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Learning to Deal with Pain

When I see a patient who is in pain, obviously the first thing I want to do is to stop the pain, or at least reduce its intensity. The second thing I want to do, if necessary, is to help the patient to deal with the pain. If someone has been in pain for some time, the pain is unlikely to go away quickly.


Learning to deal with pain is, or should be, an important part of everyone’s education. If we are human, we are going to be in pain sooner or later. Painkillers are, I think, a mixed blessing; sometimes they are a godsend, but quite a few people just get into the habit of popping one whenever they get a bit of a headache or when their back is playing up a bit – and so they put off having to deal with the pain.


I remember an old Buddhist practitioner I knew once who pretty much refused ever to take painkillers, even if he was in considerable pain, from toothache for instance. His attitude was that he wanted to be experiencing himself fully, not having part of his experience blocked out because he did not like it. I think through doing this he had probably learnt a lot about dealing with pain; no doubt all the meditation and other Buddhist practice he did helped a lot too. Not everyone may have this guys determination and positivity, and I’m far from thinking that painkillers are a bad thing per se, but I’m just wondering whether their easy availability leads to us not developing an important part of the art of being human, the ability to deal with pain.


Another factor here too is the effect of some painkillers on the body’s healing process. If our body is damaged, pain is an important message to tell us that this is so, and that we need to respond appropriately. Painkillers block this message, but sometimes also they inhibit the healing process – there is good evidence now that Non-Steroidal Anti-inflammatory painkillers slow down the healing process (1). There is a trade-off between healing and pain here then; if we want to heal quicker, we may need to put up with some of the pain.


This is all very well, but if we do not go for the painkillers (or if they don’t work!), how do we deal with pain. Of course there are other forms of pain relief, such as the ones we practice here, like acupuncture. But in Traditional Chinese Medicine there is also an interesting proverb:


“All pain belongs to the Heart”.


The Heart, or ‘Xin’, has a wider meaning that heart in western medicine. For example, it is the home of the Spirit (Shen), and so this saying means that part of any treatment of pain, and any way of dealing with pain, needs to address the Spirit. This may sound strange to some modern ears, until we learn that, for example, the pain processing system in the central and peripheral nervous systems is considerably influenced by things like emotional stress; in other words, if we are relaxed and in a good frame of mind, the pain is not likely to be so bad as when we are uptight, depressed or anxious. So from both a traditional Chinese point of view, and from a modern scientific one, our actual experience of pain, even when it is definitely caused by something like a physical injury, varies with our emotional and mental state.


This gives a big clue as to how to deal with pain – we need to attend to the Spirit. And perhaps pain, if we choose not to blank it out with painkillers, forces us to do just that. Pain can be an opportunity to learn what in the Buddhist tradition is called ‘ksanti’, sometimes translated as patience, but which also includes the ability to endure in a calm, positive and compassionate way. This includes not trying to somehow push the pain out of our awareness – which may in fact make it worse – but allowing it its place as part of our current experience (not, though, the whole of our current experience). Practices such as meditation, Chi Kung, martial arts, even philosophical reflection for those that way inclined, all help us to develop this quality.


So rather than automatically taking a painkiller for a small pain, maybe we should instead welcome the opportunity to develop our ability to endure pain positively, to develop qualities such as ksanti. This may serve us well if and when we have to face pain which is not so small, and for which painkillers might not work.


1. See for example: Altman R. et al (1995) Effect of Nonsteroidal Antiinflammatory Drugs on Fracture Healing: A Laboratory Study in Rats Journal of Orthopedic Trauma 9(5) available at http://www.ncbi.nlm.nih.gov/pubmed/8537842


Written by Vimalaprabha

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