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Heal

In “The End of Trauma: How the New Science of Resilience is Changing How We Think About PTSD” (2022), author and doctor George Bonanno highlights an inborn and often untapped resilience people can cultivate after exposure to traumatic events. A combination of being optimistic about the future, having confidence in the ability to cope, and a willingness to see trauma-inducing threats as a challenge; together can enable a flexible thriving in circumstances when one’s natural resilient abilities might otherwise be doubted. Moreover, Bonanno suggests that such skills may be honed and become easier to muster over time, perhaps even becoming partly automated with age (2022, p. 58, 123, 211).

Besides polishing skills at building resilience to address traumatic stress, author Haider Warraich in his book “The Song of Our Scars” (2022) states that to deal with various forms of pain and suffering more generally, several non-pharmaceutical approaches can be of value. For instance, exercise is a “potent stimulant of the body’s innate painkillers” (p. 232), while hypnosis, the original method of pioneering scientists including Sigmund Freud, today “offers tantalizing hints about an unexplored dimension within us all whose potential remains entirely untapped” (p. 237). Warraich similarly considers the potential of placebo medications to activate our own healing systems, even when administered with the awareness of the subject patient (p. 243). Many people also find benefit with yoga, meditation and, more recently, psychedelic therapy.

Despite the potential promise held by holistic mind-body approaches, are they not still reductionist in the sense of failing to account for the patient’s personal or social contexts? In the forward to Norman Cousins’ book titled, “The Healing Heart: Antidotes to Pain and Helplessness” (1983), Professor of Cardiology at the Harvard School of Public Health, Bernard Lown, observes that contemporary medicine has focused too sharply on the disembodied disease, rather than on the patient themselves: “This conventional biomedical model, through giving lip service to the patient as object of care, largely ignores the subjective dimension” (p. 11). Lown goes further by offering that an over-reliance on science and technology sidesteps the important aspect of human touch and connection in treating patients:

“It is far easier to learn how to interpret scientific data than to acquire the art of obtaining a sound history or performing an adequate physical examination. A skewed cybernetic ensues, wherein inadequacy of bedside skills increases resort to technical solutions” (1983, p. 21).

Warraich adds a contemporary perspective to this view in stating that

“an increasing loneliness and corresponding spiritual void set the stage for modern stressors as being borne increasingly by the individual rather than shared by the community, and rising anxiety wrought by a world that is increasingly digitally connected but interpersonally fractured” (2022, p. 177).

Addiction psychiatrist Anna Lembke, referenced in Beth Macy’s exploration of the opioid epidemic in her book Raising Lazarus (2022), expresses concern that some pharmacological approaches, including those used to wean people off opioids, can only ever be bandage solutions, as what is truly needed is

“a wholesale reinvestment in communities, starting with universal health care. If doctors keep simply medicating people who are anxious and depressed… society will be robbed of the energy that incites the political will to create change… we are broadly using these drugs to fix what are essentially social problems” (2022 , p. 216).

Even more broadly, Norman Cousins declares that ultimately “Holism means healing – not just of bodies but of relationships” (1979, p. 123).

Bonnano, G. A. (2021) The End of Trauma: How the New Science of Resilience is Changing How We Think About PTSD. New York, United States: Basic Books / the Hachette Book Group

Cousins, N. (1979) Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration. New York, United States: W. W. Norton & Company

Cousins, N. (1983) The Healing Heart: Antidotes to Pain and Helplessness. New York, United States: W. W. Norton & Company

Macy, B. (2022) Raising Lazarus: Hope, Justice and the Future of America’s Overdose Epidemic. New York, United States: Little, Brown and Company

Warraich, H. (2022) The Song of Our Scars: The Untold Story of Pain. New York, United States: Basic Books / the Hachette Book Group

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Pain

“Pain is a distressing feeling often caused by intense or damaging stimuli” (Wikipedia, retrieved October 2022).

According to cardiologist and author Haider Warraich in his book “The Song of Our Scars” (2022), prior to the advances of medicine, pain was often attributed to supernatural forces issuing some divine punishment, and whose human-induced relief was viewed as “an unnatural interruption of cosmic commandments” (p. 7). Our view towards pain shifted as medicine became science.

In an essay titled, “Pain, the Torturer” (1970), pioneering neurosurgeon Wilder Penfield writes, “Pain issues a warning with kindly intent. She calls to action and, pointing the way, brooks no delay. Thus the ancient cycle is served, from pain to cause, to treatment and cure – pro re natum and secundem artem” (p. 91). More scientifically, the adverse sensations we perceive when touch becomes unpleasant stimuli, as with internal or external threat including physical damage, are referred to as nociceptive pain, and occur when abnormal “lesions” signal the nerves, spinal cord, and brain of our sensory system. Besides nociceptive pain, neuropathic pain, where the system tends to fire randomly, is often associated with persistent, chronic pain (2022, p. 104).

Pain is complex, without any single physiological location in the brain or body. Moreover, its manifestation is “painted and layered with sentiment and expectation, and dictated by attention and recollection” which form a broad “neuromatrix of pain” and can lead to a ruminative sense of helplessness and catastrophizing (2022, p. 51, 89). Penfield elaborates: “Pain may stay and refuse to go. Clinging and clawing with no good purpose, pain, the protector, becomes pain, the torturer” (1970, p. 91).

Warraich states that people in pain who may easily forget their pain-free “absent-bodied” pasts can instead look upon their physical body as an adversary. Chronic pain that persists well beyond the initial injury can also rob individuals of their futures by placing a burden so draining on the sensory system as to remove any ease from previously enjoyable or otherwise ordinary activity. Thus, sickness, injury, and chronic pain all demand relief, which then beckons a burgeoning healthcare industry to perform its scientific miracles: A healthcare industry increasingly run by business models, where profit takes precedence in the mitigation of pain and disease.

Author Norman Cousins declares pain-killing drugs to be of the greatest scientific advancements in modern medicine and can be instrumental in the alleviation of disease and suffering. However, their indiscriminate prescription can cripple and turn people into chronic “ailers”. Warraich similarly observes we “created a pill-popping culture that placed all our hopes and dreams for relief on drugs and procedures” (2022, p. 9). In foretelling the opioid drug crisis of subsequent decades, and amplifying a centuries-old echo of elixirs to numb, Cousins observes the role of the media in the marketing of modern medicine:

“The unremitting barrage of advertising for pain-killing drugs, especially over television, has set the stage for a mass anxiety neurosis. Almost from the moment children are old enough to sit upright in front of a television screen, they are being indoctrinated into the hypochrondriac’s clamorous and morbid world. Little wonder so many people fear pain more than death itself” (1979, p. 94).

Beyond unrelenting physical pain and of efforts to assuage it, what of the deeper emotional and psychological pain many people endure that causes great suffering? Can these experiences have roots, or similar abnormal lesions, in the body? And, what of the efforts aimed at their relief, which can often look not unlike those used to numb physical pain?

Cousins, N. (1979) Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration. New York, United States: W. W. Norton & Company

Penfield, W. (1970), Pain, the Torturer, in Second Thoughts: Science, The Arts and The Spirit (pp. 91 – 93), Montreal, Canada: McClelland and Stewart Limited

Warraich, H. (2022) The Song of Our Scars: The Untold Story of Pain. New York, United States: Basic Books / the Hachette Book Group