Tuesday, October 11, 2011

Managing Pain

Lately, while dealing with my own minor muscular pains, I have been mindful of three friends with much more serious, chronic pain. One of the women is dying of cancer; the other two have tried various treatments with no success. I hope my prayers for them do some good.

I am reminded of the saying: Pain is inevitable; suffering is optional. Viktor Frankl in his classic book, Man's Search for Meaning, is emphatic in saying that is that our ultimate freedom is to "choose one's attitude in any given set of circumstances." He believes, based on his experience as a young man dealing with the Holocaust, that a positive attitude toward pain can circumvent suffering. If we have a reason to live, if we choose to focus on love or a positive goal, we can overcome any temporary pain.

But so much depends on the individual's sensitivity and tolerance for physical pain. As Joan Halifax points out in an important chapter in her book Being with Dying, suffering is the story we tell ourselves about the pain we feel. If suffering is an attitude we choose, can we rise above it, putting even the pain in its place?

As an experienced caregiver, Halifax has some valuable insights. While believing that pain medication is often necessary, she suggests that pain can teach us various lessons (about compassion, patience) if we don't let our fear overwhelm us.

Why do we fear pain? Do we fear that we will become its victim as it grows worse and worse? We become afraid it will devour us. "But when the pain is really great, we might feel so desperate to deal with it that our desperation generates the courage we need to meet it."

I am reminded of Tolstoi's great classic, "The Death of Ivan Ilych," in which the dying man, after great agony, finally--at the very end of his suffering--lets go and is somehow able to distance himself from his body and its pain. His soul comes alive, as his body dies, and he begins to ask the ultimate question, What is it all about? Why have I not lived the right kind of life? Somehow, Tolstoi has convincingly dramatized the reality of suffering giving way to release, taking us closer to this fictional character than we are ever likely to get to a real person.

Halifax says that some patients are able to focus their attention away from the pain to something pleasant or healing; distraction can be helpful. Sometimes, being fully present to our own pain can decrease its negative experience.

Each person's experience in dealing with pain, as Halifax wisely shows, tends to be different. But it's clear that the tendency many of us have to obsess about our condition, to allow our fears to build, makes matters worse and can be changed. Having the caring presence of another is very helpful, but even when we are alone, as we ultimately are in such cases, we need not despair. Pain does not last forever. "Even great pain is impermanent. More importantly, it is not who we really are." Thank you, Joan Halifax, for this and for helping me think about the fear associated with pain.

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