Our good friend EG likes to make us think, challenge ideas (old and new), look at things from different perspectives, and doesn’t mind ruffling some feathers (even ours) along the way – we love it! We’ve been having a bit of a chat recently about the ‘pain formula’ that appears in The Explain Pain Handbook: Protectomter and EG has written another great guest post with some thoughts:
Introducing the self
Can the following statement 1 stay true in face of the scenarios 2 and 3 that follow it?
1 “We will experience pain when our credible evidence of danger related to our body is greater than our credible evidence of safety related to our body. Equally we won’t have pain when our credible evidence of safety is greater than our credible evidence of danger” Moseley and Butler, 2015, The Explain Pain Handbook: Protectometer.
2 A wounded soldier in a highly threatening situation often won’t feel the pain until much later when he is safe.
3 A bank teller held at gun point probably won’t feel pain despite the threat of death.
Scenarios 2 and 3 involve very significant threats to the body, yet no pain. In fact in scenario 2, we have something which seems to completely defy statement 1. Is statement 1 still correct?
I think it is correct in essence, but I’d like to offer a revision for comment here:
“We will experience pain when our credible evidence of danger related to our self is greater than our credible evidence of safety related to our self. Equally we won’t have pain when …”
By changing ‘body’ to ‘self’, it’s possible to allow scenarios 2 and 3 without contradiction.
Let’s consider the self
Let me back track a bit to explain…
The self (aka ‘sense of self’ or ‘ego’), can be considered as ‘consciousness identified with body’, where ‘consciousness’ is ‘the thing that switches on when we wake up in the morning’ (we don’t need a more complicated definition at this point).
Since consciousness is intermittent, so is ‘selfing’ intermittent. Consciousness stops completely during NREM sleep. And whilst the body continues to exist 24/7, the self does not exist in deep sleep. So, the self is an intermittent mental phenomenon. It depends upon consciousness and is made of thoughts. The thought-feeling of “me as a solid continuous entity” is in fact quite ephemeral and unreal. When the ‘me’ is operating, it can exist in degrees – ie. we can have moments of strong self-referencing and moments of reduced self-referencing. Occasionally, the self might be completely absent in the waking state, but by all reports, this is rare.
Back to the wounded soldier
Back to the wounded soldier scenario, so I can tie it together. When safety is threatened to a massive degree, the self tends to go into relative abeyance. ‘Less self’ means ‘less threat to self’ (in the same way that a shrinking target becomes less vulnerable). ‘Less threat to self’ according to the revised formula above means less pain – or no pain. The new statement incorporating self-image allows for the wounded soldier and bank teller scenarios.
The revised statement also allows for the injured sportsman who continues to play despite severe bodily damage constituting threat, feeling no pain. A high degree of distraction is yet another way of subduing the self. Have a read of this quote by retired NBA star Bill Russell. It’s obvious he is describing what Mihaly Csikszentmihalyi referred to as ‘flow’, a state of attenuated selfing. Tell me if you think he’d be aware of a sprained ankle in such a state.
“At that special level all sorts of odd things happened…. It was almost as if we were playing in slow motion. During those spells I could almost sense how the next play would develop and where the next shot would be taken. Even before the other team brought the ball in bounds, I could feel it so keenly that I’d want to shout to my teammates, “It’s coming there!” – except that I knew everything would change if I did*. My premonitions would be consistently correct, and I always felt then that I not only knew all the Celtics by heart but also all the opposing players, and that they all knew me**”.
Russell, and many others before him, have shown us that selfing can be subdued even in full waking consciousness, with predictable results. Reduction or complete amelioration of pain is one such result.
In the clinic
So the self is a critical process to understand and reference in pain sciences. After all, it is the self that feels pain, not the body. With the revised statement, we now have three approaches to the treatment of pain instead of two. We can:
1. Increase SIMs
2. Decrease DIMs and/or
3. Decrease selfing.
Whilst the sense of self tends to be shut down automatically under duress, it can also be reduced voluntarily through focussed attention (preferable). Less self -> less pain. No self -> less pain, no suffering. Hope that makes sense.
* The reason verbalizing his insights would “change everything” should be obvious. Think about a moment of intense joy you have experienced. The last thing in the world you’d want to do is start describing it in words. Language (especially analytical language) immediately degrades and destroys the experience. ‘Zone’, ‘flow’, jhana, smadhi etc. require a relatively quiet mind. Flow actions are inspired actions – this is what sets them apart. They have an inspired quality. Most of the world’s top sports people, artists, musicians, poets, businessmen seem to speak this way.
** Russell is describing enhanced rapport. It’s a nice description – to know all the players ‘by heart’, even his opponents.
Thanks EG, I’m looking forward to the thoughts and comments of others, and the discussion that will follow
– Tim Cocks