In this paper and a few that will follow I plan to address a subject that is dear to my heart but very little understood in western medicine. I will examine how “a change in our mind” can affect or block pain.
Early on in my career I met a young woman (let’s call her Laura) who seemed very disabled by some kind of pain in her knees. All the tests and arthroscopic surgeries (during which a surgeon inserts a little tube in the knee joint, looks around and cleans up the tissue fragments if there are any) had failed to find anything wrong with her knees. When I examined her, there were no specific findings to point me to one diagnosis or another. All I could find was some diffuse tenderness. I sent her for another test which once again failed to show anything wrong with her knees. However, to my surprise, the test showed that she had a couple of broken ribs. When she came back, I asked her anxiously: “Had you, by any chance, done anything to your chest before you came to see me the other day”? “Yes” she answered candidly, “I fell down the stairs a day before and broke my ribs – this is what my family doctor said after examining me”. “How come and you did not say a word to me about this “fresh” pain that I know to be serious, but we spent a whole hour discussing a “ghost pain” in your knees that no one can find anything wrong with”? I asked.”Very simple” my patient answered. “Once my doctor described how the broken ribs look, I close my eyes, see the two ends of the broken ribs coming closer and closer to each other, until they touch… and then my pain is gone!”
This was the very first time many years ago that I came in contact with a patient who used “imagery”, a special mental technique, to block the pain. I was baffled and amazed as this was not part of what I was taught in my medical school or specialty training. After this encounter, I had many more that made me realize there were a lot of things about human pain that my neuroscience training did not teach me.
In another occasion, Nadia, a middle aged Eastern European woman came to see me for intractable neck pain. The Xrays showed a lot of degenerative changes in her neck. My medications and conventional physiotherapy did her no good. When she realized I had done my best to help her unsuccessfully, she felt sorry for me and during one of her visits she decided to show me her way of controlling her neck pain.
She pulled a large leather belt out of her purse, it looked exactly like a belt weight lifters would use in the gym, with a wide sturdy leather band at the back. This belt, however, was unique. It was studded with several hard and sharp edged rubber spikes. In fact, if you can believe it, the belt looked exactly like a bed of nails! “What in the name of God do you do with this torture belt”, I asked her. “I tie it around my lower back and then lay on the floor” she answered. “But don’t you hurt?” I exclaimed. “Of course, I do, it hurts my back like hell…. But then… my neck pain is gone for hours”! Most of us trained with conventional western medicine are skeptical of these kind of stories and more often than not, they lead us discount our patients. I, however, did not discount these patients. I had heard many similar stories that I could not understand with the type of knowledge I had acquired over my many years of my studies. I felt convinced that there had to be a scientific explanation behind all these stories and that I had to try to find what it was. This is how I began my journey exploring the scientific basis of “altered states of consciousness” to control pain. Pain is an integral part of humans and every living organism. Pain can be the natural consequence of bringing a child in this world, the product of disease and injury or even the result of treating them. Pain can also be “man-made” in the form of torture or punishment, inflicted by man to his fellow man. We fear pain and we try to avoid it if we can. All over the world people have used methods to avert pain that range from the very primitive to the most sophisticated and technologically advanced.