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In constant pain

05 October 2018

Laurie Vere relates her experience of a non-pharmacological approach to pain


PAIN can be a boring old nag, a distraction, or a flash of acute lightning — a shock that renders you still and speechless, unwilling even to hazard another breath. It can warn, admonish, and scold.

It can seduce you away from friends. It can imprison you in a world where you and it silently contemplate one another for hours. It can render you a helpless, whimpering infant. It can carry you away on black waves of unknowable depths. It can tear you open. It can render you, mercifully, unconscious.

Its agony can envelop you for a few moments (standing on a Lego brick); rack you apart for hours (childbirth, never to be forgotten until, a year on, Mother Nature suggests that another baby would be such fun); or an unloved companion through the days and nights. I have felt all these types of pain.

I am not qualified to diagnose or treat someone else’s pain, although, as a hospital chaplain, I have studied and observed my patients’ pain. I give therapeutic massage. Pain is the ultimate subjectivity: some people cope, seemingly effortlessly, with something that would cripple me; others wilt under something I would define as mere discomfort.

Thus, I can talk only of my own experience: nearly 60 years of intimacy with the extremes that my body can throw at me, some of which were iatrogenic, but from which — God be thanked for the NHS — medical treatment has rescued me.

I have a pragmatic approach to drugs. I firmly believe current research, which encourages the prompt taking of suitable analgesics to stop pain pathways from becoming established. I am first in line for any pain-relief or anaesthesia for any procedure I’ve got to undergo — double quantities, if possible.

And I have learnt that a sense of control eases pain considerably, so that using a TENS machine, or being allowed to self-administer one’s pain relief, reduces one’s need for it, whatever any objective dose might be.

But, when I was offered anti-depressants (often used at minimal doses now for different medical problems such as nocturia, and morphine-based painkillers for fibromyalgia), I refused them.

The thing is, long-term pain, whether mental or physical or a combination of both, involves long-term treatment. And my condition, fibromyalgia, is a mysterious syndrome, which has to do with the breaking down of the central nervous system.

There is no damage to the body’s tissue, but the brain interprets and transmits pain signals. So, although, as a specialist told me unhelpfully, “It’s all in your head”, the pain really is experienced, and the pain is registered anywhere and everywhere in the body.

For such a mess-up of neural transmitters, as I understand it, the only drugs that are routinely offered are ones that interfere with neuro-transmitters; and those, unfortunately, have a range of unwanted side-effects.

I had obediently taken minimal-dose anti-depressants in the past, to deal with some of my symptoms (when my fibromyalgia was undiagnosed), and they had stratospherically horrible effects on my body, mind, and soul, and no curative effect at all. Why would I take them — or, worse, morphine-based pain-killers — when I wanted to get better? So, despite bullying by two specialists, my occupational-health nurse, and a GP, I decided to try the ancient remedies for a shot-to-pieces mind and body.

The Bible has a high theology of rest. Rest is not popular in our monetised society, and I realise that I had taken to heart a toxic little epigram in a Victorian book of maxims I read as a teenager: “Rest is but rust. Work till you’re dust.” It was only what I’d been told all my life anyway.

But rest, and the holy sabbath, is really the promise and aim of the Hebrew Bible: “In returning and rest shall you be saved.” If we are to experience theosis through the sanctifying work of the Holy Spirit, it will be a state of creativity and rest.

Four invaluable sessions with a specialist psychologist and physiotherapist exposed my “boom-or-bust” approach to life, and forced me to acknowledge that I can still do anything I want to, but only if I find different ways of doing it.

Another specialist enjoined daily exercise, no matter how limited. “You must exercise every day of your life. And even when they come to carry you out in your coffin, you’ve got to tell them to hang on until you’ve done your exercises.” So I do that, almost always.

On good days, I can walk for about two hours. On a bad day, I just get up and inch about the house. I do Pilates (originally developed for the rehabilitation of veterans of the First World War in hospitals) in bed or the bath for short periods. I listen to my body, and respect its limits. There are more good days than bad. Because fibromyalgia brings memory loss, I often forget to rest after exercising; so I try to make it a routine habit.

The Buddha was good on suffering. He talked about the two arrows: the actual inescapable arrow that is sticking into you, and the arrow that you then push a little further in and waggle about. Pain can be acknowledged and respected, but not allowed to define you. Cognitive behavioural therapy (CBT) has developed the insight that our thoughts often control the way we feel and act; so, by examining our thoughts carefully, we create room to manoeuvre round the givens of life.

Spiritual training helps, too. My seven-year-old self was taught by a Roman Catholic nun that the dying St Thérèse de Lisieux would inch painfully round her cell, offering each agonising step in prayer for missionaries: “Offer it up.” “Count it all joy, my brethren” (albeit misapplied) was a frequent cheery quip on the lips of an Evangelical curate’s wife and GP.

It’s something along the lines of Richard Rohr’s “Transform, don’t transmit,” and it is helpful. OK, I’m experiencing pain, and the day’s plans have gone awry, but what can I do creatively with what I’ve got?

My rule of life helped me: it invited me to walk to church for daily mass when I might otherwise have wondered if I should. My diet was optimal and blameless. Sleepless nights could be transformed into opportunities for uninterrupted prayer, even if, sometimes, that prayer was simply a blind, frightened, urgent pursuit of a Deus absconditus.

I hope that it has made me more compassionate to others. I often forget — I forget so much — what pain is like. That is a mercy.

But, if I’m reminded sharply, then someone else’s arthritis or shingles stops being an abstract topic of conversation, and becomes very real to me: something to pray for, something to make allowances for, and to accommodate.

“Laurie Vere” is a pseudonym.

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