The Last Place

Oct 31, 2014 | Articles

I find myself exploring people’s minds for what’s going on in their body. And this is what I’ve found: The mind, particularly the part of the mind that holds our secrets, can torture us, body and soul.

I see a lot of people who have chronic back pain, fatigue, diarrhea, migraines, arthritis, and insomnia. They’ve been to their primary care physician, a specialist, a chiropractor, a psychiatrist and a physical therapist. They’ve had x-rays, scans, blood and urine tests. They’ve been on medication or supplements and may have been in therapy. They’ve changed their diets and taken meditation classes. And still they suffer.

Pema Chodron, the Buddhist monk, says we look for answers in all the wrong places. She tells us that the answers to our existential pains, self-doubts and perpetual negative thinking is not found by seeking pleasure – or in these cases the pleasure of knowing a diagnosis.  It is by looking the monster in the eye (my language – not hers). Her Buddhist understanding and solution for the existential pains we suffer help me as I try and understand these most resistant of physical complaints interpreted as medical problems.

I find a great deal of resistance, in myself and in my patients, to the idea that the answer lies in understanding rather than in treating.  For most of us, myself included, our mind is the last place we look for answers.

Please, not that. Please don’t make me look in that dark corner.  I’m afraid of what I’ll find – that I’ll discover I really am alone, little, cold, lost and rejected. Please let it be a torn rotator cuff, a slipped disc, arthritis in my hip or even the dreaded diagnoses of fibromyalgia or chronic fatigue syndrome. Anything but the emotional truths I’m embarrassed by and can’t bear looking at.

I’m vulnerable to this thinking. This time I’m going to figure out the real solution to weight loss. Just give me a little more time to figure out the exactly right amount of butter pecan ice cream every three weeks.

I saw a woman yesterday who had a rough childhood. She got pregnant and married at age 18 and then post-partum depression so deep she was admitted to hospital. When I asked her what this was like, she said it was wonderful. She said it was the first time she felt she could be open, honest and just herself – and cared for by others that had her best interest at heart. She says she felt like she could let go – really let go, for the first time in her life.

When I come to this perspective with a patient, I find an understandable reluctance to believe that our fears can have such a powerful effect on us. First is the reaction that “this is not just in my mind”. I’m not sure where this implication comes from. I never think that someone is “making it up” or just imagining their symptoms.  I suppose this resistance is based on the idea that thoughts are immaterial and thus have no connection to our blood and tendons. This is wrong of course. The stress response, mediated by cortisol, has a powerful chemical effect on every cell in our body and can cause cell damage and destruction through its effects on the digestive and immune systems (amongst others).

I imagine the other force behind this voice that wants to deny that emotions can hurt us physically is that we don’t like to think of ourselves as so vulnerable to such a wispy thing as angst. It is, however, wrong to believe that angst is wispy.  It is insidious, destructive and can be a killer.  The power of our inner terror comes in part from our instinct to box it up rather than let it out. If you tell me that my anxiety is hurting me, I want to put it in that same box up there on the back shelf. I refuse to admit it into my conscious life for fear it will hurt me. If I tell a patient that her anxiety is responsible for her symptoms, she is afraid that if she opens that box that it will hurt her even more than it already has. But another lock on that box please.

My experience is just the opposite – both with myself and with my patients. If we can tell another our most frightening secrets, if we can look the monster in the eye, it begins to get smaller. There is relief from releasing the pressure, from sharing what we thought might kill us and from opening a channel to another human – who like us, has understandable and not so horrible fears.

To Your Health