Pain, Part 2
This is Western Coffee—notes on building the creative body. Last time: Foundation. The whole series is here. Please share this email; you can sign up free below.
The great knee pain of 2023 has been gone now for almost two months. It was bad enough in the weeks before the marathon in November that I considered backing out of the race, in part for fear of making something worse. But I didn’t, and not long afterward the pain (which had been around to a lesser degree for most of a year) vanished from one run to the next: full severity Monday, gone Wednesday. The traditional treatment for runner’s knee is a reduction or cessation of activity until the pain goes away, but I didn’t do that. I kept to my training schedule, because I knew that the pain—even though it was a classic presentation of tendonitis, swelling included—was a product of my mind. I knew that when I fully accepted that that was what was going on and turned my attention away from the pain and toward an excavation of my emotional state, the pain would resolve itself. And it did.
But I only knew this because I had prior exposure to that way of thinking, without which I could easily have fallen back into the “athletic injury” slipstream of ice and ibuprofen for inflammation, then epidurals and trigger-point injections, then physical therapy, and, maybe, then invasive and life-altering surgery.
I’m going to write for a few editions of this newsletter about my experience since the marathon, a time that has advanced my relationship with the work of the late heterodox pain doctor John Sarno. I come away from this period with (this is not lost on me, as a deprogrammed Mormon) the zeal of a religious convert, the sense that If only everyone knew …—paired with the despairing knowledge that everyone doesn’t know, and likely won’t. Broad acceptance that most chronic pain is psychogenic would be an overthrow of medicine as we know it, even setting aside the further stipulations that a vast percentage of medical procedures to address pain are useless or even harmful, ditto for pharmaceuticals, and that the hellscape we were handed by the Sacklers is also a product of a whole regime of false understanding about where pain comes from, what it means, and how to fix it. That regime seems likely to persist long after the opiate scars have faded (if they ever do).
As a journalist, dispositionally, I struggle with how to relate to Sarno’s work both in care for my own body and as a writer. He never bothered to meet the clinical research standards that could have validated his approach in the eyes of traditional medicine, and thus his work can only be properly understood as speculative, if we’re generous enough not to call it pseudoscience. Yet it’s also true that many aspects of his model have aged almost extravagantly well: in the resuscitation of Freudian psychology, which underpinned his belief that deeply repressed rage was the origin of chronic pain; in the general debunking of back pain as a one-to-one corollary of structural changes in the spine; in a “novel” treatment approach that centers on gradually increasing a painful movement in order to retrain the brain not to perceive it as a threat.
Why does this belong here? Because pain has been a pivotal factor in my development as both an athlete and a writer. Because the charter concern of this newsletter is the creative act that it is just to be embodied, and pain—though it’s a legitimate and meaningful part of embodiment in itself, no doubt—also has the power to restrict the range of a life, to cut it smaller. I scarcely know anyone who doesn’t suffer from one or two of the chronic ailments (the list actually goes beyond pain) that Sarno associated with his syndrome and for which he offered relief.
I also believe, though, that clarity comes from studying the remote tectonic forces of a mind that underlie pain symptoms. The ability to see oneself more clearly does seem rather essential to an artistic practice. In some, perhaps many, cases, pain is an indication that there is something about ourselves we need to see more clearly.
As always, I’d love it if you’d pass this on to anyone you think might be interested, and encourage them to sign up for this free newsletter. More next week.
Kindly send me your thoughts, questions, and provocations: dmichaelowen@gmail.com. And say hi on Instagram, or let’s Peloton together: @leggy_blond.