Free
This is Western Coffee—notes on building the creative body. Last time: Wounds. The whole series is here. Please share this email; you can sign up free below.
This is the last for now in a series of posts about emotional factors in chronic pain (and other amorphous physical conditions), which began in January here. Thank you for your responses and comments. Please keep them coming, and please keep me updated. I’m struck by how many people deal with pain in one form or another, and what a personal struggle it can feel like in spite of that ubiquity.
If you’ve engaged with John Sarno or others who explore the psychic dimensions of physical ailments, I’d love to hear about what you’ve learned—what you’ve embraced, what you’ve rejected, where the jury’s still out. When it comes to pain, two things feel really true to me: The brain plays a much bigger role in shaping our experiences of pain than is commonly acknowledged; and medicine’s inability or refusal to reckon with this fact is a seminal, and culpable, institutional failure—one that will be as mystifying to our descendants as phrenology or humors.
For this last installment, I’m thinking about the constraints that health conditions generated by our own minds can put on our lives. And that leads me to a question: Why do we take some aspects of our experience to be so much truer, so much more immovable, than others? On the occasions when it originates in our own psyche, why does pain feel so much like an act of God, beyond our present or even future influence?
Pain is instructive for me because several times in my life it was the only truth—what my whole conscious experience reduced to. One of these stands out: when I had to get an X-ray of my first broken femur, in 2007, and the technician asked me bend my knee and hold the leg out at a 45-degree angle from the table. I screamed, nonstop, till they’d captured the image. In that moment there was no other capacity within me. I was pain.
The other instructive thing about pain is that it can vanish, or change so much as to be almost unrecognizable, from one moment to the next. And while we might associate that experience with drugs or other outside interventions, it also comes with natural variations of the interior—the frequency and intensity of signals from the nerves, the overall balance of tasks in the brain, the oscillations of mood, and our response to the care acts of others.
The exploration here of the last few weeks provides a larger and more important point: I am not merely an observer of these phenomena (or, as it pertains to drugs, a swallower of these Tylenol), but an active and collaborative participant—and not only in affecting the course of the pain, but in deciding more freely, without fear of repercussion, what to do while it’s still present.
For example, last week brought some emotional turbulence in my life. I wasn’t surprised at all when a few of the old suspects lit up in my nervous system: this knee, that glute, some stray heartbeats. (These feel like having hiccups in my chest, a few times a minute, and I find them existentially terrifying despite the assurances of at least four cardiologists at this point that they’re benign.)
I had a four-mile race over the weekend, and I’d been stepping up my interval training lately to build speed at shorter distances. In light of the symptoms, should I take it easy?
Once upon a time, this would have been a foregone conclusion. Among runners, you hear this logic all the time: “I’m backing off the ankle for a few weeks until it starts to feel better”—or, a more tragic example, “I had to give up running altogether because of shin splints.” We receive such uniform programming on how to think about pain that it seems patently unreasonable not to defer to it as undistorted, base-level truth—a one-to-one signal of structural deficiency or pathology.
But my earlier experience with these very symptoms had taught me that nothing physical I could do would make any difference—not stretching, not pausing or pushing harder, not getting a massage. The pain track was in my psyche, and only there would it either worsen or resolve.
I ran, hard and free, and I matched my best time for the distance. (Easily. I would have beat it if I’d checked my record beforehand.) That pain, so ominous beforehand, was almost absent in the race and came back to linger softly at the end. A few days later, after many hours of direct confrontation with last week’s emotional upheaval and its subliminal effects, the symptoms have retreated.
For creative people, the world supplies an endless series of forbidding truths: about our ability to do good work, about our ability to survive on it, about the possibility that it will ever change anything. And for everyone, pain, writ large, might be the reigning truth of our century. What would happen if we didn’t believe?
Kindly send me your thoughts, questions, and provocations: dmichaelowen@gmail.com. And say hi on Instagram, or let’s Peloton together: @leggy_blond.