A Guide to Pain and Suffering

Your feelings tell you about the state of your body. If you’re putting on a roof, carrying shingles up a ladder, swinging a hammer until your hand falls off, sweating it out at a hundred and ten degrees, your body will have a lot to say. You may not want to listen to it. You’ve got to cover the roof before the rainstorm comes; but, your body is trying to tell you something. It would be in your interest to listen sometimes.

The feeling of pain is the way the body speaks to you when it wants to say, cut it out, you’re exceeding limitations. When you swing a hammer until your hand is ready to fall off, tendonitis is developing. That’s why the old guy on your job, who used to swing a hammer all day, can’t anymore. He ruined his hands swinging that hammer, so now all he can do is talk to customers, write up estimates, and yell at you that you’re doing it wrong. He’d like to be on the roof and show you how to do it, but he didn’t listen to his body when it told him to stop.

I’m not saying you’ve got to do everything your body says, the instant it says it. Sometimes you have to talk back to your body and say, I hear you, but we’ve got to keep doing this. For instance, when you’ve been lifting weights, your muscles get sore. That’s because you tear up some muscle fibers lifting those weights, so the muscles will come back stronger. When you lift weights, you’ve got to be the boss of your body and push yourself a little further each set; but, you also have to listen to your body, so you can tell the difference between normal soreness and when a muscle is pulled. It does no good to push through a pulled muscle. It may set you back days or weeks, making you worse off than if you never lifted those weights at all. The ability to tell the difference between normal soreness and a problem only comes by paying close attention to your feelings.

When you were young, your body did what you told it to do, for the most part. You could work all day, party all night, and be ready to go again the next morning. Because your body was always there for you, you took it for granted. Bodies don’t like that. So, the body starts to talk a little louder. The way your body talks to you when it really wants you to listen is pain.

Here’s another example. You feel pain when you touch a hot stove. That pain is there to order you to take your hand off that burner before it gets burned to a crisp. You might not do it, otherwise. There are people who have a rare condition where they don’t feel pain. It’s called congenital analgesia. You might think this would be a good thing, but it’s not. These people don’t live long. They break their bones, burn their skin, and go months with an abscessed tooth they know nothing about. Be glad that you can feel pain, even though you might not enjoy it when it happens.

Suffering is a different matter. Let’s look at the difference between pain and suffering.

Pain is an experience you have. Suffering is one way you can relate to that experience. Pain is inevitable, suffering optional. Pain does not have to lead you to suffering; but if you are not good at spotting your feelings, it will.

Let’s see at what happens when you have pain. If your hand touches a hot stove, the first thing that comes into play is called nociception. That’s the nerves sending an urgent signal to the brain. Primary sensory neurons, called nociceptors, are activated by stimuli like tissue injury, extremes of heat, and noxious chemicals. These nociceptors are located all around the body, particularly under the skin. You touch the stove and they send a message.

Yowzer!

It’s easy to see the purpose of this signal. It’s motivating you to take your hand off the hot stove before it gets burned to a crisp. The signal has to be something you will notice, so that if you, for instance, are talking to a pretty girl while your hand touches the stove, the signal will overcome the desire to act all cool. It has to be something that’ll demand attention. We call this signal pain.

Immediately, you pull your hand off, but you’re still in pain. That’s nociception, still. Maybe your body doesn’t want you to forget touching the stove so that you’ll be certain to not touch it again. It wants you to take care of it, run cold water over it, go to the doctor. You might forget to take care of if you weren’t in pain. Nociception, in this case, is a big, yellow post-it note nailed to your forehead reminding you to look after your hand.

The next thing to get into the act is adrenalin. Adrenalin is a hormone that raises your heart rate and, consequently, your blood pressure. You get a big shot of adrenalin when your hand touches a hot stove. It causes your heart to race and your skin to sweat. You’re alert, ready for action. The adrenalin is there for a reason, just like the nociception. It’s your body getting ready to act decisively if it had to run from a burning building or put out a fire. Adrenalin, by itself, is not always experienced as something uncomfortable. We sometimes seek it out by watching scary movies, going parachuting, or riding on roller coasters; but adrenalin goes by another name when we don’t seek it out. Then, we call it stress. Within the context of touching a hot stove, there should be no question that adrenalin adds stress to the experience.

If pain only led to nociception and adrenalin, then things would be a lot simpler. As associated emotions pile on, then the nature of the experience is significantly changed. If these related feelings stick with you long enough, they take you into another region we call suffering. So, watch for these feelings when they arrive. Meet them at the door. They have come to help, but ask yourself if you really need their help.

When you touch a hot stove, you’ll probably jump around and call yourself an idiot. You might swear at yourself. The purpose of this spontaneous self-abasement is to help you realize you did something wrong — you didn’t pay attention — so that you can learn to not do it again. However, telling yourself you’re an idiot has a deleterious effect on your self-esteem, especially if you do it a lot.

Calling yourself an idiot when you touched a hot stove will have a profound effect on your self-esteem if you link this one event with other times you hurt yourself, so that all injuries form a giant web of examples of idiocy. If you rebuke yourself, not just because you burned your hand this one time, but because you keep doing it, that brings other incidents to bear on this one. It’s one thing if you say you made a mistake and touched a hot stove; when you call yourself an idiot, forgetting all the times you showed intelligence and grace, then pain starts to become suffering.

Another emotion that might arrive is embarrassment, especially if you did it in front of someone you were trying to impress, like that pretty girl. Embarrassment by itself, never did anyone much harm, except when you make a federal case out of it. Then it becomes a more destructive emotion called shame. I looked at shame elsewhere. When shame comes into play, every other emotion is strengthened, and you’ve got a real problem on your hands. We call the whole mess suffering.

You might get irritated or annoyed with yourself, with the stove, or with that genius that left the burner on. These feelings get a boost from the adrenaline, upgrading them into anger. Your anger will take off like a rocket into rage when shame is involved. Looking angry can be useful if you need to communicate displeasure, or if you need to fight to keep from being hurt again. Anger raises the stakes for others, so they know not to mess with you. Unfortunately, anger, and its big, dumb brother, rage, cause all kinds of problems from domestic violence to holes in walls. There are plenty of people who, after getting angry with a hot stove for burning their hand, will kick the stove and injure their foot. Furthermore, feelings in the anger family adds to the stress and makes you look like a moron who can’t control himself.

Coming on the heels of the immediate experience of pain are thoughts like, I won’t be able to use my hand ever again. It’ll leave a scar. There goes my career as a pianist. There may be anxiety over the burn, fears that it won’t heal properly, it’ll get infected, you’ll be in pain forever, you’ll be scarred for life. You could call these feelings dread, nervousness, fear, anxiety, apprehension, or worry. They take you well into the region of suffering. These thoughts are generally a bunch of nonsense, but they tend to work together and wind you up. You end up being apprehensive about something that never comes to pass. You grieve over something you never lose.

If the injury is bad enough and you do lose the use of your hand, you really do have something to grieve over. Grief is so important, someday I’ll have to write a book about it. For now, suffice it to say that grief is the feeling you get when you haven’t accepted change. It adds to the suffering.

If that was everything that came up as the result of touching a hot stove, it would be enough; but more is coming. Depending on the severity of the injury, there may be the fuss, bother, and expense of having to go to the doctor and change bandages. This prolongs the irritation, humiliation, and fears you already have.

Sometimes the things you use to treat an injury cause problems in themselves, adding to the suffering. Antibiotics can make you sick to your stomach, ibuprofen can mess with your kidneys, and narcotic pain medication can get you addicted. Narcotic pain medication like Codeine, Percocet, OxyContin, Morphine, Methadone, or Fentanyl are very useful in helping you manage your pain, that is, the nasty nociception and the accompanying adrenaline. They are inappropriate when you try to use them to treat suffering. But, when you try to use drugs to treat suffering, all you get is more suffering. Drugs don’t work on suffering.

Pain often prompts cries for help. Having someone like that girl you were talking to, take care of the burned hand, may be pleasurable; but for the caregiver, it gets old fast. People who are always talking about their pain become unpopular. No one wants to hear how your hand hurts for the hundredth time. But if you don’t talk about it, then you have to bear the burden alone.

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In other words, when you’re in pain, people are drawn towards you. They want to help. But, when you’re suffering, they run away. When you are in pain, people get it; they may be empathically feeling your pain themselves. But others can never completely get your suffering. No one can suffer exactly the same way you do. Therefore, suffering always involves loneliness, abandonment, misunderstanding, alienation, and isolation.

Pain is an automatic response. You don’t have a lot of choice over it. Nociceptors get into the act without you directing them to. Adrenaline also gets going on its own authority. When feelings get into the act, they’re brief and harmless unless you dwell on them. Then, they will lead you into suffering.

Suffering is an entirely different animal. Pain is like when that undesirable relative comes to visit. Suffering is when she won’t leave. Pain is a beneficial signal that something is wrong, like when a smoke alarm goes off in a fire. Suffering is when the fire’s out and you can’t turn the damn thing off. If you throw your back out, the pain at first tells you to take it easy and let it rest. If, weeks later, you’re still in bed, then it’s because suffering has gotten involved. At this point, the worst thing you can do is rest. You need to move around, stretch those ligaments and build some muscle, but suffering has taken over from healing, so you do the opposite. Acute pain has become chronic pain. Another word for chronic pain is suffering.

The thing is, suffering is not inevitable. You can’t stop nociception. That’s automatic. But it only hurts for a little while. Everything else that comes along, you can do something about. If you take a few deep breaths and think calm thoughts, the adrenaline will wear away a lot faster than if you run around, acting like a madman. You’re better off being kind to yourself than calling yourself an idiot. If you’re embarrassed, know that similar things have happened to everyone. Getting irritated with the person who left the burner on will not help you as much as accepting and coming to peace with what happened. Worrying about the future will not change the future. If you lose the use of your hand, that’s something to grieve about only until you’ve made an adjustment to living without it. Use narcotics for what they can help with, the pain, and not for what they make worse, the suffering. Ask for help if you need to; but try to do things for yourself. Avoiding suffering is really very simple. Look out for it and send it away when it arrives.

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Keith R Wilson is a mental health counselor in private practice and the author of three self-help books, three novels, and innumerable articles.

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This post was previously published on Change Becomes You.

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