“On a scale from 1 – 10, how would you rate your pain?” As someone with a long history of chronic back pain, I’ve heard this question more times than I can remember. Often it’s accompanied by a row of comical faces ranging from bright and cheerful to downright miserable. “Which one represents you”? Until yesterday, I didn’t really give much thought to this standard measurement of physical pain. But I was connected with an old friend from elementary school who has also been dealing with back pain and wanted to know what’s worked for me. We talked at length and then he asked a question that stuck with me, catching me off guard. He said “I don’t mean to get too personal, and if you’re not comfortable sharing I understand, but can you tell me HOW your pain has impacted your life”?
As I answered his question it occurred to me that there are some big differences in how we treat physical pain vs. emotional pain. And, as I reflect on the way my friend asked that question, there are some interesting similarities.
First, the differences. In general, we are way more comfortable talking about and treating physical pain. We can empathize, relate, swap ‘war stories’ (Moms, how many of us have recounted our experiences of child birth?) and ask for help. Over the counter pain meds abound, most of us have a bottle of Tylenol, Advil or Aleve in our purse or in our medicine cabinet. Not to mention the growing controversy over the use of opiates to treat ‘severe’ pain. Aside from a fear of doctors or needles, most people won’t think twice about making an appointment for a sore elbow or knee, especially if it prevents us from participating in our favorite sport or activity.
We are sympathetic to others pain, particularly when it comes with a clear cause. “I have a head splitting migraine” (Ouch!). “She broke her shoulder in THREE places” (ouch, ouch!). “My wife was in hard labor for thirty – SEVEN hours. With triplets.” (Ouch, ouch, OUCH, legs crossed, doubled over)!!!
At the same time, we tend to be skeptical of ‘vague’ or undiagnosed pain. “She has fibromyalgia” (yeah, isn’t THAT convenient for getting out of work). “I’ve been to half a dozen doctors and no one can find a cause for my back pain” (probably shopping for pills). “He had a horrible headache and couldn’t make it to his morning classes all week.” (More likely a headache from too much partying).
When it comes to emotional pain, it seems to be much harder to talk about. Perhaps it’s because we don’t have the same language skills to describe this type of pain. Those pain charts at the doctor’s office list adjectives such as sharp, burning, shooting, stabbing, aching, throbbing, dull . . . we circle the ones that fit our situation and can generally find some combination that conveys our pain. Sometimes we are given a list of ‘what makes your pain better’ to again, circle our choices. No such charts in my therapist’s office. With intense emotional pain, I find myself so consumed, so overwhelmed, that I can’t begin to come up with the words. Sometimes I can’t even speak the words. My mouth just can’t seem to form them or they get stuck in my throat. All I can muster is ‘it hurts so much that I can barely breathe’.
Certain types of emotional pain are socially comfortable or familiar, meaning we all go through them sooner or later, or know someone who has. We have some idea of how to react, what to say, someone else takes the helm and leads us through, or at the very least, there is a Hallmark card that can give us the right words. These hurts stem from the loss of a loved one, a terminal diagnosis, a devastating catastrophe that unifies a community, a nation or occasionally, our world. But with personal pain, the stuff that comes from depression, loneliness, failure, disappointment, personal loss of hopes or dreams, the walls go up quickly and firmly.
I saw this last night with my daughter. I quickly realized that the pain had been there, lurking under the surface, maybe even doing a few push-ups to stay strong, just waiting for that moment to catch her off guard. For some reason the pain chose that instant to swoop in and take hold. I saw it in her face, her demeanor, her stance. Gently, I asked her what was going on. For a few minutes she opened up a crack, let me hold her, hug her, listen to her words as they came up between punctuated sobs. My own pain loomed as I realized that there really wasn’t anything that I could do to make it better. She was mourning the loss of what might have been, what should have been, the years of her childhood that were dominated by illness. My only option was to just be there, trying to use that long hug as a conduit to send through my love and warmth. And then, all too quickly, the moment was gone. The wall went up, the pain shoved down, hopefully a little less than before, but surely still there.
In that brief moment I was reminded of how isolating and unpredictable our deepest emotions can be. Often we are afraid to think of them or acknowledge them; for fear that these emotions will grow bigger than us, swallowing us alive. We tuck them away, securing the lid tightly. Sooner or later, the lid will come loose again, or pop right off, and there it will be. Pain.
For me, and from what I’ve seen in my girls, that fear of overwhelming pain is what keeps us holding on to it tightly. After all, sharing emotional pain means sharing some of our most vulnerable thoughts, experiences and feelings. Not something we’re likely to put on Facebook or sent out on Twitter. How do you even put those all-consuming feelings into 140 characters??!! It’s not easy to find someone in our social circle who can relate to, and understand, our circumstances. But ironically, talking about our pain, or just allowing ourselves to cry, scream, collapse into a puddle, can be some of the most effective ways of lessening and defusing the intensity until time can work its magic.
When my friend asked me that question: “I don’t mean to get too personal, and if you’re not comfortable sharing I understand, but can you tell me HOW your pain has impacted your life” he said something beautiful. He made the connection between physical and emotional pain. He recognized that my chronic pain had an emotional side to it, one that crosses into that private, personal, confidential area. Maybe, these two types of pain aren’t quite so different after all. Maybe, just maybe, we can respond to all pain in a way that will encourage us to let it out to dilute and dissipate rather than intensify and build inside of us.
Nanci Schiman is a licensed social worker with a Master’s degree from the University of Wisconsin-Madison. She has over 12 years’ professional experience in child and adolescent mental health, family support, advocacy, writing, public speaking and collaborating with local and national mental health organizations. On a personal level Nanci has three daughters ages 17, 19 and 21. The oldest and youngest were diagnosed with mood disorders at ages 9 and 10 respectively.