Working With Pain

Lou Carcasole
April 13, 2016
My Cousin’s Great Aunt Lala
Working With Pain

I recently witnessed a dramatic exhibition of how powerful our mind is in either increasing or reducing the level of suffering associated with pain. In this case the pain was of a physical nature, although working with emotional pain would be the same.

Around the beginning of March, my cousin’s great aunt Lala (that’s the name everyone knows her by), who turns 106 years old sometime this year, got her feet tangled up in blankets while trying to get out of bed, fell and broke her right shoulder and wrist. Now this would be something serious at any age, but quite another matter at hers. They did not put her in a plaster cast for reasons that weren’t explained or that I forgot. She wore a device that restrained her right arm from moving around. To make matters worse, she developed a skin tear on her bottom making sitting for long periods of time quite unpleasant, not to mention the need to get her to stand up for a minute or so every ten minutes, to allow that part of her anatomy to breathe in order to promote healing. The good news is that remarkably, she persevered through it all over the last six weeks. They removed the device last weekend, and now keeps her arm in a sling in order to avoid much movement for another three weeks or so. X-rays show that the shoulder hasn’t completely healed. The wrist has more or less healed. However, the right hand is quite swollen to about three times its normal size and looks like a balloon about to burst. It was recommended that she do a few moderate exercises to get some circulation going in the hand so that the swelling might go down soon.

Now this aunt is a fairly tough old bird. For a centenarian, her mind is remarkably as sharp as a tack. And, she knows what she wants. She refuses to sleep in her bed -opting to sit in the samw easy chair all day and all night long.  All attempts to put her in her bed, or, to get her into an electric reclining chair that was purchased specifically for this situation, have not been successful.

We dropped by earlier today and to lunch there. Lala lives with her only daughter, who is no spring chicken herself anymore. My cousin has been there religiously from early morning to supper time, every day since the fall. My spouse, Norrey, is an occupational therapist with considerable experience with people who have lost function of some of their body parts as a result of accident or stroke. She is familiar with this kind of situation. Anyway, as I mentioned, Lala is supposed to do some mild exercises like moving her fingers and hand, as well as to gently massage her hand, to regain function and reduce the swelling. Norrey attempted to help do a round of exercise. It was a challenge. At Norrey’s slightest touch, Lala would tighten her whole body and cry out in pain. Moving the fingers or massaging the hand evoked loud screams sprinkled with more than a few cuss words for added color. Now the interesting part is this – Norrey kept trying to get Lala to open her eyes, which she steadfastly refused to do. You see, the idea is that with eyes open, it’s likely that Lala’s attention might go to places other than her pain. She could look around the room. She would have to engage with Norrey whose face was mere inches away. She might engage in conversation – answering questions put to her. But Lala was intent on keeping her eyes closed tight. Of course, it was pretty plain to see that her attention with closed eyes was 100% on her pain, greatly magnifying it and resulting in big suffering and the aforementioned colorful language. When Norrey finally was able to get Lala to open her eyes, the suffering (or subjective experience of the pain) seemed to greatly diminish. It was quite a dramatic display of how powerful the mind is in being able to turn pain into either  a huge problem, or into something more manageable.

Of course, this is what meditation is about in terms of working with pain. There are two strategies, actually. One strategy is to turn one’s attention away from the pain, as Norrey was attempting to get Lala to do. In that way, the mind won’t be engaged in judging and reacting to the pain and turning it into big suffering. Another strategy would be to actually move right into the pain – to be willing to feel it completely –  to relax into it and not fight it. In both strategies, the key is to not fight the pain. It’s in the fighting of the pain that suffering is generated and increased. However, these strategies are not easy to accomplish. They require a great deal of skill. Meditation is about cultivating those skills – awareness (including concentration power) and equanimity (the ability to not fight discomfort). Think of these the same as you would think of many other skills – like bicycle riding, skiing, dancing, piano playing, etc. These skills are developed through practice. They are capacities. They are not skills that one can invoke when one feels like it. The capacity is either there or it isn’t. Kabat-Zinn says it’s kind of like weaving a parachute. You don’t want to start weaving the parachute when you’re about to get thrown out of the plane. You want to have been weaving the parachute morning, noon and night so that if you do get thrown of of the plane, it may actually hold you.