In My Own Write: Beyond wear and tear
"No pain, no gain" gives way to "No pain, no brain"
Edvard Munch's 'The Scream' Photo: Wikimedia Commons
If you ever get a chance to see a 2010 film called Under the Hawthorn Tree, grab
it. It’s superb. This poignant love story, directed by Zhang Yimou and set in
the 1970s during the Cultural Revolution, will break any stereotype of the
Chinese as incapable of deep emotion – so much so, indeed, that I spent much of
the movie aware of the painful lump in my throat caused by choked-back tears.
Many in the audience, I intuited, were feeling the same.
We often cry
when we feel greatly moved. The occasion may be a happy one, such as a wedding;
but what is that squeezing of the heart that brings on the tears, if not the
physical expression of a kind of pain caused by thought and emotion? The same
thing can happen when we listen to beautiful music that touches our senses
profoundly: Even as our hearts soar, we experience a physical clenching, an
exquisite anguish – you might choose to call it heartache – which may be what
British composer Benjamin Britten meant when he spoke of music being “cruel” in
its beauty, having “the beauty of loneliness, of pain; of strength and freedom.
The beauty of disappointment and never-satisfied love....”
Now pains like
these are clearly not caused by any physical hurt or injury to the body; rather
they are triggered by thoughts and emotions which affect the nervous system all
the way up to the brain, and back – resulting in the physical effects described
WHEN IT comes to chronic physical pain such as the persistent knee
or back pain that plagues millions of people worldwide, medical experts are now
looking more and more at thoughts and beliefs as contributing
The traditional view has been that tissue damage – erosion of
cartilage and wearing down of the disc – inevitably leads to pain.
for many experts, such as neuroscientist Lorimer Moseley, this is no longer a
Advances in brain imaging over the past decade have
enabled neuroscientists to see the areas of the brain that are working when
someone is in pain.
Watch Moseley’s humorous but serious YouTube
presentation called “Why things hurt,” in which he demonstrates that pain is one
of the things the body does to warn and protect you when it is under
The nervous system screams “Danger!,” all the way up to the
brain, which responds with pain, sometimes excruciating pain – even in cases
when there is no real danger.
It might seem counter-intuitive to some. But
it is now held that a person’s thoughts, feelings and beliefs – shaped by an
understanding of what is happening in the body and a gradual conquering of fear
of using the painful part – can help wind down and “undramatize” the messages
the nervous system transmits to the brain, thus reducing the pain.
recent times we know that wear and tear of the tissue occurs naturally, and that
some people have a lot of wear and tear and yet have no pain; others the
opposite,” Jerusalem physiotherapist David Fidler told me. “So X-rays don’t tell
the whole story.”
“The new approach to chronic pain is to look at all the
contributing factors – physical, mental and social – in returning a sufferer to
I LIKE this view a lot – and can support it
personally – since I suffered from osteoarthritis in the hip for many years and
more than once came up against the discouraging medical response of “What can
you expect? You have no cartilage left.”
“Move house to where there are
no steps, and in general, do as little walking as possible. Travel? Join a
senior citizens group,” counseled a distinguished Jerusalem orthopedic surgeon I
“Just live your life,” he advised cheerfully, as he saw me to
Since I was far from senior citizenship status when this advice
was given, I was dismayed at having been thus forcibly aged before my time, and
didn’t see myself “living my life” amid these restrictions with any degree of
Even back then, my feelings and beliefs played a part: I
ignored the orthopedist’s diktat, and after several years of gradually ridding
myself of fear of pain and regaining confidence in my ability to walk, I am now
pain-free – although, as I have written previously in these pages, I credit the
regular taking of Vitamin D as prescribed by Jerusalem nutritionist and
dietician Edite Tsevi for much of my remarkable improvement.
with people with knee pain,” comments Fidler, “you see that once they learn it’s
safe to move the knee, they can return to functioning by bringing in all the
components that contribute to chronic pain; and by decreasing fear and
increasing understanding of what is going on inside the knee.”
HE GAVE an
example of lack of awareness that resonated compellingly, since in my earlier
days of writing a food column called Short Order, I had devoted an entire
article to the phenomenon of driven Jewish women who cook massively and
obsessively against the clock on Fridays preparing huge meals for Shabbat, often
for large numbers of guests. I called the column “Keeping up with the Cohens,”
and quoted one acquaintance saying plaintively: “I used to make thousands of
dishes; now I make only hundreds.”
“Some of these women working in the
kitchen on Friday preparing meals for Shabbat may have sore knees,” observed
Fidler, “but they ‘have to get it done,’ and so they carry on anyway – and then
on Shabbat they are in agony.”
If you push it, he said, your nervous
system and brain will sensitize themselves to creating more pain as a way of
protecting you more.
“Those Friday cooks who press on regardless, through
the pain, need to take regular breaks and be more in tune with what is happening
with their knees, rather than saying, ‘There are 10 people coming for dinner – I
have to do this.’” It is now known, said Fidler, that the brain is capable of
amplifying or reducing pain in a way that doesn’t necessarily reflect the state
of tissues in the body.
None of this is to say that medications and other
therapies do not have their place in setting a chronic pain sufferer on the road
to less pain and better functioning. But clearly they are not the whole
Getting in touch with your body and your feelings, overcoming
your fear, gaining more understanding of what’s happening in your body and being
an active participant in your recovery are all very much in tune with the modern
approach to healthy living.
IS THERE such a thing as “good pain”?
According to my Alexander teacher, Dalia Altmann, there is.
“Good pain is
when there is a change, when you start to get your body into better balance. For
example, if it has been tilting in any direction as a habitual pattern, you will
experience pain as muscles that used to be tight, or were never used, begin to
It’s something I keep in mind when I feel my muscles
protesting during a session.
WHAT ABOUT emotional pain, such as the
tremendous blow of a broken-off relationship, or other emotional hurt? One thing
to observe straightaway is that while it can be gut-wrenching at first, such
pain is almost never chronic, and so one can look ahead – mentally, if not yet
emotionally – to better times.
“Broken hearts can mend,” a wise friend
One recipe for emotional pain is to tell yourself: “I’m
feeling terrible now, it’s true, but I know that tomorrow I will feel a little
less wretched; and slightly less bad the day after that, and so on. The extreme
emotional distress I’m experiencing now will not last.”
Just knowing that
intellectually can be a comfort.
TO END on a philosophical note, the
Lebanese-American artist, poet and writer Khalil Gibran compared a person’s
existence in the world to a full goblet, into which happiness can be poured only
to the depth that sadness has been drunk out. It’s a way of saying that without
darkness, there is no light; without grief, there is no joy; without pain, there
is no ease – or, at least, no appreciation of it.