“Pain” is a Four-Letter Word

I thought I was done with “four-letter words”. But …

Emotional and physical pain are part of being human. Not that we should expect them, but they do occur, and no one is exempt.

Western medicine has developed a vast array of drugs to combat pain, both psychological and physical. Even so, it’s the elephant in the living room—definitely there, but too often, not discussed.

People on both sides of the patient/physician spectrum have deep-seated notions about what’s “acceptable” as far as expressing pain. We all, at some level, think that it’s “better” to simply endure silently or with as little fuss as possible. “Complaining,” “demanding,” “difficult”—all these words are the last labels we want attached to us as patients.

We’re taught to “quantify” pain to try and understand it better. We say, “On a scale of 1 to 10 …” On this scale, 1 is barely a nuisance, while 10 is so excruciating it is unbearable.

If I’ve learned one thing, both as a healer and as a recipient of healing, it’s that people’s scales are all different. One person’s 3 is another’s 9.

Many people have also absorbed the “no pain, no gain” lesson a little too deeply. (I know I have—and then I wonder, “How am I supposed to relax and receive if it hurts so much?”.)

Medical students spend a lot of time learning how to fix the body, diagnose symptoms, and prescribe drugs that will produce specific results. With so many drug choices, pain can become just another symptom to assign a chemical solution to. We hear, “Tell me where it hurts,” or “Describe your pain,” but seldom are given much more than a few minutes to try and respond. Yet too often, pain robs us of our ability to communicate clearly, both with ourselves and with those trying to provide healing.

Pain is one of the biggest obstacles to effective healing. You can’t “just relax” if you’re in such severe pain. You can’t “just take some deep breaths”. Pain clouds our ability to process information, take suggestions, or sort through the emotions that get kicked up when we’re hurting.

Drugs often only add to this cloudiness, and many people either use too much of them to sink into oblivion, or avoid using them altogether in order to maintain mental clarity.

It might not make any difference at the general level whether the pain being experienced is psychological or physical. But how we, as healers or caregivers, approach our calling with respect to pain management has to flow from compassion and understanding, not simply a practical desire to “make it stop” or “get rid of it”.

The first step on this road is to acknowledge that, as healers, we are not going to be able to alleviate all pain. To think that we have this kind of power is arrogant and can be deeply harmful to us and our clients.

Second, we must go beyond simply having people rate their pain on a 1-to-10 scale, or describe it as “hot,” “cold,” “aching,” or “stabbing”. We can, and should, ask all these questions, but don’t just stop when you’ve gotten the answers you want.

Pain is a companion. Long after the appointment has ended and the prescription has been filled, people will still be living with it.

The approaches to managing it are as varied as the kinds of people we encounter as healers. What brings relief to one person with a particular condition may have no effect on a second person with the same condition. Pharmaceutical companies produce drugs that work on a broad range. If we are providing truly compassionate healing, we must target the specific ways that each of our clients can find and experience pain relief.

Sometimes, when there is no way to change the actual situation, simply being heard and acknowledged is enough to bring tremendous relief.

Pain manifests itself in innumerable outward responses. People lash out or withdraw. They cry. They stop speaking. They scream. They pass out. Pain increases the severity and duration of asthma attacks. It raises heart and breathing rates, heightens muscle tension, exacerbates inflammation, causes insomnia and anxiety, depression. It has such a capacity to stir up every realm of life—physical, emotional, psychological, and spiritual—that it is no wonder that so much “treatment” is aimed at eliminating it.

I have talked with many, many people, both as a healer and just as another human being, and heard many stories about the pain of loss, disease, disappointment, grief, loneliness, separation, disability, depression, injury, aging. Some conversations have been less than five minutes long, while others have been dialogs that span years, decades.

I don’t stand above these encounters, looking down on them and thinking, “Oh, here’s what you should do”. I try to see the circumstances from the perspective of the one I’m listening to. How would I feel, for instance, if my daughter dropped out of school, or my brother got angry and refused to speak to me for the rest of my life, or my employer let me go with lame excuses after I’d worked for ten years? What is it like to feel powerless to control myself when presented with a particular chemical? What must it be like to lose a husband after thirty years of marriage, or learn that I have a disease that will gradually rob me of my ability to think coherently? How would I respond if, on an ordinary drive, my car was hit head-on and I woke up three days later unable to walk?

The answer I have is, “I don’t know”. But I can ask questions, listen to the responses, and learn. By learning, perhaps I can pass something along to someone else in a future conversation that will help them.

And, if there is no “concrete” suggestions to be made, just the asking and the listening are a gift that goes too often overlooked.

We can find “concrete” aids to pain management—medication, meditation, music, massage, just to name a few. But there is no substitute for compassion and no prescription or dosage instructions for understanding. These must spring from the heart, without regard to how the other person will receive them, repay them, or respond to them.

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