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Swati Desai, Ph.D., LCSW Headshot

Take Away Suffering From Chronic Physical Pain

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Shinzen Young, a well-known meditation teacher, uses a very apt metaphor for describing the difference between physical pain and suffering. Suffering is like the area of a rectangle, the base of the rectangle is the physical pain and the height of the rectangle is the resistance we create to the experience of the pain. When we reduce the resistance to the pain, the suffering from the pain is reduced. If the height of the rectangle becomes zero, then the area of the rectangle becomes zero too, although the base is unchanged. If we manage to completely take away the resistance to the pain, the physical experience of the pain is still unchanged, but the suffering we create is reduced to zero.

The key then is to understand what resistance to the pain we may be holding. Resistance to the pain comes from what we attach to the pain. Because pain is our body's way to tell us to pay attention to something being wrong, we tend to attach several fears and anxieties to the experience of pain. The pain may trigger some deep belief which in turn creates fears and anxieties that are not so much about the pain itself, but about the underlying bigger issue that got triggered. That is what creates suffering.

I would like to offer examples of such fears and anxieties (and one possible underlying bigger issue) creating suffering:

1) I am aging and this pain is going to disable me into a dependent old person (fear of aging).

2) I am a failure if I keep having this pain (wanting to be perfect).

3) This pain means that I would not be able to do most of what I do now (fear of asking for help).

4) I am not disciplined enough to (or I don't want to) do all the physical therapy exercises, so this is doomed (impatience or non-acceptance).

5) Why can't some doctor just fix this problem! They don't seem to have a clue and I hate this insurance setup. I hate all this. Pain -- just go away (pattern of blaming external circumstances).

6) I want someone to coddle me and care about my pain. Why don't they seem to care that much until I make a big drama (deep longing for love and caring)?

This resistance to the pain is sometimes conscious and sometimes it requires detective work exploring the psyche. Once this resistance and the underlying issue are correctly identified, there is a sense of clarity or a sense of relief. There is an experience of an "Aha" moment. Things make sense and then we know what we want to work on. The work may require separating the irrational part of the fear from the reality, acceptance, getting what we need and to stop the unjustifiable restrictions you may be putting on yourself.

A common question that comes up in reducing the resistance is, "Does this mean I just give up and accept the pain?" The answer is, "Not at all!" Identifying the resistance does not exclude investigating the cause of the pain or to work on reducing the pain by medical methods acceptable to you. Another common question about suffering and pain is this. Could the pain be created from past suffering? Could it be because of the "muscle memory" from a past trauma that can create pain? Yes, it is entirely possible. In such cases, some factor about the pain (location, magnitude or onset) cannot be explained by usual medical explanations. In such cases, it is essential to investigate any past trauma that could have led to the onset of the pain. Identifying and desensitizing the effect of the trauma helps in reducing the pain and the suffering both.

Physical pain creates psychological suffering, just the way psychological suffering can create physical pain. Investigate, get clarity and then work on the underlying issue. The existence of the physical pain can be used as a good opportunity to take us to a stronger and less fragile place.

For more by Swati Desai, Ph.D., LCSW, click here.

For more on consciousness, click here.

For more on chronic pain, click here.