What of pain as a factor in psychological and physiological evolution? How much is known about pain, and the larger syndrome of stress to which it belongs? How does it function in the learning process, in the development of the self-concept, in inhibition, in consciousness: can it be used constructively to facilitate deep-seated personality changes?

The most recent and comprehensive research on the mechanisms of pain and its perception favors the viewpoint that pain is not precisely a sensory modality like vision, hearing, smell, touch, taste, or even the more diffused sense of kinesthesia. Each of these six senses requires specialized receptors, and a localized sensory center in the cortex. It is no longer believed that pain is a fixed response to a hurtful stimulus, or even that the intensity of pain is proportional to the intensity of the stimulus. The work of Livingston’, Melzack2 and Wall’, suggests, rather, the great extent to which the perception of pain is a function of the whole individual, modified b3 his past experiences, expectations and more subtly, by his culture. There are no specific “pain receptors” as such. In addition, five different neural tracts or pathways are involved in the coordination of the perception of pain, and the cortical areas affected are widespread, not localized.

We can now begin to appreciate the powerful contribution of psychological processes in the perception of pain – the uniquely subjective nature of pain, and the importance of the meaning given the pain producing situation. It has been experimentally demonstrated, for example, that “if anxiety is dispelled (by reassuring a subject that he has control over the pain-producing stimulus), a heat is perceived as significantly less painful than the same stimulus under conditions of high anxiety.”4

The amount and quality of pain are determined by past experiences to such a degree that it is important to make a real distinction between the purely sensory aspect of pain (the perception of stimulus) and the affective aspect (the emotional significance) of the total experience.

Individuals respond not to discrete stimuli, but to whole situations (patterned groups of neural stimuli) as painful or not. Therefore, pain is learned, and presumably can be unlearned, or at least is subject to modification, especially as higher centers make their influence felt.

These findings are important insofar as they suggest that painful experiences in an individual’s past might set certain inhibitory limitations upon his self image. A pattern of pain perception and response, once needful for the individual’s physical and/ or emotional survival, may continue to function beyond the period of its usefulness. How many of us labor under such archaic and anachronistic psychosomatic structures? Because opportunities do not often arise in daily living (and because we are conditioned to avoid pain whenever possible) we do not often apply the requisite control over the painful stimulus and the aura of past anxiety that surrounds it. The cycle of inadequacy and limitation is physically perpetuated.

If, on the other hand, a painful experience of special personal consequence could be recreated which would allow the person to distinguish between various aspects of the pain involved – i.e., sensory vs. affective, physical vs. psychological, past vs. present, destructive vs. constructive, (etc.) – the undesirable response pattern and that which nourishes it might be modified.

Most forms of psychotherapy attempt to locate traumatic moments of pain in order to release the grip of these terrors. Most techniques rely upon encouraging the patient to verbalize subconscious material. But the possibility that the physical body itself might provide the most direct avenue of evidence, recall and release, has not occurred to many practicing therapists. The most classical (Freudian) psychotherapists would never dream of laying hands upon a patient, or causing him physical pain. (Physical restraint and electric shock therapy are, of course, extreme measures, and since they do not really solve the problem, are not really at issue here.) Only the most radical psychotherapeutic groups, namely the Reichian and Gestaltist factions (and to a lesser degree the Jungians) have paid more than lip service to the idea that the body might be the key with which to open the personality to the fresh winds of change.

Any modification in personality as evidenced in behavioral change implies both destructive and constructive phases. It is my own contention that the self needs to undergo both fortification and demolition. In the imaginary center of the self we observe two tendencies at work: centripetal (intake) and centrifugal (output). The constructive phase involves the tendency to keep the body image within its confines, and the destructive phase involves the tendency to expand and extend it, even to dissipate it.5

Movement and expression belong to the destructive phase insofar as they “loosen” the fixed and rigid boundaries of the self. They might help to destroy useless limitations imposed upon one’s personal motor model. But this active, motor-expressive means is only half of the picture. What about the passive, sensory-receptive phase of behavior? We have seen that the inhibition of motor responses is an important aspect of imagistic consciousness.6

In stasis, or suspended action, thought and perception lead to crystallized images. These are the static movement systems of posture which give substance to the self image. But it must be remembered that even these static systems are movement systems, and as such are subject to change. How are changes in these most stable of all of the self-produced forms brought about?

We are suggesting that such changes might be brought about consciously, with pain and deliberation. One must become aware of an undesirable pattern before one can do away with it. Since these neuromuscular patterns were laid down with pain and inhibition, it occurs to us that these patterns may be examined only with some trepidation – at least until the new pattern can be established, and a physical release is experienced.

Because these postural “crystallizations? are so intimately connected with our veriest selves, we do not perceive them readily. They are relatively nonmoving. Like the field of gravity itself to which they are automatic “adjustments”, they have become the ground of our selves. To plow up that ground is no easy task. Some may ask, is it even desirable? If an answer could be offered it would be that any change which does not go to the root of the matter can at best be only superficial, and temporary.

Does pain then have a constructive aspect? Yes – in fact it is the mechanism most responsible for the operation of the self within the presence of fixed, safe limits. Its survival value must not be underestimated. Can pain actually be used against itself to destroy its own restraining limitations? According to our theory, yes, if the process of bodily change proceeds in an orderly fashion – if what is arbitrary and random in the neuromusculature can be changed to produce a more naturally flowing pattern, and if the individual can experience some control over the pain-producing situation.

But why is pain important in the evolution of consciousness? This writer believes, with British philosopher Gerald Heard, that the human experience of pain is significantly different from that of animals, in that it is, the result of man’s unsuccessful attempts to expand his consciousness and dilate his awareness. Such psychic, or emotional, pain exists on a continuum with bodily injuries which we received as a result of experiencing the limitations of our animal bodies.

Pain, then, is a warning and a reminder that we have failed to achieve some desired goal in the past. Because pain reminds us of our limitations, it reinforces and perpetuates an outworn helplessness in the face of today’s realities. In Heard’s words, pain is a symptom of “a balked reservoir of vital force”.7

In order that “frozen” or “bound” evolutionary energies may be released it appears necessary that the pain must be re-experienced in such a way that it is discharged, or “played back” as the individual stands by and consciously takes note that the feeling of the discharge of pain is not the injury itself, rather it is the process whereby he is made whole.

I personally believe that such discharge permits the individual to energize his higher faculties, “relieves his body from anguish and conflict” and eventually, when enough distress has been run off, “gives the mind direct apprehension of a supra-animal, supra-temporal world.”8

NOTES

1. William Kenneth Livingston, “What is Pain?,” Scientific American, March, 1953, pp. 59-66.

2. Ronald Melzack, “The Perception of Pain,” Scientific American February, 1961, pp. 41-49.

3. Ronald Melzack and Patrick D. Wall, “Pain Mechanisms: A New Theory,” Science, vol. 150, no. 3699, November, 1965, 971-979.

4. Work done by Harris E. Hill at U.S. Public Health Service Hospital, Lexington, Kentucky, cited by Melzack, op. cit., p. 43.

5. Paul Schilder, The Image and Appearance of the Human Body (New York: International Universities Press, 1950), p. 301.

6. Thesis being developed as part of the theory of Structural Integration, see Doris W. Davis, “Towards a Philosophy of Integration,” Bulletin of Structural Integration, vol. I, no. 3 (Summer, 1969), pp.34-38.

7. Gerald Heard, Pain, Sex, and Time (New York: Harper & Brothers, 1939), p. 173.

8. Ibid.

“Pain is an opinion”
Fritz Perls