Uncomfortably Numb: Finding Purpose in Pain

Sad woman with head downI saw a new client the other day, the wife of a man succumbing to a vicious opiate addiction which recently landed him in inpatient rehab. She wondered how on earth this happened to them. They were an upper-middle-class couple, with healthy and intelligent kids, one preparing to take the SAT and looking forward to moving on to college and the other already enrolled in an Ivy League school. They both came from good parents, good families, and good upbringings. They reported no depression, anxiety, or any other history of mental health criteria whatsoever. So how could her husband be found passed out on the side of the highway, crashed into a guard rail with a substantial amount of oxycodone, roxycodone, and hydrocodone on his person (according to what the police officer told his wife)? Well, it turns out this man suffered from a lot of pain.

He got into a work accident three years ago, went out on disability, and was prescribed painkillers ever since. His doctor, like many physicians, did not counsel patients on the nature of narcotic painkillers and the risks of addiction, and also did not see the risks inherent in prescribing painkillers for a three-year period of escalating amounts. The rationale for this is in the nature of pain. Pain is subjective; it is a very case-specific phenomenon. What is painful for you may not be painful for me. We all have unique thresholds for pain, what we feel we can tolerate, and what we feel is unbearable.

This man’s physical pain became so great, so pervasive in his life, that he began stockpiling pain medications and began what is called in the addiction world as “doctor shopping”—getting prescriptions for the same symptoms from multiple providers. A vicious cycle may ensue wherein the tolerance of these medications grows and grows, to the extent that dosages that would be harmful or even lethal to someone initially starting out on painkillers may not even affect the pain anymore. This is a scenario that is cross-cultural, cross-economic status, and may be even more specifically an issue for those in fields requiring significant bodily exertion. That can range from construction workers to professional athletes to physicians themselves.

Thus, the way to address addiction most often for those who struggle with pain is to question what exactly pain is, and what does it tell us? It is an automatic human reaction to retract from pain. It is our body’s way of communicating to us that whatever behavior we are engaging in is threatening, and continuing to do it may prove harmful. It is why we experience pain on differing levels—potentially lethal behavior generally has a lot of pain associated with it. If you doubt this, touch a hot stove. Better yet, just trust me—it’s quite hot, may very well lead to a burn, and is very, very painful. Our bodies are programmed to avoid, eliminate, and escape pain whenever necessary.

Pain is not only a physical phenomenon, but a mental and emotional one as well. Just think of the feelings involved after a recent breakup, a negative remark from a loved one, or a demotion at work. Emotional pain is something we also avoid at all costs, and can be just as hazardous to our health. It is the reason addiction is so powerful and has such a draw—substances numb pain. They also numb other emotions, including happiness, shock, love, lust, and a host of others. But they do numb pain. And thus we are drawn to that experience in a visceral way.

Ultimately, pain is a part of life. For some, it may be said that we cannot experience the positive emotions we crave without the experience of pain. Pain is something that informs us we are alive, and ought to stay that way. Pain inclines us to alter our behavior. Pain, in a way, is an aspect of the initial process of healing. Once an injury occurs, the first stages of how the injury begins to repair itself may be quite painful. It is a lesson from our bodies not to repeat that behavior, a memory-inducing state that hints to us, “If you continue to let others jump on your arm to the point that the bone breaks, I will encourage you to feel pain so that the next time someone thinks of doing that, you remember this feeling.”

However, that state is not permanent, either physically or emotionally. Even chronic pain ebbs and flows, where some days are worse than others. And so we must learn to live with a certain amount of pain that is inherent in life. Perhaps, rather than attempting to avoid pain at all costs, we should try to learn from it, learn that some pain is a part of a process in healing and improving. Some pain indicates that we should not repeat past mistakes. Some pain may be inexplicable, but at least it reminds us of how our bodies and ourselves endure and stay alive.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Jeffrey Kaplan, MA, LMFT, Systems Theory/Therapy Topic Expert Contributor

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Doc V

    February 13th, 2014 at 1:22 PM

    We have patients calling our office all the time, and it’s really pretty sad because it is quite evident from the first meeting who is doctor shopping and looking for a wya to get more and more drugs filled. The good thing is that many pharmacies have started to pay closer attention to who is getting what pills and how many and they will often call us asking if we are sure that the patient can have more and they will fill us in a little more on the patient history. Because no matter how dangerous the ommission of information is there are still those patients who will do anything to get more and more drugs and they will leave out the fact that they have already had so many of those pills this month. I don’t know where the insurance companies draw the line too with how many prescriptions they will allow them to have filled in a month, but I am sure that these are people who know the system and how to work it to get the most out of it.

  • John E. Moyer, M.Ed. LPC

    February 14th, 2014 at 5:14 AM

    I encourage my clients with this issue to attend Al-anon meetings. They will teach you what you can and cannot control when it comes to living with someone with substance abuse/dependency issues. They inevitably learn to live happier lives whether their loved one continys to use or not.

  • brock

    February 14th, 2014 at 11:13 AM

    Where did the idea come from that we don’t wnat to have to live with pain? That pain is all bad? What happened to accepting this as a normal part of life and there are things that can be learned from this part of our journey just as there are things to be learned from the good times too?
    That’s where some of the focus should lie, looking at why there is always this tendency to run and hide from the things that hurt. Life hurts, so why not choose to make that your mantra for getting stronger?

  • Bo

    February 15th, 2014 at 5:05 AM

    I have a little twist on this that I am curious about how it relates. What about those people who cut themselves and intentionally injure themselves? How is that like this or is it? We have people trying to numb the pain and then at the other end of the spectrum you have those who are hurting themmselveson purpose just to feel something I suppose. Is there any kind of relationship to these behaviors that on the surface look like they are opposites of one another?

  • Heather A Vandegrift

    February 17th, 2014 at 7:58 AM

    Absolutely, there is a common theme! The people who are trying to escape their physical pain are often feeling it very often, and as the medicine tolerance builds, not only do they feel their original physical pain, but the pain of withdrawal when they try to take less. These drugs numb the emotional pain associated with being in constant physical pain, to be sure, but that isn’t the reason they take the drugs. They take the drugs to get rid of the physical pain.

    On the opposite side of the spectrum are those who self-harm. These people may or may not be in physical pain as well, but the overwhelming passion they feel is emotional and mental. Often these people are, paradoxically, in both extreme mental and emotional pain but also feel emotionally numb. This is because they are overwhelmed with emotions. To get a release from those emotions, they physically hurt themselves, because the physical pain shuts down the emotional pain via the release of adrenaline and neurochemicals that shut down emotional noise due to the primal nature of new, severe physical pain. In the instant you burn your hand on that stove, your brain stops concerning itself with how you feel about yourself and whether or not you are “good enough” for this world; all it thinks about is “OUCH! THAT HURTS!” That temporary release from the emotional noise is the reason people will harm themselves; they just want peace, even for a few seconds, and the only thing that breaks them out of that mental noise is physical pain.

  • Anne

    February 17th, 2014 at 4:47 AM

    My take on this is that it often takes the very worst kind of pain before someone realizes just how much in need of help they are. And that is something that we have to let them find on their own. That means no more diving in and saving them at the drop of a hat, because how much pain do they really come to feel if we are always jumping in and saving them before the worst hits? This is about letting someone reach the bottom, letting them expereince some of this for themselves, and perhaps that could be the wake up call that they needed. I know that it’s hard to step back and let this happen, but I think that most of us know that there is someone in our lives who needs this, who needs us to step back and let them take a little bit of the fall.

  • Marg C

    February 17th, 2014 at 7:39 PM

    It’s quite obvious that most of you have never had to deal with chronic pain on a daily basis for months and years at a time. It is quite obvious as well that by using this one example where addiction took hold of someone and not mentioning the thousands more who yes may be dependent on narcotics for pain control have never doctor shopped nor increased their dosages. It is so obvious that you appear to connect physical pain in with emotional pain and oh yes please pass the pain pills here before I cry from an upset. I find much of what’s been written here condencending and a true disservice to those with chronic pain. Have you any idea how many people end there lives due to chronic pain for NO other reason then to end the physical suffering they have to endure? Even their pets get better care when it comes to pain and that’s because the Vet has ten times the training in pain than most MD’s. One more thing do you honestly think that those who suffer chronic pain just sit around taking pills? Heck no…they get up each day hoping for a cure. Stop blaming the victims and start learning the facts.

  • NotBrock

    November 3rd, 2014 at 2:13 PM

    Clearly Brock has not experienced and is not experiencing chronic pain. I pity anyone who has to deal with him or her in their lives because they surely will not gain from his expectation that they can “just” tolerate pain and “just” get stronger. I have had chronic pain for almost a year now with some relief from physical therapy, and then a worsening when my hands became very pain-filled. I am only 54 and I’ve been veru successful throughout my life in everything I have tried: sports, art, academics, work and fun. It is horrible to have so much pain that you cannot do what you ordinarily do without pain; it can feel terrible to deal with others when they cannot “see” what you are experiencing and more so when there is no specific diagnosis or one that many professionals credit only as a ‘garbage’ diagnosis – meaning that they have not been successful as physicians in finding a doiagnose that they can feel confident about. Pain interrupts sleep, sometimes constantly. It is not something one can always exercise “will” over. It inserts itself into everything one does and for many, it is such a common feeling that one begins to recognize the “absence of pain” as being unusual. I object to his remarks.

    As to solutions, I haven’t found any yet but I try everything I can that is NOT likely to lead to addiction. Today sat upside down on a chair in the hope I would get some relief. And I did. This gave me hope. Hope is good. But I cannot sit upside down all the time.

    And I hate to go to bed because it is so hard to sleep when my body wakes me constantly. And in the morning, when the anti-inflamatories have worn off entirely, I lay there in pain.

    In two words: it sucks. I could only wish to be able to will is away. I am not saying that mind does not matter; but the notion that suddenly, at this stage of my life, my attitiude toward pain is the problem; that I should accept it and “get stronger” is so much more easily said – than done.

  • Jessica

    March 31st, 2015 at 9:23 AM

    This article makes me sad. Sad that the stigma of chronic pain is what it is. That we are judged as weaker or lesser people because of what we endure and that we want help just like any other person should with any medical condition. There is not words that do justice to the physical pain that people with chronic pain endure typically 24/7. It is exhausting on every level and it is a miserable existence at times. I am 28 years old and I have multiple chronic conditions. Two years ago I was working full time, in college full time, as well as maintained a very healthy active lifestyle, but I still got sick. It was nothing I could avoid and nothing I did caused it, It just happened. For years I searched for answers, I tried supplements and physical therapy, and holistic remedies, and some things helped a little, but the pain and other symptoms persisted. This isn’t pain like you stubbed your toe, or a sore muscle. It’s like every ounce of your body is broken and being ripped apart. It’s the kind that hurts so bad you can’t move…and sometimes you can’t even cry. Until you have endured that kind of pain, I don’t think you have the right to judge a person’s decision to seek pain management. I tried everything I could before turning to pain management. And unlike the stigma, I have one dr, who I see monthly, and who monitors me very closely. No amount of medication will ever take the pain away. It makes it tolerable so we can function. Without it I lay in bed, with it I can play with my son, do the dishes, be somewhat normal. Not all of us are constantly seeking hirer doses either. I take the lowest dose and have for quite some time. I said all of that to hopefully help you understand that we are people, just like you, trying to live as best we can. And your words hurt, your judgement hurts, your stigmas hurt. I am stronger than most because every day I face a battle that most will never know about, and I win every day. I find some way to live, to enjoy life, to smile, to love, and to be compassionate to others every day. If you haven’t lived with chronic pain, please don’t judge it.

  • Sandy

    June 14th, 2017 at 10:08 PM

    I just wanted to make a comment regarding those of us who SUFFER from chronic pain and can only get relief using prescribed drugs. The author of this article is insensitive and judgmental. Although we follow our doctor’s orders, take less than what is often precribed, we are treated like criminals. Pain is like any other serious disease. You can’t see pain, but it restricts our activities and many of the joys of life. God, I wish we could will it away. Those who SUFFER could benefit from more compassion and less criticism.

  • Jeffrey Kaplan

    June 16th, 2017 at 10:03 AM

    I am so sorry if you felt that your pain was diminished or minimized in anyway. In no way do I believe that the pain suffered, especially in chronic pain is unreal or criminal in intent or basis. On the contrary, the clients I work with experience very real and very substantial pain everyday. I don’t mean this judgmentally whatsoever. I remain in continued awe and amazement of the courage and strength needed to pursue everyday while managing that pain. This article was not intended as a judgment on those struggling with pain, but rather a reflection on ways to utilize that pain as motivation to thrive rather than as an inescapable obstacle. I applaud the overwhelming majority of pain sufferers. They do not fulfill the negative stigma of addiction and criminality, but rather try ways to manage their lives every day and continue to live life. I applaud you all, and try my best to help those who are unable to escape the temptation of addictive behaviors and the overwhelming difficulties presented in life to pursue the strengths many of you exhibit on a daily basis.

  • Jackie J

    May 31st, 2015 at 12:02 PM

    Yes, chronic pain is difficult to deal and or understand at time’s even you are the person living with it as I do.
    I don’t take anything for my with exception of an occasional aspirin.
    I have experienced the pain, which at one point it had me contemplating suicide because the pain was so sever and 24/7 day after day.
    Believe me I if thought drugs would fix the problem may be I would pursue medication, however I don’t believe that a solution.
    But for the folks that choose a different path I do understand, I just want a solution!
    The above is not ment as a judgmental confrontation of those who might judge those who have chosen medication to function.
    But please understand that we are all very different and individually we have different needs.

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