How often have we heard it. “Physical pain can never compare to emotional pain.” If we rephrase to say “Emotional pain can never compare to CHRONIC physical pain”, it is a different matter.
What is emotional pain? Why it is emotion that feels BAD. What is physical pain? Well, it is physical sensation that feels bad. You see we cannot escape the word “feel” so we are always back in the soup. We are near using a word to define itself, a big “no,no” in dictionaries.
Physical pain takes on many characteristics which will be apparent if one questions the sufferer carefully, and if there is shared experience to give meaning to the words. Pain is in fact regarded by doctors as the one area where patients provide good medical histories, with little or no coaching. Pain is supposed to have definite characteristics. Without these, it may not conform to the word “pain”, but what then is it?
There should be no trouble in giving a description of the general type of pain. Such pain is read by the somatosensory cortex or SI, which tells WHERE the pain is located, the parietal cortex or SII, which tells what kind of pain it is, and the INSULAR cortex, which registers the painfulness of the pain. It is a given however that we allow someone to speak of emotional pain without being in the least specific. We never stop to question how much precision we demand of physical pain and how foggy and vague we allow emotional pain to be. But since we had to use the word “feel” in both definitions, we really mean more than one thing although we are using the same word.
The imaginary dichotomy between emotional and physical pain can only refer to ACUTE pain, which may be experienced with little or no emotional pain. By comparison, chronic pain ALWAYS involves a heavy component of emotional pain, because of inherent brain chemistry and because of the hopelessness.
What engenders hope more than that there will be a relief from severe physical pain? What takes away hope most? The fear that no relief from severe physical pain will or can occur, so long as one lives. This proposition, that chronic pain cannot really discussed without considering emotiional pain is obvious, but never fails to initiate a huge debate. This proposition that emotional pain is something else entirely from chronic physical pain and that longlasting severe pain is an entity apart from emotion, can only be settled by subjecting the hardhead to some extended period of severe physical pain, which of course, they are unwilling to undergo. So, we are at a standstill. Repeating Augustine, “Physical pain is the greatest evil”.
Not enough has been written about how emotional pain always accompanies chronic severe physical pain. This is not to say that one cannot work on having as good an attitude as possible, but deep in the night, in a darkened room, for the ten thousandth time, as the sheets are burning beyond endurance and all distractions fail, EVERYONE is going to have a truckload of emotional pain. Good attitude is for facing the public. Internally, such people feel worthless, rejected, and most of all, HOPELESS. That is a very painful experience, emotionally AND physically.
There is an inordinate amount of searching where emotional pain is concerned. We call the emotional part of the brain the “LIMBIC SYSTEM”. It is also sometimes called the “Papez circuit”. When we feel emotionally bad, and it continues, we are so out of touch with our feelings that we may pay thousands of dollars to a psychiatrist to find out WHAT we are feeling. “I feel BAD but what am I feeling?” Sometimes it takes years of psychotherapy to even realize why we are depressed or why we feel bad or even that our bad feeling IS depression. We pay a lot of money for this information. Therefore, emotional pain is VAGUE. No one questions this and no one attacks a person so afflicted for not immediately recognizing what is going on.
Let us suppose that a child has a dominating parent, or one who demands some peculiar or special talent before the child may be praised. If overriden constantly, the child loses itself. It may almost have no self and be swalloed up in the battle-axe mother or tyrannical father who demands certain things, usually designed to make the parent feel better about their own deficiences or fears. Basically the child learns they are unlovable UNLESS they let the parent live while they kill their own feelings. Space hogging mothers expand so far that they and they alone are permitted to be fully alive in the home, usually because they don’t feel fully alive in the first place.
Similarly, if a child is viewed in a utilitarian light, they may also be required to annihilate themselves. A parent with unmet needs may attempt to fulfil them through the child. A mother who insists the child MUST be a ballerina, be pretty, or be talented, and only then will the child be acceptable or lovable can do a terrible mutilation of the child’s self image. The child desperate needs love and so will go to any lengths to attain it When they finally have torqued themselves enough to gain parental approval, they are acceptable, but also numbly dead. They become narcisstic, in love with their false front, their image. Deep inside however, they mourn the loss of their self. The real self was unlovable and not good enough. Humans always mourn their own death.
These are examples of the kind of emotional pain that may not be obvious to the sufferer. The public has no problem if a person cannot exactly pinpoint how they are feeling. After all, every person has had similar experiences to some degree. No one expects immedate laser accurate medical histories from these people. The assumption that they CANNOT give an accurate self analysis supports untold numbers of psychologists and psychiatrist, as well as other therapists.
Now we come to physical pain. There, we expect the person to give us an answer, If we say we are in pain but cannot say what the pain is, we will get a swift boot to the hind end. EVERYONE can identify what kind of physical pain is present, although they may go to the doctor to find out WHAT IS CAUSING the pain. However, the nature of the pain should be obvious, and everyone, including the doctor, banks on this being the case, in order to do his job of diagnosis.
But what if, just possibly, the brain could somehow NOT tell much about the physical pain, but knew that it was terribly bad, like terrible emotional pain. Would the public, the doctor, or even your mother buy this? Not if you are an adult. If you expect anyone to believe you are in physical pain, the same person who was infinitely flexible in hearing of your emotional pain will become angry if you claim agony but refuse SOME SORT of meaningful description. In other words, if you have Central Pain, you are up a creek without a paddle. You WILL NOT be believed. Your pain is coming from C fibers which lack discriminatory features.
You yourself cannot verbally describe the exact nature of your burning. You will say it is like acid under the skin, after some reflection, but at first you will simply know you are in pain. Then, of course, there is that “cold” component in there which is not really cold but you can’t think of the right word and so you will just omit it. The “pins and needles” sensation is also driving you crazy and the muscles so sore you might consider amputation to stop it, but the burning is just unbearable so you will speak of that. Wait a minute! You have just misled anyone listening to you. THEY don’t get it because YOU don’t get it. You don’t get it because there ARE NO WORDS!!! Central pain has no vernacular and not even any technical vocabulary. The psychologist cannot help. He/she deals with emotional pain. You have plenty of that, but it would stop in an instant if the physical pain went away. At least, it would be much, much better. (Painonline was the FIRST database, under Patrick Wall’s direction, to create a doctor’s vocabulary for central pain. In this it was greatly aided by the preceding efforts of S. Weir Mitchell, Jean Dejerine, Gustave Roussy, George Riddoch, Jorgen Boivie, Ron Tasker and David Bowsher).
When someone first asks if you have “PAIN” you may say “NO” because you have had pain and know what that feels like but central pain is something different, more penetrating, more diffuse, and more emotionally frightening. It causes a great deal of physical suffering, but it feels awkward to call it pain. It is several pains mixed together. It is something very new and potent. It is alien. It is the devil. You must get away from it instantly before it locks onto your body. But lock on it does, and if you think you will reach this point without emotional pain you are wrong.
This is why we find the fMRI and PET scans which show a heavy signal in the emotional centers to be irrelevant. Of course you are emotional about unending, confusing, pervasive, pointless pain. With time, you will certainly have an element of hopelessness. What would really be odd is if this suffering DID NOT cause you emotional reaction.
We need to change our view of physical pain to allow for the fact that we go to the doctor so he can tell us WHAT KIND OF PAIN we are feeling. This may make some people think it is all in the head, but a little reflection will explain why this conclusion is erroneous. Chronic, severe, pointless, physical pain is perhaps the MOST POTENT cause of emotional pain that exists.
Central Pain is when physical pain goes limbic.