Why Do You Have Pain?

     Right from the start of my medical practice two decades ago I disagreed with the mechanistic theory of illness, which assumes that pain is "caused" by anatomical aberrations.
     According to this explanation, neck and back pain have their origin in spinal misalignment, headaches have something to do with erratic vascular flow or meningeal inflammation, infections are contagious, cancer is genetic, allergies are environmental, and accidents are--well, accidental.
     None of this has ever made sense to me, because the question, "Why this pain, instead of that?" doesn't get answered.  Isn't it curious, for example, that a person should have rheumatoid arthritis rather than ovarian cancer, or migraine headaches instead of chronic hip pain, or a rotator cuff tear but not carpal tunnel syndrome?
     The existence of the "subtle body," which has been established in psychological and spiritual texts, but ignored by allopathic medicine, is left out of mechanistic explanations of pain and suffering.  The subtle body is a template along which the physical body organizes its activities and symptoms.  The subtle body works behind the scenes.  Like the unconscious, it is unconcerned, for the most part, with a person's role in the world, or suffering and losses, or imminent death.  The unconscious has a panoptic view of life, and a prospective function, which is to say that it sees farther into the distance, and more broadly, deeply and purposefully than your or my absurdly small brains and culturally conditioned, subjective, "conscious" hopes and plans. 
     There is a parallel question, having to do with our dream lives.  Even if one has been seduced entirely by science, and therefore adheres to the reductive idea that dreams are merely the end-product of spontaneous neuronal firing--nothing more than chemo-electrical phenomena--one can't discount the fact that images in dreams are very specific.
     Why is it the case that you dream of an elephant, and not a bird?  Why was someone chasing you in last night's neuronal outpourings, and not the other way around?  How has it happened that your brain reached into the cauldron of memory and pulled out Jane McPhereson, from your seventh-grade homeroom, and not Jeremy Black or Susan Little?
     The choices made by your psyche, like the symptoms and diseases manifested by your body, are every bit as informative of underlying processes as an imminent cold front, a change in humidity, the germination of certain flower seeds along a walkway and not others, or the composition of foam and sludge deposited along a shoreline.  Cold fronts, humidity, flowers, and sludge are "symptoms" of  atmospheric conditions, soil make-up and pollution issuing from distant locales.
     One way of managing pain is to welcome it as the voice of the personal unconscious and perhaps even of the collective, the social group within which we operate.  You "listen" to it, just as you might pay attention to a weather report, or hear a train conductor telling you, "This is your stop," or attend to a companion who warns you not to step in the gopher tortoise hole up ahead.  Your unconscious is that weatherman, train conductor and companion, and your symptoms are messages--ignore them at your peril.   Staunching symptoms, so you won't feel pain, is like closing your ears to this information.
     How can you enter into the pain, to hear its deep message?  How, once you hear it, can you interpret it?  The doctors we need, to day, are the ones who can help understand our individual and collective symptomatology.  Your various pains, like nighttime dreams, speak a language unfamiliar to our rational, scientific mindset.  We need doctors who can take information from our symptoms and dreams and use it to develop our souls.  We don't need today's practitioners, whose aim it is to crush and eradicate pain, without hearing what it tells us.
     When someone calls out, "Fire!  Fire!" you would be crazy to drop a bomb on that person because you don't like the sound of his voice, or what he's saying.  Instead, you attend to his meaning:  Where is the fire?  How did it start?  What is fueling it?  Is it spreading?  How can it be put out?  What is it about the surroundings that permitted a fire to start in the first place?
     No one likes pain, so the urge to crush it by taking migraine medicine, or visiting a chiropractor for an adjustment, or a surgeon for surgery, is natural.  But think how often these treatments fail!  The recurrence rate of painful symptoms, even after definitive, corrective treatment, points to our failure to get at the real "cause" of pain, which is something like the message, "Fire!"
     One technique for "hearing" your pain is to meditate on it in a quiet place.  Imagine increasing the pain to an intolerable degree.  What would happen, do you imagine?  Would your back break in two?  Would your hand fall off?  Would your head explode?  Exaggerating symptoms in an imaginative way can give you clues about what the symptoms are saying.
     If your back pain were ten times worse, and you imagined your spine breaking in two, it's possible that something structural in your life may need to break, or the weight you're carrying has to be unloaded, or you don't have a backbone, or you have too much of one. 
     If you imagine that your hand would fall off if your pain got much worse, perhaps you need to "let go" of something, stop grasping, or cease "handling things."  It might help to immobilize your hand with a splint as a way of understanding what the pain wants you to do.  "I can't live without my hand," you say.  But living without your hand is exactly how you might accomplish what the subtle body is insisting upon.
     If your head explodes, in imaginative bodywork, it's possible that your thinking is getting you into trouble, that brainwork and logic are overriding important messages from your physical or emotional being.  A head under this much pressure has been pushed to its limits.  It needs a siphon, for drainage.  The ancients had it right, when they trepanned, but they took the message of "too much pressure" literally, when it should have been understood psychologically.
      Making generalizations about physical symptoms--as though there might exist a handbook for understanding the subtle body, by equating each symptom with an emotional cause (Lousie Hay did this, disastrously)--is not possible.  Individual people have symptoms which speak uniquely to them, and must be understood in the context of their toiling, and alongside their dreams.  The interpretation of symptoms cannot be applied to groups.
     The failure of western medicine is how doctors approach symptomatology, including pain, as purely physical phenomena--we use needles, surgery and bomb-like medicines, rather than the finely-tuned approach of psychology.  Despite many innovations in psychoanalysis over the past 150 years, we have failed in medicine to integrate a psychological understanding of illness into our treatment protocols.  We give lip service to "mind-body medicine," but no one really practices it, and insurance plans certainly don't cover the cost of dream interpretation and symptom augmentation.
     We need a new breed of doctors that isn't one-sided, and we need a braver population of patients, who are willing to look inside, not outside, for treatment.
     Unless we face our inner natures, painful and grotesque as they may be, as depicted in our dreams, our outer world, which we only imagine is outer--but in fact mirrors our deep, psychological selves--will decline, and fall into prehistory, requiring us to start the human race all over again.