Photo: Richard Wheeler
How Yoga Works: Compassion for Suffering
The sooner we deal with pain, the less destruction
BY MAGAZINE EDITOR SUSAN MAIER-MOUL
From the devastation of grief to the throbbing of headaches, pain is more amenable to relief the sooner relief is offered.
When we don’t deal with pain soon enough, its momentum and magnitude may swiftly become greater than our resources to change its path. In spite of this, many of us ignore our pain and are dissociated from our own suffering.
Why are we averse to doing something about it?
Writing earlier this year for The New Yorker, Louis Menand wondered
Is this because of what the psychiatrist Gerald Klerman once called “pharmacological Calvinism”?
Klerman was describing the view, which he thought many Americans hold, that shortcuts to happiness are sinful, that happiness is not worth anything unless you have worked for it. (Klerman misunderstood Calvinist theology, but never mind.)
We are proud of our children when they learn to manage their fears and perform in public, and we feel that we would not be so proud of them if they took a pill instead, even though the desired outcome is the same. We think that sucking it up, mastering our fears, is a sign of character.
A choice between easing suffering or fighting its cause
A pair of recent news items cast different light on pain, yet each came to the same conclusion: the ideas we have about the meaning of pain and suffering get in the way of doing effective things about it.
Last week The New England Journal of Medicine published a study that showed people who receive care specifically designed to reduce their suffering live longer, even in the most dire end-of-life circumstances.
The research was based on a group of 151 patients newly diagnosed with a specific form of lung cancer who received either early care for pain and suffering together with standard cancer care such as chemotherapy, or standard cancer care alone.
Specific attention was paid to assessing physical and psychosocial symptoms, establishing goals of care, assisting with decision making regarding treatment, and coordinating care on the basis of the individual needs of the patient. *
Both physical pain and personal suffering were cared for in the palliative group. There are two key points to observe.
- dealing with pain began immediately
- health care was tailored to individual needs
The result? People who received palliative care lived longer than those who did not, in spite of the fact that at the end of their life care was less medically aggressive. The group receiving care for pain lived on average almost 3 months longer than the non-palliative, aggressive care group.
When you have less than a year to live, that’s a big deal.
Fighting for every day of life
Reporting on the study The New York Times observed, “There is sometimes tension between medical specialties, since surgeons and oncologists often view cancer as a battle, while palliative care specialists are seen as “giving up.””
In an editorial accompanying their study Dr. Diane E. Meier and Dr. Amy S. Kelley wrote, “Physicians tend to perceive palliative care as the alternative to life — what we do when there is nothing more that we can do.”
Each of us lives out this very same tension daily as we dissemble about what really hurts us and bluff our way through personal pain. What Menand observed is true – we tend to associate the concession of pain with shame or weakness.
We shouldn’t be quick to judge these feelings in ourselves nor we should we be hasty to judge our instinct to suppress them. Though it causes us angst and self-doubt, the complex interweaving of psychology and physiology is an innate part of being human for good reason.
Even when survival is far from likely, our spirits draw strength in mysterious ways.
The will to survive
I remember being held at gunpoint in a bodega robbery in Boston twenty years ago. I can attest that your life really does flash before your eyes in such moments.
As I knelt on the floor I had vivid thoughts of my baby son who thankfully wasn’t with me; I was experiencing an intense love for him. The tight group of us huddled under the guns were in the subtle ways possible, kind to each other. We exchanged brief glances and small touches, helping each other to cope.
When the robbers unexpectedly ran from the store, I was surprised to find mingled with joyous relief at being spared, another relief – that I had not been a coward. It was a strange peace that steadied my nerves after the shock of violence.
Compassion for fear
Is it possible our cultural values reflect an innate instinct for survival that prioritizes calm?
Fear and anxiety are, after all, their own terrible kind of suffering, and in our day-to-day lives, it’s fear and anxiety with which we are often most familiar. In addition to physical pain, fear and anxiety are part of what palliative end-of-life care is designed to relieve.
What Meier’s and Kelley’s study of palliative care teaches us is to address our daily fear with as much compassion as we do our fear at the end of life. Waiting until there’s nothing else we can do about our situations except break down is waiting far too long.
True compassion recognizes our need to live with dignity and our need to manage suffering in equal measure. This is the steadiness and calm we reach for again and again on the mat, and its resulting equanimity in the face of challenge is the highest possible quality of life off the mat.
Maybe that’s why so many find relief from pain and suffering by practicing yoga.
Tomorrow we’ll take a look at another news story, about ALS. Lou Gehrig expressed nobility in the face of pain. Did his valor cost him his life?
You can download the research paper free of charge from The New England Journal of Medicine.
Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer.
The excellent accompanying editorial written by researchers Dr. Diane E. Meier and Dr. Amy S. Kelley is also available.
More How Yoga Works on The Magazine of Yoga
Frank Talk About Care at Life’s End
By JANE E. BRODY
Published: August 23, 2010
Under a new law in New York, physicians who treat patients with a terminal illness must offer information about prognosis and options for palliative care.
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© 2011, The Magazine of Yoga, LLC.