Claiming Multidimensionality of Pain: Part I
Claiming Multidimensionality of Pain: Part IPerception of Pain is Multifactorial
by Ma'ayan Simon
Perception of pain cannot be isolated to a single factor, which underlies a fundamental paradox of pain: certainty of perceiving pain is often at odds with understanding what exactly one is perceiving (Thernstrom 15, 281). One may know the experience of being in pain innately, but to piece apart the intricacies it is difficult to go further than superficial terms such as "it hurts when I bend this way," or "I feel stressed or anxious when I think about x." So, then, what is it to perceive pain?Consider, for a moment: how do you know you are not in pain? If you are experiencing pain, relate this question to part of yourself that is not currently in pain. What is it within you or about you that is indicating and providing feedback that pain is not present or anticipated? Is it a sense you have in your body? A feeling? An awareness in your mind? In other words, what is absent in the experience of not being in pain?As you will notice, the absence of pain and, conversely, the presence of pain, cannot be pinpointed to a singular factor. Indeed, to experience pain multiple factors inclusive of mind and body must be in play. Melanie Thernstrom, author of The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering, describes the perception of pain as "…the elusive intersection of three overlapping circles—cognition, sensation, and emotion," (284). To put it another way, perception of pain encompasses what we think (cognition), brain-nervous system inputs (sensation), and what we feel (emotion) (Butler and Moseley 18-21).No singular factor of pain operates unilaterally and neither can pain be cordoned off as an experience of either body or mind regardless of "type" of pain, anatomical, emotional or other (Thernstrom 281). For example, if you think of an experience of emotional pain you will notice that your internal understanding of this experience encompasses sensation in the body such as a feeling in the pit of your stomach or a heaviness or tension in your chest, and what you "feel" and “think” about your experience, too (Butler and Moseley 19). This is because we are not a body or a mind; it is not an either/or proposition.To have one’s pain dismissed as “psychosomatic” or intimated as crazy is one of the most infuriating and demoralizing experiences for a person in pain (Thernstrom 141, 149; Edwards 11, 20). The person in pain is, in effect, saddled with all of the judgments and stigmas put on mental illness. "No!" one might insist, "my pain is real. My pain is physical." However, pejorative connotations notwithstanding, all pain is in fact psychosomatic in that, physiologically, the psyche (the mind) and the soma (the body), are so completely, indiscernibly entwined. (Butler and Moseley 19, 21; Thernstrom 290).Despite empirical evidence proving body and mind as inseparable, dualism of “physical” and “mental” pain continues to serve as grounds to dismiss and marginalize people experiencing chronic pain (Edwards 11). This takes us to our next fundamental tenet of the multidimensionality of pain: understanding that all pain is "physical" and all pain is "mental."More next week!Don't forget to submit your email address (right side menu) to receive posts directly to your inbox. You can also follow me on Facebook to see posts there.