Working with pain

I remember when the pain first started. I was standing at work, washing dishes at a seafood restaurant in Frederick, Maryland. It was an achiness in my low back, just above my tailbone. I was 18 years old. 

I figured it would go away, but it didn’t. It became more consistently bothersome while standing that summer. 

Some months later, I started an internship at a local physical therapy practice. As I learned some of the common exercises that were prescribed to people with low back pain, I tried them in hopes of ridding myself of the pain. But there it stayed. 

It stayed with me through college and graduate school, through residency and fellowship training; through all of the hours thinking about it and experimenting with everything I was learning in an attempt to get rid of it. 

It began to become more than pain. It became my adversary, my enemy. When it was there I felt frustrated and ashamed. What's wrong with me? Why can’t I get rid of this? How can I help anyone else with their pain if I can’t even help myself? It constrained my life, diminishing my desire to do things that involved standing for any length of time.

Then something began to shift in my relationship with the pain. It was around 2018. I heard an interview on the radio with Dan Harris, a journalist-turned-meditation advocate, about the benefits that he’d gained from meditation. I was intrigued. I began to practice meditation and study Buddhist philosophy. From there, my interest expanded to other Eastern philosophies.

It was at this point that my relationship with pain began to change. 

A War on Protection

I didn’t even realize that there was another option.

Pain is unpleasant, so why wouldn’t I do everything in my power to get rid of it?

But what I came to realize is that approaching pain as an adversary can be counterproductive. This is for one simple reason: that pain is a form of protection. It is one way that our body-mind attempts to protect us from potential danger or harm.

So in a very real way, I was making protection my enemy. I was in an adversarial relationship with a mechanism designed to keep me safe. And what happens when protection is made the enemy? More protection. More protection = more pain.

Cooperation

But it’s not always so easy to shift our relationship with pain. It’s not as if we can flip a switch and suddenly be OK with this unpleasant and sometimes scary experience.

But we can take steps toward this, steadily moving from war to peace. And we might even be surprised at how quickly this can occur.

The first step towards this cooperative relationship involves developing a proper understanding of pain. When we really understand that pain is protection—and that this protection involves not just the physical body, but all parts of us—then we can also know that when pain occurs, it is telling us something useful.

What is it telling us? That there is something here worth paying attention to.

Something to be learned.

Everything Changes

When we take this approach toward pain—of seeing pain as something to learn from and work with—everything changes. 

• We begin to open to pain, allowing ourselves to experience it—even if just a little bit—so that we can develop an awareness and appreciation of its behavior. 

• We begin to notice what factors are associated with it: what makes it better, what makes it worse, what influences it.

• We begin to experiment with the relevant factors, modifying the conditions and contexts of our lives to make real changes in the pain experience.

• We begin to carve a path of healing through learning, cooperation, and working with. 

But when we shift from working against pain to working with pain, something else changes too. Something that underlies everything mentioned above.

In the deep recesses of our nervous systems, in those ancient parts that have been there through thousands of years of evolution, a shift occurs. A shift toward more safety.

More Safety

If there is one thing that the human organism strives for above all else, it is safety. There is nothing more foundational than safety. Safety is survival and survival is wired into every fiber of our DNA.

When we begin this process of working with pain through proper understanding, curiosity, and learning, we are sending a profound message to our protective systems: I am safe. 

And there is nothing more pain-relieving than safety, because when we are safe we do not need protection.

Every time we work with pain, we are sending this profound message to our body. 

• With every moment of awareness: I am safe. 

• With every moment of feeling without resistance: I am safe. 

• With every movement experiment: I am safe. 

• With every calm, relaxed breath: I am safe. 

Each moment compounding on the last, moving us ever closer to comfort and well-being.

Nothing Has Changed

My journey with pain all began with my wanting to get rid of it. And guess what? I still do. But what I have realized is that working with pain—rather than against it—is the best, quickest, and most enjoyable way to do just that.

And what I’ve also gained along the way is the wisdom that comes from seeing what is there when I look at the pain and when I look at myself, and the empowerment of knowing that there are things that I can do right now to work with it and ultimately influence it.

So while everything has changed for me and my relationship with the pain, at the same time nothing has changed. There is still a part of me that doesn’t like it (it is unpleasant, after all!) and yet there is another part of me that can appreciate it and what it teaches me when it stops by.

Happy working,

Andrew