While I was earning my PhD in medical sociology at UCSF, I conducted ethnographic observations in a neuroimaging pain lab and interviewed neuroscientists from across the globe. I asked many of them the same question: were there parts of the pain puzzle that science could never answer? Most scoffed. “I don’t believe that anything is unknowable,” one scientist told me as we sipped coffee in the courtyard outside her lab. “I think it would just take lots of incremental steps to get to the answer.”
Designing scientific studies that can systematically capture the subjective nature of pain is no small feat. One neuroscientist I interviewed, a wiry young man with a gentle nature, had devoted his career to developing stronger methods for objectively studying this squishy, subjective side of pain. His aims were lofty. “If you think it all the way through to the end,” he riddled, “you get at questions about consciousness.”
I asked how close he thought we were to solving those questions. “I don’t think we’ll solve the consciousness question soon,” he told me. “People have tried for 2000 years or longer. I’m not that optimistic that our generation is so much smarter than all the generations before.” He looked down at his hands and then chided himself for being pessimistic. I leaned back in my chair and tried to listen more than steer. Eventually he continued. “Because pain is a conscious experience, if I say we can’t solve consciousness, then probably we also can’t solve the pain puzzle completely.”
He offered this as a limitation – almost an apology. I’ve come to hear it as something more optimistic. Pain is bound up with our capacity to be aware at all, to take in beauty, to grieve, to feel connected to another human.
Christof Koch, one of the best known consciousness researchers, once wrote that if he has a tooth abscess, no clever argument that his pain is an illusion will lessen it one bit. Anyone who has lived with pain, which is to say anyone at all, knows this. Pain can’t be argued away, and it can’t be fully measured from the outside. It is part of what makes us human.
That idea sits at the center of my work with clients. As a pain coach, I draw on what I learned in those labs all the time. I know how today’s tools for working with pain were developed, who they tend to work for, and where they fall short. But no scan or pain scale can tell me what your pain feels like from the inside – only you can. When pain is treated as real and human, rather than as a problem to be argued with, the path out of it gets a lot clearer.
