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Chronic Pain
I still had a great vacation.  How could I help it with those marvelous little animals, my granddaughters as companions?  Despite passing kidney stones. 

I passed the first, but surgery was needed for the last one.  The first hit without warning.  I had no idea what was happening; if the pain would last a few minutes, or last a week.  It ended up lasting for about half an hour. 

That was the most pain, prolonged pain, that I have ever experienced.  After the worst of it was over the second stone, which I later learned was stuck in the ureter because at 8mm it was too large to pass, caused periodic pain, but not nearly as severe because it moved only periodically.  We were a ways from any facilities, and thought the pain might end, so it was three days of it before Gail and my daughter Erin took me to the ER in San Francisco.  During that time I could stand the pain a bit, and used the long hours to think.

About pain.  I didn’t handle the pain of the initial stone as well as I would have liked.  In my work I injure myself frequently, and have developed a high tolerance to pain.  But this was above the threshold of my tolerance.  Fully expecting the severe pain to return, I tried to prepare myself.

Pain, pain with internal causes, I came to conclude, is the most fully psychological state we can enter.  I was haunted with the notion that I was imagining my pain.  Imagination and knowing are intimates. 

Looking back, I saw that I had been fighting the pain.  Trying to keep it away.  Fully patholocical, it was my enemy.  It really did want to kill me.  Reflecting while experiementing with my pain, I considered the extreme position of cronic pain.

What if this pain would indeed last forever?  There would be only one course of action:  to make my pain my friend.

Nothing else could be closer to one than one's pain.   No one else is able to feel it, it is mine. It is as close to me as are my thoughts as they form.  If I am to have unremitted pain forever and maintain sanity I will have to develop some good relationship to this my pain, that may only be a thought, or wish.

If my pain becomes my lover, I will perish.   Enemies and Lovers are too similar.  We will have to be friends. 

I know some people have explored pain experiementally, but I haven’t.  If you are one of these, would you care to share your insights?  Or share an opinion if you are uninitiated like me.  I think that it’s very possible that the discussion may lead to valuable insights that would help in everyday life.
My condolences sir, you have suffered the greatest pain that humans endure (renal colic), or so they told us in medical school. I am surprised that you were able to go three days without relief in the Emergency Department. I am an expert, being both medical doctor and recovered chronic pain patient. I spent five years on methadone for back pain. I regret it now and will forever; the methadone, especially at the very high dose I was prescribed, changes the very basic functions of your brain (should I say mind?). Those were the worst years of my life and since stopping I have learned to live with discomfort, pain, despair, hopelessness and other demons of the human mind. In fact I have never felt better than I do now (although ages twenty to forty were fairly wonderful) even with daily pain. I am not depressed anymore, for sure.

Mindfulness has saved me. The kind of mindfulness that Gotama Buddha taught as the way to resolve our basic discomfort with our existential crisis (you know born suddenly, never get enough of anything, then die too soon). Also called Vipassana (Insight) Meditation, or just Mindfulness, it is taught at every Buddhist religious establishment in the world. It is also now being taught in hospitals, universities and in medical schools to the medical students themselves as a therapeutic modality. Its merits have been demonstrated over and over again in high quality clinical trials, beginning in mid eighties with Jon Kabat Zinn at the University of Mass. School of Medicine. He has popularized a very secular version of it (although no Buddhists really drape it in much religious significance when teaching it) called Mindfulness Based Stress Reduction (MBSR). Mindfulness itself refers to watching your mental processes - how thoughts emotions cravings aversions and obsessive mental behaviors arise on their own in your mind, then fade immediately when you notice them. In some formulations it also includes learning to distance one'self' from the mentals events that you watch. This is thought to be the main mechanism behind improving the quality of life with chronic pain.

Read Thich Nhat Hanh, Stephen Batchelor or Steven Hagen for more about the methods, mechanisms and meaning of mindfulness. Mindfulness does not need to carry any religious baggage with it - in fact the three authors cited above are all Zen monks who have taken the technique into popular territory successfully. Those who chose to call it their way of life now can call themselves "secular buddhists", implying a modern scientific and totally non mystical belief in the methods of Mindfulness.

By the way, drink more water.

In response to Renzo
Sounds that you’ve earned your mindfulness, Renzo. 

Is there something wonderful about pain?  No, the proper way to approach it is to consider how a sufferer intentionally uses pain.  Pain itself has no value.  It is in our use of it.  Inflicting pain… well, not so good.  Can we stop here?  Can we say no, resolve the issue by saying that the lone sufferer is in the best position to cease inflicting pain?

I would assume that most of us have experienced making our pain worse by fighting it.  Then we inflict pain, self-inflicted pain.  There again, there is inflicting pain on a person we think is responsible for our suffering.  In neither case do we stop pain.  Can we call it the “Interior Mansion,” the only place we’re able to stop suffering in its tracks. 

The human species is very well equipped for making pain art.  From the most subtle to the most brutish are the arts and crafts of pain.  We would have to include love, wouldn’t we, as the most astonishing way to deal with pain.  And don’t we have to include both ambition and laziness?

Chronic backache, passing kidney stones.  Additionally, we can’t forget the pain of thinking—in order to accept we have to reject its opposite, a making impossible of unity.  Emotional pain—desiring in a world where nothing can ever be possessed.  Social pain—which is ontological pain, the fact that in order to be we must be separate, thus alone, unable to immediately help or be helped.  Epistemological pain—that our knowledge becomes transparent under its own gaze.

What baffles me, Renzo, it that “mindfulness” is an achievement.  Because once we begin we immediately realize that we could have been mindful all along, even without learning anything extra or developing further skills.  What’s going on with that?

It seems so anti-climatic, so beneath mention.  Very, very little separates a novice from Buddha.  Like, no duh, dude!  In fact, there is nothing to be studied or learned: only the simple ability to pay attention and to practice paying attention—the text of which is in the unfolding of everyday events.

Are we forced to admit that only pain can bring us to the place of living?  Not pain itself, of course.  In fact we cannot be essentialists at all—accepting that nothing is essential but gains value unfolding in place. 

We don’t cease pain by becoming friends with it.  My previous terminology was wrong.  Pain continues, will always continue, I suppose.  Maybe the nature of this friendship is in accepting responsibility.  We continue hurting but, like in any friendship, acknowledge our role. 

Do you think that of all the four letter words we use, that the word love does us the most harm?  Friendship has a better reputation.  I would loath to love pain, but have experienced becoming friends with pain, mostly of the common sort, and value it.  

Take, for instance, the pain of loving sex.  It is extreme.  If we are friends with it though…! 

Is there anything better than being with a friend?  We understand one another.  We accept one another, complete with warts.  Together we face, and courageously, insurmountable odds.

It’s a mistake, I believe, to conflate these ideas with Buddhism.  I’m aware of the similularities to traditional Buddhist theachings, but that’s like saying that the only way to experience fish is as sushi.  In reality, a good place to experience fish is in water.  Paying attention to daily events and our personal responses.

In response to ted berryman
I don't think Buddhism is the ONLY way to get there, or even necessarily the best way. It was just the way that I followed, although I have not followed a religious path at all in any way... Mindfulness is the other side of the coin from Empathy, which seems so much lacking in modern times. Christ spoke volumes about it also, but to call compassion or empathy "christian" would also be a mistake.

We could emphasize teaching children to recognize their emotional states, their bodies, their needs and their indulgences. But I think we don't . If a youngster gets to that state of self awareness (among all the gadgets and distractions) it is a tribute to his or her environment and teachers (including parents extended family and friends).

Yes there are many cloaks that pain wears. Struggling against it, instead of walking around it, seems the most basic mistake. I did not find drugs to be a good solution (I tried a lot of them). Pain, like hitting bottom for twelve steppers, can be the beginning of learning to live. Woe that it could be taught before that necessity arises.

I think mindfulness is inherently secondary to our evolutionarily shaped personality (or brain) structure. "Your Brain at Work" by David Rock has an excellent introduction to the brain anatomy&electrophysiology involved. Another excellent introduction to the subject is found at MindMatters - a blog site by Grabovac (I think) - one of the authors of a scholarly article on the psychology and neurophysiology of mindfulness. It seems (from both sources) that one circuit in the brain, the "default / narrative circuit" processes items popped into working memory from storage when it is not suppressed by trained or deliberate activity of the "direct experience circuit". Activation of one or the other is exclusive, and suppresses the other when active. Only one circuit at a time. Thus when you concentrate on your breath, the default constant running commentary of our mind (sometimes negative, sometimes fantasy, sometimes projective, sometimes ruminative) is stilled. And vice versa.

I believe that the primacy of the default network must have evolved from our millions of years on savannahs of Africa where the ability to remember somewhat precisely how the big cat emerged from the grass last time it tried to kill you would protect you from another big cat attack (and allow you to reproduce again). This ability to imagine, remember, entertain, fantasize and reconstruct became(or lead to) both language and the default network of our brains. Since digging endlessly for roots to eat or hunting twelve hours per day is no longer necessary - our modern free time allows the default network to race, jump, recycle and overwork our brains - causing stress and depression and other things. That's my impression.
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Latest Post: August 27, 2011 at 7:36 PM
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