Suffering, Pain, What is the Difference? It All Hurts.

No, No, my friends, there is a big difference.  In my scheme most of us suffer but few feel pain.  Why is that?  It is a bit of a tale but pray let me clarify.  First of all they come from a difference play in the brain and play a very different role; and you better hope for pain cause it will take you out of your suffering.

If I kick you in the cojones you suffer but it can go away. If your father kicks you there you feel pain and you suffer because it has multi-determined meaning; as Freud said, it is over-determined.  How could my father do that?  Does he not love me? I feel hurt, wounded and unloved: I suffer.”  That suffering has implications that hurt and make us suffer.  A broken heart is suffering. A faulty heart valve is pain. Pain can be fixed; suffering is another matter.

There is a structure called the ACC  (anterior cingulate cortex).  When we are babies and mother disappears we send out a distress call; a specific call that demands, “Whaa, Come back now.  I need protection and care.”  We need love and protection at all times when we are young; we don’t often get it: stop crying and stop acting like a baby.  And so we do and we begin to lose that alarm signal that makes help and comfort rush to us.  The pure pain areas overlap with the emotional suffering part. When research subjects were make to feel isolated and rejected the ACC got busy but the higher ventral prefrontal cortex did not.  And from the research we begin to know why it hurts so much to lose a family member.  But the distress can be lessened with painkillers, as we all know.  What they were showing was the difference between emotional and physical pain. They were not identical and involved different areas of the brain.

For my purposes it is the over-determination, the meaning of the pain that is repressed and remains unconscious so that we then walk around and not feel the suffering we are in.  “They don’t like me and there is nothing I can do.”  It happened to one of my patients who was born in error; neither parent wanted him and they made him pay throughout his life just for being alive.  The parents made up reasons for disliking him; but it was clear. He had “ruined” their life.  In suffering the ACC can mount while the pain centers remain aloof.  And what is our job? To make suffering into pain.  Why on earth would we do that? Because all of that suffering means unrelenting hurt.  That suffering must be made conscious, which means conscious/awareness/pain.  Then it can be dealt with, resolved and put and end to it.  So long as it hurts we cannot shake it.  In other words, according to the research we need to bring the limbic lower level suffering up the cortex.    It needs to be made consciously/aware.

Too often the patient demands help with her suffering so she is given tranqs and painkillers and the suffering is subdued for a time. But it will always return because it has not been made into pain.    And the suffering that is most troublesome and that cause serious addiction, is that from the brainstem. It is often horrendous and remains suffering because it is so deep and remote and inaccessible.  When we make that into pain we are on our way.  Pain is resolvable and suffering is not; it can only be suppressed.  Suffering is diffuse, amorphous, without shape, time or place.  It is an imprint often without words, but it endures for a lifetime.  Pain is a conscious, connected event which takes suffering makes it specific and we are done with it.  Pain, like the kick in the cojones, stops the vagueness; it is over and done.

It has been disconnected from its source, time and place and therefore remains a mystery.  When it becomes, “Oh my God. They hated me and blamed me for it.  And I thought it was my fault and that I was bad and unlovable. “  Or it can come from a traumatic birth and or a carrying mother drinking alcohol or smoking.  Many ways to suffer; only one way to feel pain.  Pain is connected and specific; you cannot be driven there by a therapist but you can be led there when the time is right.

So now we know that specific pain is held down by the gating system.  It was meant to be hidden so as not to be too disruptive.  But it continues to spray its agony all of the system, and we get high blood pressure, headaches, even epilepsy.
It is a mystery to everyone.  No one can see a carrying mother chain/smoking decades later but there it is and that is when it all began.  So what we need to do is wait till the patient is far along in her therapy and can safely descend
To lower levels;  we then using primal techniques to help dredge up those early pains from remote times, bring them up with the help of the right orbitofrontal cortex make them concrete and resolving.  That is  a different matter from suppressing pain. One is time consuming and evolutionary, and the other is always an emergency measure.  We should never do one without the other. We can kill pain with drugs while we are traveling to the lower depths.  But let us never fool ourselves; temporary measures, pain killing is not cure no longer how long it lasts.