Photo: Melanie Thernstrom
Mystified by Pain
The author of The Pain Chronicles says her personal journey helped her write the book she needed to read
BY MAGAZINE EDITOR SUSAN MAIER-MOUL
Book Review: The Pain Chronicles
Pain itself is impossible to put a boundary around because it is so complex–a complexity that cannot be captured by any single discipline.
Susan Maier-Moul In The Pain Chronicles you describe your initial assignment in pain research as random, part of a conversation that included other options.
Melanie Thernstrom The assignment from The New York Times Magazine was to just to write a short article about chronic pain, but the more I researched it the more I wanted to learn about the subject.
Susan You make important distinctions between acute pain and chronic pain – a difference of great significance in treatment. Were you interested in why some pain persists?
Melanie I was particularly interested in the question of healing. Why do some people escape from pain’s clutches, while others remain captive? Is there a recipe for healing?
Susan After your work was underway, when did it become apparent you wanted to go on to write more than the assignment, and in fact, an entire book?
Melanie For the initial assignment I followed pain physicians and observed hundreds of patient appointments. But after the article was published I found myself wanting to stay in touch with the patients and see whether the treatment that the doctor recommended worked and if not (as was often the case), what did work.
So I followed a large group of those patients for eight years and I wrote about the stories that struck me as most illuminating about the nature of pain and its treatment.
My book is also the story of my own journey towards healing.
Susan In your book, you describe sitting in a doctor’s office reading a magazine article
about the body’s miraculous healing powers: “90% of pain resolves itself in six to twelve weeks, regardless of the method of treatment used,” … our ancestors had healed themselves without any help from neurologists. I began to feel I had simply been impatient; surely my body would reveal its healing powers.
Melanie Writers often say they write the book they wanted to read. In the years I felt mystified by my own pain, I never found a book that addressed my experience. Indeed, it was only because of the good fortune of being given that assignment that I had the opportunity to research and learn about pain in a way that allowed me to find effective treatment. I wrote the book in order to share what I had learned with others.
Thinking about pain you experience changes the brain
Susan What area of your research was the most difficult to define or put a boundary around?
Melanie Pain itself is impossible to put a boundary around because it is so complex–a complexity that cannot be captured by any single discipline. I wanted to understand not only the science of pain, but the meaning of it–spiritually, psychologically, philosophically, historically, and culturally.
The desire to understand and avoid pain threads through all of human history.
Pain is a perception that is generated by the brain and draws on many parts of it, including the meaning-making parts, which is why emotion, feeling, memory and cognition change pain.
Susan In The Pain Chronicles, you’ve written
For many years, researchers sought the demon in the machine – the “pain center” in the brain – in order to exorcise it. But there turned out to be none.
Unlike senses such as vision and hearing that depend on activation of clustered portions of the brain, pain is a complex, adaptive network of neurons (a neuromatrix) involving roughly half a dozen areas of the brain that transmit information back and forth.
As pain is one of evolution’s most important functions, it is distributed over many different areas, so that if one part of the brain is disabled through injury or disease, the system can continue to generate pain.
Most of the time, damage to pain circuitry results in greater pain.
Melanie I was particularly interested in pain imaging studies that document the way in which thinking about pain actually changes the way the brain generates pain.
I participated in one such study at Stanford University where I was given a painful heat stimulus and watched my own brain activation. Then I tried picturing something pleasant while undergoing the same burning stimulus and I was able to see that there was actually less pain activation in my brain.
This is why pain treatments that are purely mental like meditation and hypnosis can work and why other good pain treatments like yoga combine both physical and mental elements.
Don’t miss Melanie’s valuable advice on writing a book about your own personal journey, tomorrow, in part 2 of our Conversation, when Melanie also talks about trances, faith, and pain.
Hear Melanie when she appears next week in the KGB Reading Series in conversation with Dan Menaker KGB 85 East 4th St, New York November 9, 2010.
We may publish any content, comments or ideas sent to us.
Name may be withheld by request.
© 2011, The Magazine of Yoga, LLC.