Reflection Two: On Pain
In 2001, I injured my back lifting a box of books from the back of my car. I had never experienced such sudden, excruciating pain. For nearly three weeks, I could barely walk. Slowly, very slowly, the pain receded, and I was finally able to get on with my life. Little did I know at the time that the seed was then planted for what would develop into a recurrent and then chronic condition. A couple of years later, I mowed my yard and raked the grass on the same day (a very bad idea), and the next day I was suffering from a deep, muscular ache in my spine that would last for the next fourteen years. I was unable to sit down for more than half an hour, unable to engage in any physical activity more intense than walking, and suffered from debilitating back spasms which would make simple actions such as rising out of bed to a standing position agonizing ordeals. I feel as though I lost those fourteen years (or at least what they should have been) to fear, pain, and hopelessness. At last, after years of fruitless therapies, pointless exercises, and products designed to brace, support, or otherwise comfort my back, I found an exceptional physical therapist who got to the root of the problem.
Though I am not by any means healed, and probably never will be, I have the condition under control at last. I’ll never forget the pain, though; the shocking, explosive pain of the back spasm. It was the worst pain I have ever experienced. So, besides ibuprofen and a back brace, what helped me stay sane for those fourteen years? Philosophy did. I turned to my old mentors Seneca and Marcus Aurelius to help me gain some measure of mental perspective and control over the pain. In this installment of the A.W.E.S.M. series, we’ll take a look at what these two ancient world philosophers have to offer us when it comes to managing pain and how we should perceive it.
Everyone reading these words has known pain of some kind, be it physical or emotional; it is part of the truth of our mortality. We need, in addition to whatever modern medical science can offer us in the way of relief, a reliable mental perspective to help manage the fear and stress that can accompany our pains, as they can tend to throw our minds into disarray and lead to great misery if we lack the discipline to see them for what they are. Let’s start with what Marcus Aurelius has to say.
In The Meditations, Book Six, Passage 33, Marcus tells us that: “Pain of hand or foot is nothing unnatural, so long as hand and foot are doing their own work. Likewise no pain is contrary to the nature of man, as man, so long as he is doing man’s work. And if it accords with nature, it cannot be an evil” (98). Pain is a part of our nature; we are supposed to feel it. When we use our hands and feet or any part of our body for what they are designed for, pain may often result. They can be overworked and get sore, or get injured if pushed too far. That’s okay, because nature designed us to feel pain, and it cannot be evil if nature designed it, Marcus says. Pain is a warning system for us, meant to tell us that something is wrong. We would, in fact, be in a good deal of trouble without that system. I have a friend who has suffered nerve damage in his back, to the point where he cannot feel his feet. He has had to have a number of toes amputated, as they became cut and infected, and since he could not feel pain in them, he didn’t even notice until the infection had advanced so far that amputation was needed. Pain can be good. Now, that is small comfort to the person who is unable to see through the cloud of chronic agony; I wouldn’t have wanted someone to lean over me when I was in the full grip of a back spasm and say, “It’s okay, man. Pain is natural, not evil. Hey, it’s a good thing!” At least I would not have appreciated such a comment in the moment. However, once recovered from the spasm, reading such a passage as Marcus wrote above would indeed motivate me to take action. The pain was a message, saying “Something is wrong, Jeff. Find the source, and don’t give up until you do.” The pain isn’t evil; today, even with most of it under control, it is a reminder and motivator to exercise as I have been taught and take care of myself, not doing anything stupid. Thanks, Marcus.
The Emperor isn’t done with pain yet. In Book Seven, Passage 33, he says: “Of Pain. If it is past bearing, it makes an end of us; if it lasts, it can be borne. The mind, holding itself aloof from the body, retains its calm, and the master-reason remains unaffected. As for the parts injured by the pain, let them, if they can, declare their own grief” (110-11). With great pain can come great emotion, particularly if the pain is intense and/or chronic. For fourteen years, I lived with a fear of engaging in even moderate physical activity lest I bring on a back spasm episode and be unable to stand or walk for a week. I was afraid to sit down for more than half an hour, particularly in a car, for the same reason. When in the grips of a spasmodic episode, the pain was so intense that my reason often got pushed aside by grief, fear, and self-pity. I would think, “Am I going to suffer like this for the rest of my life? Why did I EVER pick up that stupid box!” On occasions like that, reason took a vacation. I needed passages like this to help me regain my perspective. I needed to be thankful, in true Stoic fashion, for what I wasn’t suffering; I wasn’t paralyzed, my back wasn’t broken, and I didn’t have sciatica pain running down my leg. I could still walk, and the episode would always end. Things could be worse, and for many, they are. Marcus Aurelius reminded me that I could bear the pain unless it was strong enough to kill me. He reminded me that the pain shouldn’t have been able to affect me emotionally; I should have been able to detach my mind and my reason from what my body was feeling and not let it control how I reacted toward others or what I thought about myself or my future. I know, that sounds easier said than done when you are in the grips of great pain. However, with practice and reflection, I do believe that this is an achievable mental state, even when the pain has you in its talons.
Here is one last reference to pain found in The Meditations: “When in pain, always be prompt to remind yourself that there is nothing shameful about it and nothing prejudicial to the mind at the helm, which suffers no injury either in its rational or its social aspect. In most cases the saying of Epicurus should prove helpful, that ‘Pain is never unbearable or unending, so long as you remember its limitations and do not indulge in fanciful exaggerations.’ Bear in mind also that, though we do not realize it, many other things which we find uncomfortable are, in fact, of the same nature as pain: feelings of lethargy, for example, or a feverish temperature, or loss of appetite. When inclined to grumble at any of these, tell yourself that you are giving in to pain” (116).
Let’s see what we can glean from this. The passage begins with the acknowledgment that there is nothing shameful in feeling pain. We are not weak because of it; it is part of our nature, and our bodies are wired to feel it. However, just because we feel it does not mean that it can command our thoughts or reactions to it. We need to keep it in perspective, remembering that it will end in time. We can’t cave in to it. There are many feelings we have as human beings that can override our reason if we let them. Marcus frequently mentions in many other Meditations passages how our bodies tempt us and hold us back, pain being only one instrument of distraction, alongside others like hunger and desire. Keeping our reason and logic at the forefront and resisting the vices that our bodies are drawn to are two goals of philosophical practice, and it takes constant vigilance to stay strong in this way. Pain can have its say, but our higher minds must have the last word.
Seneca too offers us some guidance when wrestling with the challenges that pain brings. In his Letters from a Stoic, Seneca relates what helped him navigate a difficult time in his life when he was suffering from what he calls a “catarrh,” or discharge or buildup of mucus in the nose or throat, causing inflammation of the mucus membrane: “On many an occasion I felt an urge to cut my life short there and then…I commanded myself to live. There are times when even to live is an act of bravery. Let me tell you the things that provided me with consolation in those days, telling you to begin with that the thoughts which brought me this peace of mind had all the effect of medical treatment. Comforting thoughts contribute to a person’s cure; anything which raises his spirits benefits him physically as well. It was my Stoic studies that really saved me. For the fact that I was able to leave my bed and was restored to health I give the credit to philosophy. I owe her—and it is the least of my obligations to her—my life” (131).
There is no question that a positive outlook on a difficult or painful time in one’s life can help a person weather it. I know only too well what it can be to succumb to grief and frustration—to lose hope. I fought my own pain for so many years, repeatedly seeing new and promising therapies or routines raise my hopes only to have them collapse after practicing them for up to a year with no discernible change in the pain. There is no greater antagonist to a person’s spirit. It’s like laboriously building a sand castle only to have the tide inevitably wash it away. After the inevitable “dark time” that descended after each failed attempt, I shook my reason free of the grip of despair and started researching again, knowing that an answer had to be out there. Philosophy helped me stay sane during the quest. I too owe “her” the quality of my life today.
Let’s look at one more of Seneca’s passages, from the same letter as quoted above: “For when pain is at its most severe the very intensity finds means of ending it. Nobody can be in acute pain and feel it for long. Nature in her unlimited kindness to us has so arranged things as to make pain either bearable or brief…What in fact makes people who are morally unenlightened upset by the experience of physical distress is their failure to acquire the habit of contentment with the spirit. They have instead been preoccupied with the body. That is why a man of noble and enlightened character separates body from spirit and has just as much to do with the former, the frail and complaining part of nature, as is necessary and no more, and a lot to do with the better, the divine element” (133).
If our pain is past enduring, it would kill us. Pain over. Nature has seen to that. If it is not past enduring, then we must learn to separate our body from our spirit so that the pain will not take control of our words and actions away from our reason. Again, this can prove difficult depending on the intensity or duration of that pain. We need to keep the pain in perspective and work to control our fear or despair, taking our lives back.
Seneca gives us more: “ ‘I’m suffering severe pain,’ you may say. Well, does it stop you suffering it if you endure it in a cowardly fashion? In the same way as the enemy can do far more damage to your army if it is in full retreat, every trouble that may come our way presses harder on the one who has turned tail and is giving ground. ‘But it’s really severe.’ Well, is courage only meant to enable us to bear up under what is not severe? (136). What good does it do to pity yourself, to wish that whatever is causing the pain you are experiencing had never happened? It did happen; it is here—now. Stand before it with the full strength of your character, not wishing for things that you cannot control, but focusing on the resources that are within your power to help you endure what you are feeling. A little rule from Marcus Aurelius’ Meditations which echoes this sentiment is: “When anything tempts you to feel bitter, don’t say ‘This is a misfortune,’ but ‘To bear this worthily is good fortune” (75). These philosophers are in our corners and rooting for us. Let’s not disappoint them.
Now, listen carefully. Many of you reading this may be in pain right now, of some degree. If you are not, then revel in your current condition and go out and make the most of the present moment. If you are experiencing pain, don’t let it control the situation. Stand before it, accept it, explore it with your mind, and put it in its proper place. I understand how hard that can be to hear; you want it to go away forever so that you can have your life back, or just so that you can resume your regular activities. I’m not saying that philosophy should be a replacement for good medical care or proper medication to help alleviate some of what you are suffering. I am saying that it can be a powerful complement to them, strengthening your spirit and helping you to accept the pain for what it is, but not for more than it is. Don’t let it have too much psychological influence over you; never give up seeking to control it with new treatments, new medications, and yes, with the proper philosophical mindset that can fortify your courage to face any pain and endure it with dignity.
Go and put on some relaxing music; something that you know always makes you feel good. Then settle into a comfortable position, close your eyes, and breathe deeply. Don’t fight the pain; just accept it and acknowledge it for what it is, letting the words of the philosophers resonate through your mind. It cannot overcome your reason; it is stronger than your pain is. Let this final passage from Seneca’s letters give you courage: “When a man is in the grip of difficulties he should say ‘There may be pleasure in the memory/Of even these events one day’ (Virgil, Aeneid, I: 203). He should put his whole heart into the fight against them. If he gives way before them he will lose the battle; if he exerts himself against them he will win” (135).
And with philosophy’s help, so you will. Peace be with you.
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Antoninus, Marcus Aurelius. Meditations. Trans. Maxwell Staniforth. New
York: Penguin Books, 1964. Print.
Seneca, Lucius Annaeus. Letters From A Stoic. Trans. Robin Campbell. New
York: Penguin Books, 1969. Print.