Thursday, 16 October 2014

If he stops to think he starts to cry…

I have been a U2 fan for as long as I can remember: from 1980’s Boy LP (when I Will Follow grabbed me by the pit of the stomach – and has never let go…) onwards (we didn’t have CDs – and it would have taken over seven hours to download using a well connected 28.8 kbit/s modem – in those days, y’know – so ask your parents or grandparents why those twelve-inch circular slabs of (mainly) black vinyl are “Even better than the real thing”) – and was fortunate enough to see them perform at their peak in Leeds, in 1987 as part of their Joshua Tree tour. Although I don’t recall it in perfect detail – Wayne Hussey, lead-singer of The Mission, later said that he didn’t remember it at all: and they produced a barnstorming set as one of the support acts! – I do recollect that it was as much religious experience as concert.

As you can imagine, I was therefore (in a minority of those?) delighted to ‘discover’ that U2’s latest album, Songs of Innocence, had automagically appeared on both my iPhone and iPad (as it might have done on yours), as part of Apple’s typically lavish launch of the iPhone 6.

Art – great or otherwise – depends for its ‘success’, I believe, largely on meaning – not that it should signify or suggest, necessarily, the same thing to different viewers, readers or listeners. Interpretation – and the bond that forms between subject and object – is key.

It doesn’t matter, therefore (perhaps) what Bono intended when he conceived the lyrics for The Troubles – the last of his band’s Songs of Innocence. However, it does matter – to me – that they provoke a response (in addition to that of the almost epilogic music): in this case, deeply probing my emotional innards – “Somebody stepped inside your soul” – and speaking (singing) to the quintessence of the being I have become – not necessarily through choice; but in response to the major, injurious incidents (and their repercussions) that have helped(?) shape me, and which have been refined by my respondence.

I have a will for survival
So you can hurt me and hurt me some more

Ten years ago, learning a new way of living, I produced an essay (for one of my medical specialists) entitled Always deal with what pain is…. At the time, due to enforced medical retirement, and being bound both to bed and barracks (by my then perceived limitations), I had been doing rather a lot of reading – as I’m sure you can imagine. And one of the books that made most impact on me – because of its strong humour and resilience (things that I no doubt needed to share in, just then – and still do…) – was Robert Twigger’s Angry White Pyjamas: about him joining “the Tokyo Riot Police on their year-long, brutally demanding course of budo training”.

Coincidentally (and resonantly) enough, Twigger deals frequently with his (and his companions’) experiences of pain; and I found the following excerpts filled with that resonance:

…pain is personal, pain is subjective. You should never judge another man’s pain. Not only is the amount of pain subjective for any given injury, so different people are sensitive to different pains. It is difficult to conclude that someone has ‘a high pain threshold’ because he may tolerate a migraine without painkillers but scream blue murder if his finger is nicked by a penknife.​
     The area is further muddied by imagination – indeed, this is the major contributor to an over-reaction to pain. It’s not the pain in itself, it’s what the pain means which is so distressing.
     It is one thing to be able to suffer pain. It takes a second level of stoicism to ignore the damage that the pain signifies.

It’s easier to convince yourself it doesn’t hurt when you are shouting. This is the distraction-method of fighting pain, the preferred Western way. The preferred Eastern way is detachment.

I asked [Sato] why he never let pain show on his face.
     “If I show pain, I feel a different kind of pain, a kind of pain that tells me to stop. But if I keep a clear face then the pain is not so bad. We call it ‘the face of Kannon’, a face like the Buddha.”

Dimly, I could already grasp there were two levels of pain. Pain (1) was the actual sensation. It was on the level of an objective observation: “I have been stung by a bee. There is a pain in my upper left forearm.” Pain (2) is the subjective reaction: “Ow! It hurts! It really hurts!”
     Young children only experience pain (2). It hurts and hurts and hurts and then it’s over and they stop crying.
     The basic character of pain, and almost indistinguishable from it, is the desire for it to go away. A masochist doesn’t want it to go away. This serves to neutralize the pain (2) content of the experience, since pain (2) is the “It hurts!” side, when it seems as if the pain is everywhere and not localized, as if it is attacking your brain directly, and is indistinguishable from the desire for it to stop. In a way pain (2) is “Please stop now”.
     Growing older increases the domain of pain (1). We may experience chronic pain, for example, which won’t go away. We either become miserable or we cordon it off, localize it, objectify it (“There is a pain”), and then we learn to almost ignore it. Almost.
     Slowly I was beginning to see that the senshusei course was a lot about coping with pain, about losing the pain (2) experience and getting pain under control on the pain (1) level. If you train until you faint then you have lost the pain (2) element. If you stop when “it hurts” you may be doing the safe thing, but you are not commanding your body, it is commanding you. There may be a time when your life depends on who is in command.

I was also delving into a plethora of what could be described as ‘medical textbooks’; and Twigger’s revelations tied in well with Jean Craig’s “two levels of pain”, described in Managing Chronic Pain:

The primary level is where the ‘sensation of pain’ is sensed through the nerve endings that recognise pain in reaction to an injury [nociceptive pain]….
     The secondary level of pain is the ‘perception of pain’ where the pain message radiates from deep structures in the brain to the outer cortex where it is linked with thought, feelings, mood, attitudes and beliefs.

But my foremost bookish love is fiction; and there’s a leitmotif of chronic pain in Mary Doria Russell’s wonderful, heart-hollowing book The Sparrow, and its sequel Children of God – both about “the nature of faith and what it means to be ‘human’” – and I think one of the most telling passages (at the time, for me, and my understanding of phantom pain and its correlation with chronicity and plasticity…) is this:

“My uncle lost most of his right hand when I was about eight…. My aunt used to think he was lying about the pain to get sympathy,” Joseba said…. “Dead dogs don’t bite, she used to say. The hand’s not there anymore. How can something that’s not there hurt? My uncle used to tell her, Pain is as real as God. Invisible, unmeasurable, powerful –”
     “And a bitch to live with,” Sandoz whispered…. “Just like your aunt.”

However, to get back to Robert Twigger for a moment – and an elemental objective for the rest of my life:

Always deal with what pain is and never with what it means.

And that’s the main challenge, isn’t it? Because of the make-up of my personality – especially my introversion and intellect – I am compelled to research as deeply as I can the situations I find myself in, one by one. And then I have to draw my own conclusions from the plethora, the mountains, of conflicting information: so that I can try and take my life forward. I have to draw my own conclusions… – and then ignore them….

Atypically (and somewhat astonishingly), what prompted all this was that my consultant had asked me how I saw myself working in partnership with him to help me deal with the constant high levels of pain I experienced (and still do…); and what I had been through (endured) before encountering him. And, in response, one of the best summations I had found – that expressed what I felt, at the time, more pertinently or skilfully than I could have done – came from Eloise Carr and Eileen Mann’s Pain: Creative Approaches to Effective Management:

We now live in a society that has high expectations of what health care can deliver, and those in pain are no longer prepared to suffer in silence. However, when we are faced with pain that challenges our ability to relieve it, or even in some cases understand it, the encounter can be frustrating and unsatisfactory for [medics] and patients alike.

In essence, what my answer boiled down to was that I wanted to be in control… – and still do (to some degree) – of the pain; this situation; my life (especially as people in chronic pain who take control are known to get both better treatment and life quality as a result): because I knew that, as every day passed by, achingly, slowly, so my self-identity was gradually being eroded. But I was repeatedly reaching the twin, defeatist dead-ends of either “having to live with it” (my fault, if I couldn’t, or didn’t want to) or “there’s nothing else we can do for you” (their – or medicine’s nameless – fault; but still really mine, for having the temerity to ask for help…).

To go back to Robert Twigger – for the last time – what I really wanted…

…was to break the subjective link between how you feel and how you perform. Instead, [the aim was] to replace it with a decided goal and achievement of that goal using the body, rather than the body dictating what the goal should be.

And I therefore finished my essay with a list of objectives (which were more like demands) – the most important of which was to “Learn my limits” – so I could then ignore them, as well as my conclusions…!

There are so many things that I used to take for granted, that came so easily, that are now so difficult or too painful to make any sense of in what I’ve come to think of as an ‘increased-pain/benefit analysis’…. I walk because it has helped to get (and keeps) me fit, and has helped me lose significant weight (putting less stress on my body). I type this document to express my thoughts so much better than I do when I open my mouth, etc..
     But, where, between bungee jumping and struggling to get out of bed, do my true limits lie? What makes sense? What could do me an injury (apart from [my neurologist’s] advice not to do “anything that involves significant lifting or manoeuvring one’s head into awkward and difficult positions”)…?
     Jean Craig says that “Acceptance of chronic pain is probably the most difficult step of all but the most important, because it allows you to get on with your life”; and that this means “not only acknowledging that you are in pain, but that while you are experiencing pain, high physical and mental demands on yourself are quite unrealistic”. But, as you’ve already said, this (to me) is “b*ll*cks”. Why should I accept it? I know there are limitations – but I don’t want them to be at such a low (almost vegetative) level….

He, thankfully – of course – agreed.

So what does this all have to do with U2?

Well, like Tom’s “little green devil” in Smitten Kitten, I have always personified my pain – as a constant presence in my life – and quite frequently talk to it, have a moan at it, sometimes chide it for its bad behaviour – it’s very rarely good – as catharsis. As you can imagine, these interactions tend towards soliloquizing; but they are my way of getting by, getting through what current Government benefit application forms call – in their typical Miniluv doublespeak – permanent and significant “discomfort”.

Having therefore elaborated to my pain management consultant (a fairly new specialism in the UK, back then) that I knew there were “limitations” to my physical (and, sometimes, psychological) exertions – I made it acutely clear that I didn’t want to feel (and would try not to be) trapped by them. I still don’t. And I try my best to expand and exceed them on a regular basis – always knowing that this “bad behaviour” on my behalf will then come back and bite me on my overweight behind… – but that I will still have achieved an infinitessimal incorporeal victory in an eternal campaign of war.

Listening to The Troubles for the first time (using the modern and minute miracles of Bluetooth-enabled hearing instruments), it was obvious to me immediately that the “Somebody” the song referred to was my “little green devil” made concrete – voiced by Lykke Li in this colloquy – and how it had taken (attempted to – had I let it? – take) over my life:

Somebody stepped inside your soul
Somebody stepped inside your soul
Little by little they robbed and stole
Till someone else was in control

However, there is a subsequent message (meaning and interpretation) in there – sung by Bono himself – aimed squarely at me, and my profession to understand and be able to overcome my limits:

You think it’s easier
To put your finger on the trouble
When the trouble is you
And you think it’s easier
To know your own tricks
Well, it’s the hardest thing you’ll ever do

And I could quite happily walk around with a T-shirt (well, it would have to be a fleece-lined hoodie, at the moment…) bearing the following response:

I have a will for survival
So you can hurt me and hurt me some more

Another principle I would wear proudly – from Pat Wall’s ‘bible’, Pain – the science of suffering – is already engraved on every cell of my recalcitrant body:

Coping is not ignoring. In fact, it is the opposite… [learning] to live with… pain in a realistic context… the beginning of a series of steps that give a sense of understanding and a type of control.

…and this – even though it is someone-else’s (hard-won) conclusion – I will never disregard. In its perceptive summation, it is what drags me out of bed in the morning; what pushes me along the footpaths by the River Avon; what stabs my stubby fingers imperfectly at the keyboard. It has become a promise to myself – the hardest thing I’ll ever do…. But if I’m coping successfully, I’m living victoriously – besting my pain at least once a day (rather than controlling it) – by hauling myself up (maybe with a stick; maybe one at a time) that series of steps. Even if it only the beginning….

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