Pain is Personal

Jacob Eckeberger
September 14th, 2016

Sometimes people look away from a friend in crisis because it’s painful to watch.

Friends who don’t look away—who see the suffering for what it is and still pay attention … who identify with pain because they’ve been through it themselves—those people are in a good position to help in a crisis.

If this sounds easy, it’s not. And making assumptions about another person’s pain is riskier than it sounds, because going through pain is profoundly personal.   

Perhaps you know someone who’s had a baby … like, maybe, your mom? Some women experience childbirth in blinding, screaming agony—the worst pain they’ve ever known. Other women seem to regard childbirth with more of a, Wow … if I’d known that part would be so easy, maybe I would have started sooner.

My own informal research … meaning I’ve asked around … makes that second reaction seem pretty farfetched for most women … but it’s not unheard of. Why? Because the way we experience pain is very personal.

This is why pain scales exist: So doctors and nurses can get a read on how much pain a individual is feeling. They ask a patient to compare her present pain … how much she hurts right now with her worst pain ever. Medical professionals can’t ask us to identify our pain on a universal chart between, like I hit my funny bone, to, like a chainsaw amputation

Funny Bone – 1 – 2 – 3 – 4 – 5 – Chainsaw

There is no such standard. They can’t just ask how bad the pain is because we might reply, “Bad, Doc; real bad!” … which wouldn’t give them much to go on.

So over time, medical researchers and practitioners have refined pain scales—most of them seem to run between zero and ten—to measure personal pain. Generally, pain in the seven to ten range makes the normal activities of daily living … eating, bathing, dressing, walking, and going to the bathroom … difficult or impossible to accomplish without help. [1]

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No one expects the pain following knee surgery to register on the bottom third of the scale. But since pain assessment depends on the one who is actually doing the suffering, it doesn’t help to assume the patient will experience pain in the top third either (even before the patient can hop out of bed and run to the bathroom alone). The post-surgical … or post-childbirth … or post-trauma … pain that puts one person completely out of business may be somehow easier for someone else. Why? Nobody knows….

At this writing, nobody knows why one person says, “Yeh, it was uncomfortable … I’d call it a five or six I guess,” and another person who experienced a seemingly identical event says, “Oh, it was totally a nine-point-nine. If it hadn’t been for the painkillers, I would have paid a hobo to knock me out.”

And then there’s emotional, spiritual, and mental pain.

If eating, bathing, dressing, walking about, and going to the bathroom are examples of normal physical activities in daily living, what are the normal daily activities of the mind, the emotions, and the spirit?

When my parents divorced I drifted into emotional numbness for about five or six years.

I suppose the shock of being in the household as it fell to ruins produced an initial period of numbness that helped me cope. Then, somehow, I never … not for years, anyway … found my way back to the range of normal emotional experience. Sometimes I felt extreme rage or hilarity, but more normal emotional states were lost to me.

The family crisis splashed over into my mental functioning, too. There were stretches when, I would say, my thinking wasn’t too clear. In fact, some periods remain very hazy to me now, bookended by vivid memories before the crisis struck and after it resolved.

All in all, I felt pretty lost spiritually… I stayed involved at a religious level, but that time was spiritually fuzzy, self-indulgent, unconvinced.

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I don’t know where I would have rated my mental, emotional or spiritual pain on a scale of zero to ten. Had there been somebody present to explore that with me, maybe I could have dialed it in … maybe, for example, I would have made a more productive choice than deciding that not feeling was better than feeling…. But there wasn’t anybody, and I didn’t get it dialed in (and does it go without saying that remaining numb had long-lasting consequences?).

Eventually—starting in my spirit I think, then my mind, followed by my emotions—I found more normal ranges of daily activity as a whole person. That’s another, longer, story….

What I still don’t know about pain … emotional, spiritual, mental, or physical … is the degree to which my experience is like any other person’s experience. So, I have to ask, because that’s the only thing I know to do. I have to ask: “How does this compare with the worst pain you ever experienced?” I think asking that sort of question, and listening deeply to the answer, is the best any of us can do, whoever we are, when friends can’t function normally because they’re in crisis. To make it work, we have to learn to empathize without projecting the way we remember processing our own pain on friends who are in pain right now. It’s no good treating them as if their pain is greater or less than what they perceive inside their own skin, even if we can’t imagine reacting the same way. This has a lot to do with taking people as seriously as we want to be taken.

In practical terms this means we don’t really get to vote on another person’s crisis.

It would be totally unfair to diminish a friend’s misfortune because I don’t see how that misfortune would be a crisis for me. You probably know this if anyone ever teased you in the middle of a romantic breakup. We’re all free to make light of our own heartbreak, but teasing a friend in pain is beyond rude—it inflicts further damage. Trivializing another person’s sadness is what insensitivity looks like up close.

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Having said all that, it’s also worth saying there’s no reason to borrow trouble. It’s nobody’s responsibility to project his personal history of crisis on his friends … That was a crisis for me, how could it not be a crisis for you? Boy, are you ever in denial…. It’s also bad practice to assume the worst, based on an earlier crisis … It threw you before, how could it not throw you now? People grow and change—it’s important to give them space to live into that growth.

By the same token, someone who is otherwise strong may surprise everyone—including herself—by being overwhelmed and sliding into a crisis. In such cases it’s much better to say, “Talk about why you think this got to you …” than to say, “I can’t believe this got to you—I thought you were bigger than this!”

Bottom line: Crisis is always personal.

It’s nobody’s responsibility to expect the worst, and it’s everyone’s duty to pay attention to signs that a friend’s well-being is compromised to the point that … for whatever reasons … she’s struggling with the normal activities of daily living.

This is why crisis is difficult to predict, but not so difficult to spot, if you know what to look for. Don’t make a judgment about whether your friend should be in crisis. Just learn to recognize signs that he may be in crisis, and be prepared to offer help.

If you see a friend tripped up in the ordinary routines of daily living, or a friend who seems to have lost her balance, or a friend who is, by his own definition, lost in pain … if you see any of that, and don’t know what to do, whatever you do, don’t look away. Don’t decide it’s none of your business. Don’t project your own experience on your friend, and assume, Well, I went through that, and it wasn’t a crisis for me, so.

Decide in advance—and renew the commitment every day—to see what you’re seeing, and continually look for practical ways to help. 

[1] http://www.webcitation.org/6Ag75MDIq and http://aspe.hhs.gov/daltcp/reports/meacmpes.htm (both accessed 01.19.16)

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jim Hancock@JimHancock writes books, designs curricula and makes digital movies for youth workers, parents and teenagers. A lot of his work is at thetinycompanycalledme.com. Jim attended his first National Youth Workers Convention with Youth Specialties in 1980. Since then, he’s missed just three conventions.

Jacob Eckeberger

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