ESC the Pain

If there ever was something that human beings sought to avoid, it is pain.  Whether physical, psychological, social, or even spiritual in nature, pain is certainly something that is both feared and despised alike.  Pain is also expensive.  A previous analysis found that total costs (in 2010 dollars) ranged from $560 to 635 billion annually in the United States, with additional healthcare costs ranging from $261 to $300 billion dollars.  It was estimated that the value of lost productivity was between $299 billion to $335 billion dollars each year.  The costs of pain are more than diabetes, cancer, and heart disease. 

Unfortunately, despite all the attempts to reduce pain in our society, including making it the (controversial) 5th vital sign in healthcare, there is no clear evidence that our society is experiencing less discomfort.  Sadly, responses to pain, such as the widespread development and usage of exogenous opioids, has been partially responsible for opioid epidemic, which claimed over 70,000 lives in 2019.  In 2017, the Department of Health & Human Services declared a public health emergency as “increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive.” Beyond even the fatalities, it was estimated that over 10 million people misused prescription opioids in the past year.

As we grapple with this epidemic, in conjunction with just the difficulties of pain in general, it behooves us to consider all the ways in which it can be addressed in a healthy, holistic manner.  It also serves as a reminder that as Scott Jurek once said, “Not all pain is significant” [i.e., reflective of a serious condition to be addressed], but understanding what is and is not is part of the convoluted equation.  For as bad as pain is, the only thing worse would be if it didn’t exist, in that we can’t forget that it serves a tremendously important function.  Simply put, whether it is torn ligament or an unhealthy relationship, it is designed as a clear marker to let us know that something is wrong, and must either be monitored and/or addressed. 

Over the years, I have written various articles in reflecting on psychological and spiritual remedies for pain, professional advice on holistic solutions, lessons on painful transcendence, teaching our children how to deal with pain,  and/or opportunities pain offers to grow in various ways.  Yet recently, as I was watching a webinar on pain given by a colleague, I found myself reflecting deeply on one of the simplest slides presented.  Simply put, it noted that pain is tripartite in nature:  emotional, sensory, and cognitive (ESC).  While there was nothing groundbreaking about this idea, the more I pondered this reality, the more it seems that one of the biggest problems with pain is the same problem we have with so many aspects of our lives (and our faith)―we compartmentalize it. 

Said another way, we often assume that the specific way in which pain is received is also the way it should be treated.  For example, we assume that if pain is stemming from a physical injury, we use physical means to address it (e.g., ice, ibuprofen, etc.).  If we are struggling from a painful breakup or traumatic circumstances, we often resort to social or psychological methods to address it.  Of course, this isn’t always the case, but it is very common for human nature to treat a “scar” the same way it emerged.

The reality is that if pain is multi-faceted in general, then it reasons to assume that the best response must also be this way, too.  As I learned on the trails of Yellowstone, any physical remedies for my serious feet woes were only going to take me so far.  Yet in our search for immediate relief, or just lessening of chronic pain, it is understandable that we treat pain as an enemy instead of as an informant and a challenger.  I mean, it hurts, right, and who wants to hurt?      

Yet what if within all of our pain, and our natural response to want to get rid of it, we as a people cultivated a different approach altogether, one designed more towards long-term growth and healing rather than just immediate palliation.  Again, I am not saying we shouldn’t seek out immediate relief in some cases, especially those that are excruciating and unbearable.  But what if in trying to ESC our pain, we not only looked at all sorts of possible healthy remedies that incorporated the sensory, cognitive, and emotional world, not just the source of the symptoms themselves.  

In doing so, there is one key component in shifting our mindset toward pain, and undertaking this journey.  Simply put, we can’t keep looking at pain as an enemy to be conquered, and a foe to despise.  For those rare individuals who can’t feel pain, they more than most understand that pain is like any other natural offering, such as food or perception, as long as it remains in accord with God’s design.  Without pain, we would have no idea that something is wrong, which puts use at serious risk for all sorts of physical, psychological, social, and spiritual calamities.  Yet in first seeing pain as an enemy, I would argue that it already increases the likelihood that we will feel it, and thus heightens our response to it in the short and long-term.  Research has long since proven what human beings already know.  When we approach something (or someone) as a threat, this mindset permeates our being, making it hard to shift to a more a balanced, and potentially formative, place. 

Pain will always hurt, just as it should.  But as our country attempts to navigate a multi-billion problem, and a growing epidemic in response to it, ESCaping the pain can’t happen until we turn back towards it, and reconsider what approach we are taking.  Maybe pain isn’t the enemy after all, but the way we are treating it is. 

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ABOUT THE AUTHOR

Dr. James F. Schroeder

Jim Schroeder is a married father of eight children who lives in Evansville, Indiana. He is a pediatric psychologist and Vice President in the Department of Psychology & Wellness at Easterseals Rehabilitation Center. He graduated with his Ph.D. in Clinical Psychology from Saint Louis University. He is the author of 7 books and a number of articles, which can be found on this site.

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