in often tells me when I’m heading into a flare up or that I’ve been overdoing it lately. We can resent it all we want, but in a chronic illness it does occasionally have it’s moments of usefulness. Still, in learning to live with the pain, I think it’s the emotional pain that is hardest to deal with. But deal with it we must, because otherwise how would we have the emotional strength to deal with the physical pain?

Nevertheless, chronic pain doesn’t fit into any of those points, does it? It’s not serving an evolutionary purpose, it’s not a warning signal about health status, it’s not anything really useful at all. It’s just, well, PAINFUL.