Use your brain


Pain clinics usually have psychologists. That’s not because chronic pain is a mental illness, but because the mind has resources that can help us change the way we look at our pain. Pain psychologists are more like sports psychologists than ordinary psychologists. They are basically interested in getting us to perform better.

There are parallels between elite athletes and people with chronic pain. The most obvious is the necessity for exercise. To manage chronic pain we must be in training always. The type of exercise may vary depending on your level of disability, but I must have significant exercise every day to give the cardio-vascular system a work out.

At the moment, that means I start my walk with the ritual of calling the dog, getting her to sit and attaching her lead. Then we walk for 10-15 minutes. My next goal is to take a slightly different route that will add 5 minutes to my walk and conclude with a significant climb.

Deep water-running
Deep water-running

When summer comes, I take to the swimming pool and do ‘water-running’ and gradually build up my times and my effort. I’m currently on 4 x 50 metre laps, at just over 4 minutes a lap. My pulse and breathing rates get to near my safe limit, so I will continue doing 4 laps until my vital rates are lower. Then I will add a half-lap, and then another.

To do this properly requires a bit of obsession. I have to be disciplined like an athlete preparing for a big meet. To keep on track, I have to use my brain, and not only for exercise. Like an athlete, I use my brain to reframe and refine my attitudes. For example, the attitude that the world owes me is not a helpful attitude for an athlete or a person with long-term pain. My attitude needs to be not that I am owed anything, but that I have something to give, and I have the capacity to achieve.

Along the Bibbulman Track
Along the Bibbulman Track

Near the town where I live is a walking trail called The Bibbulmun Track. Named after the local aboriginal clan, the trail winds its way through most of the traditional Bibbulman lands. Walkers take up to 6 weeks to trek the length of the trail through jarrah and karri forests and coastland heath. From September to November, the wildflowers fill the bush with colour. The cool mornings of winter bring a crisp mist to the karri forests. I think it is the most beautiful country on earth.

For some time, I have not been able to walk on the Bibbulman track. It’s not that I want to walk from one end to the other. I would just like to be able to drive to a place where the trail intersects the highway and walk for three hours or so.

I am not physically able to manage that walk at present, but I use my brain to motivate my body to heal. I hold it up to myself as a goal. I set myself this goal as a participant in the Pain Understanding and Management Program at our local hospital. Now many months later, I am not much closer to my goal. But having the goal has kept me walking every day. Having the goal has increased my appreciation of our own native garden.

Our front garden
Our front garden

My brain can heal my body, and I like getting the most out of it.

No Sex, Please: We Might be Sore


SEX AND PAIN
Definition of sexuality:
“Being so attentive to another that you tend to merge with that other.”
Those words, with capital ‘O’s, could equally be a definition of spirituality.
“Being so attentive to an Other that you tend to merge with that Other.”
For some mystics, sexuality and spirituality are aspects of the same reality: the purpose of human life is to “get out of oneself” and merge with the larger Reality. Saint John of the Cross, for example, lusciously described his prayer life as sexual pursuit and mutual seduction.

The Bible regards human beings as in-breathed bodies, that is, spiritual bodies: not spirits AND bodies, nor flesh AND soul, but just one united package. In classical Christian thought, no division can be made between body, mind and spirit. To emphasise one aspect (say, the spiritual) over another aspect (say, the physical) depreciates the essential wholeness of the human person. So for Christians, having sex is never purely physical, because the human beings engaged in sex are spiritual, emotional, thinking (etc!) bodies. Having sex should be making love. If it is not, the act is expressing hate, or showing indifference. The physical act is inextricably linked to the greater human reality.

For those in pain, sex may be painful. Doctors today even recognise this. In the 20 years following my major operation, sexuality didn’t appear to exist for pain sufferers. Doctors paid attention to the effects pain and pills had on every other function of your body/mind, but avoided mentioning the major impacts pain has on your sex life.

Nowadays, there are questions on pain questionnaires which ask you to rate the obstacle your pain causes for your enjoyment of sex, but I have not yet met a doctor willing to actually discuss the questionnaire results, which in my case document the additional pain of having sex and the decrease of enjoyment of sex. A doctor prepared to discuss sex and pain with me would be a bonus.

For those in pain, it can feel as though the physical pain is taking away the emotional and spiritual joy of making love. But that is not all. Not only is the pain a turn-off, but also body image,
disappointment and lack of control contribute to a diminished sex life.
The pain itself lessens the enjoyment of sex. The person in pain then sees their body as being less than it should be, and their body image becomes yet another barrier to full enjoyment of the other.

Faulty body image means not that something is wrong with the body, but with a person’s picture of their body. A faulty body image arises in chronic pain from not looking at the whole body. A person with chronic pain who looks carefully at their body, however, will find more that is right than is wrong. Looking attentively at what is really there is not only a spiritual act, but also a healing one.

Disappointed with their body’s betrayal, they withdraw from sexual activity, fearing more disappointment. Pills, the pain and one’s partner’s reaction to the medicalising of our lives all reduce one’s sexual response. Sometimes I’m aroused, but at other times, not. This loss of control adds to the spiralling decrease in sexual interest.
It’s easy to give up, or to give in to anger and resentment. But there are genuinely positive ways of responding.

1. Talk about these things to your partner.
Researchers have noted how difficult it is for even loving couples to talk about sex. It may be that your pain and the challenges it brings is a gift to your sex life. It can oblige you how to talk together about sex. The aim is to make love. The agenda of your conversation is how do we make love given the physical and emotional obstacles pain causes?
hold-hands-cropped1
2. Fall in love all over again by realising how precious touch is; all touch, and not just sexual touch.
So hold hands. Gently brush your partner’s skin as you pass. Kiss when you wake up and kiss when you get ready for sleep. A sexual relationship is not restricted to 20 minutes in bed. Its joy is its anticipation of the constant presence of your lover.
Touch, too, is the precursor to massage. I am one of those who dislike massage. But a gentle touch relaxes my muscles and can reduce pain.
On the principle that ‘it is more blessed to give than to receive’, share the touching and be attentive more to your partner than to your pain.

3. Keep your bedroom a bower for intimacy (and sleeping!), and stop it looking like a hospital.
Take pills off the bedside table; put medical equipment in the cupboard; take pain diaries and exercise charts down from the walls and put them out of sight, preferably out of the bedroom. Cover hospital pillows with a quilt or colourful slips.

4. Be tolerant of your mind’s nocturnal fantasies.
Sexual dreams involving others are not necessarily temptations to infidelity. They may just be your mind working out ways of maximising your physical and emotional enjoyment of life under restricted circumstances. Learn to welcome your unconscious mind’s attempts to link physical sexuality with emotional and spiritual love. Your mind knows how important it is for you to love your body and with your body.

In all things, be attentive and open to the love of the Other. As other human beings do, make love as best you can within the limitations of what you are given.

In times of temporary or ongoing celibacy with chronic pain, the two-way definition of loving the other/Other still applies: “Be so attentive to an Other that you tend to merge with that Other.” In the 13th century Franciscan theologian Dun Scotus taught that every creature is a little Word of God: an instance of Incarnation. Every person or being to which one gives one’s loving and respectful attention draws us closer into union with God.

For those of us in continuing pain, this knowledge is a beacon of hope. We do have the ability to look beyond our preoccupation with ourselves and our pain, and look into the face of God. That’s sexy. That’s the ultimate in spirituality.