Phantom Pain

I often refer to my mastectomy as an amputation.  This tends to freak people out a little bit, which is totally intentional on my part.  The term “mastectomy” does not do justice to the shock of having had a body part cut off – it polishes the word up and makes it socially acceptable.  Amputation more accurately conveys the physical and emotional trauma involved in losing a piece of your body when there was no other alternative to saving your life.  It also brings to mind that the suffering endured by this loss goes on long afterwards – something “mastectomy” does not.

One of the aftermath components that is taken for granted in amputees, but not often discussed in mastectomy patients, is phantom pain. By far the majority of limb amputees experience physical sensations in the limb that is no longer there, ranging from twitches and tingles to outright pain.  The pain or sensation is “out there” where the body part was but is not the actual source of the discomfort.  Mastectomy patients also experience this sensation although due to frequent rapid reconstructive surgery may not identify it as such.

Scientists don’t really know exactly why phantom pain happens.  In part the sensations are due to the nerve path being interrupted.  But it is also thought that phantom pain could be caused by complex cross wiring in the brain which, in an attempt to “fix” things,  remaps the injured/missing part of the body’s circuitry to another area.  A sensation that should be felt in a missing foot is felt somewhere else – like a hand for example.  Our bodies and brains are designed to keep up functioning even when we experience trauma and have developed mechanisms to keep us moving onward and safe. Sometimes the result is misplaced pain in an attempt to heal and keep going both in our physical bodies and our emotional ones.

While sitting in meditation in yoga class after a particularly emotionally challenging week, I experienced a stabbing sensation in the missing breast that made me flinch (it is common for amputees to have increased phantom pain in times of stress) and I instinctively reached to my empty right side.  Dropping my hand when my brain caught up with the reaction, I looked within at what was going on.  The pain I experienced was definitely originating outside my body on the same plane as my other breast – I could have put my hand on the exact place in space.  Yet it was also within my physical body.  I could feel tendrils reaching into my chest cavity and could feel the pain in my ribcage even though it clearly was not originating from this area.  “How interesting” I thought, “my brain knows that the pain is not really coming from where it seems to be but still reacted on it trying to fix the situation.  And where IS the pain coming from if it is not from where I felt it?”

I let go of thoughts about the missing breast and the pain passed as I gave it room to exist without a fight.  Continuing my meditation I sat in silence observing thoughts glide by without doing anything about them.  Soon memories of the harsh words I spoke at my partner about how I didn’t feel loved enough by him floated on by.  I noted them in curiosity as they surfaced, thinking how that is not really how I feel about him and wondering what was really behind the feelings.  Releasing the thoughts I continued to sit in meditation until the pain of my son’s recent rapid departure from my household as he turned 18 arrived and suddenly I am flooded with grief and aloneness. “Ah” I thought. “So there it is”.  There was the source of my phantom pain – the amputation of my last child leaving, an event that I could not control which left me feeling alone and grasping for control.

How often in our lives do we experience pain – do we lash out about an issue or at a person – when where we direct our attention is not the origination of the issue?  Like the pain an amputee experiences, the cross wiring in us that keeps us moving forward can also mask the reality of our feelings.  When we are feeling most hurt, angry, overwhelmed or out of control –we often experience our pain and frustration in a place that is disconnected from our true hurt and react accordingly to that.  We move what is really going on with us to a place where we can act on our feelings without dealing with the more difficult issue underneath.  Instead of tackling the hard stuff  we yell at partners about things that are really not that vital to us or we cover up with bad habits, addictions and denial.

When my daughter is stressed about something she gets sick.  Every time.  There is nothing wrong with her immune system; she just unconsciously decides she can’t cope with whatever it is going on around her. Whenever life gets overwhelming for her she gets sick as an expression that she needs someone else to take over and take care of her/the situation.  Now that she is an adult a long way from mama  (and her family is on to her!)  she has to rely on herself and is learning coping strategies to help her gain courage, strength and stamina in the face of her challenges.  The feelings of needing to be taken care of are not wrong or bad, only that they should not have the power to debilitate her life.  She is learning to see the illness as an indicator that something else is getting at her and it is time to look within and do some self-care.

My own fears about being alone now that both my kids have left the house left me confronting my partner about why didn’t he love me in the way I wanted, in the amounts I wanted and when I wanted (all of which were relatively inaccurate statements!) because I was scared of being left alone by everyone.  He didn’t deserve to take the brunt of my heartache over being an empty-nester, but there it was. He was the easy “source” of my pain instead of looking past the obvious and having to take responsibility for soothing my own soul.  FIX THIS PAIN, FIX THIS PAIN everything in me shouts….but the only fix is to sit with it and say….Ah, there it is – that is what that hurt really looks like.  Where are the tendrils from this really reaching back to?  What is the real origin and how can I work with it?

We tend to be right or left brain dominant….we either think and rationalize our way through situations or we feel and experience our way around.  Too rashly acting on the action oriented side of us might result in misinformation about what really needs to be done to be effective.  Indulging in the feeling aspects alone can result in an equally inaccurate assessment of what is truly happening and bog us down in emotional gunk that is hard to get out of.   We need to learn how to hold the truth of the experience of both realities and explore the underlying issues. To do this we need to sit back and observe ourselves and our symptoms.

Watching our thoughts and issues as they come up without grabbing a hold of any of them allows us to stay focused on the reality instead of getting wrapped up in the drama.  I could easily have latched onto the thoughts of my partner’s perceived relationship short-comings and gone deep into a story about how one  or the other of us was right or wrong.  Instead, by noting the “facts”, I was able to let it go and see what else was out there that might be the key to getting the feelings resolved.  By allowing ourselves the space to really get to the heart of the matter, we are able to accurately place the pain and then take care of ourselves in a way that heals instead of perpetuating the hardship.

It can be terrifying when we let go of the immediate need to FIX something.  When we pause to observe without trying to solve, we can feel we are opening a door to unending chaos and potential for the feelings to overwhelm us.  We think that if we don’t maintain our tight grip on the situation – even if we might be wrong or too narrowly focused– that we will be better able to take control and wrestle the demons back into place.  But we will find that when we sit with our pain instead of running or controlling, the feelings don’t take over.  Instead they start to dissolve.  There is a bottom to the ocean, and our pain will not take over if we become an honest, compassionate listener. Our struggle to control situations and people and our harsh judging of others and ourselves are what causes most of the angst that threatens to overwhelm us.  Often all that needs to be done is for us to be present with ourselves and really listen without grasping onto bits of the story.

When we breathe into what is surfacing for us, the very act of our attention begins to heal the issue.  Even though it feels like we are about to fall apart if we look too closely, it is not the observation of the feelings that will cause them to take over.  The constant mind chatter about them and believing we can think our feelings into submission causes the real drama. By quieting our mind, giving ourselves permission to have the feelings and ceasing the resistance around being uncomfortable for a moment, we allow for our inner lives to stop screaming at us for attention.  In the same way that  rationalizing to a screaming baby why it should be quiet doesn’t make it stop,  trying to fix the problem by talking ourselves out of it does nothing but cause it to show up someplace else as a “phantom pain”.  Not holding onto the pain by over-thinking or by ignoring the situation speeds the healing and allows the emotions to move through us instead of taking over us. And when we are fully present first instead of acting first, we are better able to make an accurate assessment of what is happening/what we are feeling and what truly needs to be done.

As we spend the time to re-wire our emotional circuitry to get a more accurate assessment of our internal lives, we are better able to be present and focused for ourselves and in all our relationships.  We can get more comfortable dealing with the “unpleasant” stuff that comes up in us as we start to see it for what it really is, instead of what is most convenient for us to blame.  We are better able to be in relationships as we communicate from a place of honesty and compassion as we learn to “act” instead of “react”.  We can cease the habitual tendency to see the source of the pain as “out there”, and instead look within for the origination and know that we are capable of appropriately dealing with whatever comes up.

One of the treatments for phantom pain in limb amputees is to use a mirror device to “see” the missing limb so that  the brain will cease trying to fix the situation by moving sensations to another area of the body.  In much the same way, learning to look directly at where/how our phantom pain is appearing will help us re-learn how to appropriately respond to our deeper emotional challenges and traumas.  We can learn to stop re-mapping our pain so that we can deal directly with what limits us and can live more full, heartfelt lives.