EXERCISES IN DISCOMFORT FOR THE SELF-MANAGEMENT OF PAIN: DISCOMFORT AND RELAXATION

In order to condition our mind to be less disturbed by pain, we are deliberately going to expose ourselves to some degree of discomfort; at the same time we shall keep our mind calm and relaxed so that the discomfort simply does not disturb us. And because it does not disturb us, we do not really perceive it as discomfort at all.

You suffer from pain. And I suggest to you that you expose yourself to further discomfort. I can see your reaction. “No, I have enough suffering. I don’t want any more. I could not bear any more.” This reaction is understandable. But just remember two things. You will not experience any feeling of discomfort; you will merely place yourself in a situation which under ordinary circumstances would be uncomfortable, but because of your relaxed state of mind, you do not feel as uncomfortable. And, secondly, remember that this is an important step in the

self-management of pain, just as exposure to the phobic situation was in the relief of phobic anxiety.

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WAYS OF COPING WITH STRESS: DRUGS AND STRESS

In different cases, different factors operate in precipitating an individual into the habit of drug-taking. It may be simply a matter of relentless pressure of one’s peers, or nothing more than the desire to explore new fields. To experiment. ‘How can you evaluate something that you have never experienced?’ Nevertheless, stress plays an important part in bringing many people to take drugs for the first time, and in maintaining use of the drug before actual addiction has set in.

People under stress hear that marijuana brings a feeling of relaxed well-being and counteracts the anxiety and nervous tension of stress. There are usually friends who say, ‘I take it. You can see it has no ill effect on me. What do you lose by giving it a trial?’ So he tries it, and discovers it does bring a feeling of relaxation, and dispels some of the anxiety of stress. So he repeats it, and soon becomes a regular user.

It helps a lot, but maybe it does not relieve all the tension. Then one day the tension is more severe than usual. ‘Perhaps I need something a bit stronger. Just once, or a couple of times to settle me down.’ And he is off on heroin.

But in more than forty years of psychiatry, I have seen enough to know that those who do not go beyond marijuana may still suffer terrible consequences. Even old hands at the game may suddenly have a bad trip. This may occur after starting some orthodox medication, after an unaccustomed amount of alcohol, after some additional stress or in the incubation period of some virus illness. Perhaps, more commonly, the sudden bad trip appears without any discernible cause. In the bad trip the individual may injure himself or others, or even commit some antisocial act of which he may have no subsequent recollection.

I have seen several young introverts precipitated into schizophrenia by their experience of the dreamy unreality that often goes with the taking of marijuana. But distinct from the schizophrenic reactions, others have developed a toxic psychosis requiring hospitalization in a psychiatric institution.

There is another, less spectacular and less well-publicized reaction which may follow the use of marijuana. This is chronic marijuana intoxication. It occurs in people who have been taking the drug for some time. It is the counterpart of chronic alcoholism, but the clinical signs are slightly different. In chronic marijuana intoxication there is a general falling off the individual’s performance, both socially and at work. The person concerned is unable to accept this, even when it is pointed out to him. His typical reply is, ‘I am all right. You can see I’m all right.’ He is likely to repeat this statement several times, which in itself is evidence that he is not quite all right. Perhaps the most obvious feature of chronic marijuana intoxication is the individual’s lack of concern. The unconcern is all pervasive, extending not only into all aspects of his own life, but into the affairs of others and of the community in general.

We have discussed how stress may precipitate the individual into drug-taking, and how the effects of the drug may come to have a disastrous effect on his life. But there is another reaction which occurs in the early stages of drug-taking. There may come an awareness of increasing dependence on the drug. Then a panic: ‘Am I hooked? Have I become hooked without knowing it?’ The acute problem adds to the individual’s level of stress, and so makes withdrawal of the drug still more difficult.

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MAJOR PROBLEMS LEADING TO STRESS: CANCER

“I had the lump there. But sometimes you get bits of thickening. He said he thought it was OK but thought he had better do a biopsy. Then this report and he says I must have it off. Next week at the latest. So casual about it. Just an incident for him, but for me, my life. More, think of it! Fondling, loving. Oh, God. He’s sweet. Says he will love me just the same. But it can’t be. Says it’s me that he loves, not my body. But my body is me. Such an important part, for me and for him. Cuddling. Misshapen. I cannot think of it.

‘People talk about alternatives. He didn’t. But some people do. So little is known, could I take the risk?

‘The children. To grow up without a mother. So young. So different from what might have been. Deformed in their way. A child growing up without a mother becomes deformed in the spirit. Deformed, just as I shall be. Life, as I knew it, is at an end.”

The devastating problem, the effect of the cancer on herself, is made worse by the associated problems of its effect on her husband and children. Her brain is filled with so many nervous impulses that it ceases to function properly. She cannot think clearly. She does not know what to do.

She urgently needs to reduce her nervous tension. Of course, this can be achieved most effectively through simple meditation. If you should ever have the misfortune to find yourself in some such similar situation, don’t react by saying, ‘How can I meditate when I am distraught like this? You need to be calm to meditate.’ No. Just let it come, slowly, just slowly, and little by little calmness comes to our mind. And as we repeat the process, the effect of it gradually flows on into our life as a whole.

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