Detailed guides to painful problems, treatments & more

Triggers, causes, and our deep need to explain pain: some follow-up

 •  • by Paul Ingraham
Get posts in your inbox:
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

My “back pain triggers” post was a hot item on Facebook. The comments contained dozens of examples of triggers, such as:

  • Schnauzer lifting
  • rage hoovering
  • teeth brushing
  • both “I do too much" and “I don’t do enough”
  • two cases of injuries induced by bottom wiping
  • dog doo pickup

Now, about that need to explain pain, no matter how badly. Once again, here is that nice quote from poet Anne Carson …

One of the principle qualities of pain is that it demands an explanation.

Plainwater, by Anne Carson

I may have vexed a few of you with another recent and related post, “Pain demands an explanation,” which doubled down on the idea that people are prone to flailing a little — or a lot — when trying to figure out the nature of their pain. Some people seemed concerned that I might be saying that people should never indulge the impulse to explain, and several comments emphasized how irresistible and understandable that “demand” is:

  • “For me, it was almost pathological … I needed to make sense of the nonsensical.”
  • “Couldn’t this desire to explain the reason for our pain come from a simpler, mammalian, instinctive place? Pain is scary. Why are we scared? Because unexplained pain could, we worry, mean impending death. So if we can give our pain an origin that’s not deadly, than we can worry a little less.”
  • “I think that people need explanations. Explanations make simple and safe what’s sprawly and scary. What kind of nutcase would just ‘sit with’ raw experience without attempting to soothe via rationalization? Even if the explanation arrived at isn’t rational?”
  • “Pain requiring an explanation makes sense from a evolutionary biology standpoint. The adaptive value is to change behavior, ergo, the mind must create a hypothesis. If someone has chronic pain and has NOT tried to explain it to themselves in some way wouldn’t that be the more maladaptive behavior?”

All those points help make the point: the compulsion to try to explain and understand pain is potent and primal, and must be understood in a variety of ways. I begrudge no one’s need to know, no matter where it leads. We do not have a snowball’s chance in hell of actually resisting the temptation to explain our own pain, even when we have no Earthly idea.

But we should at least be aware of the danger of bad theorizing! We have all kinds of cravings in life that we need to tame and temper, and it’s always easy to be led into serious errors by them. So we should make every effort to understand and mitigate that risk.

How? Education and some restraint. You’re going to have theories, and you’re going to care about them, but try not to over-commit to them. “Strong opinions, loosely held.”

(And then some more education.)

Finally, I reserve the right to be amused by the wackiest ideas that people cook up. But, obviously, I would never make fun of anyone directly for being hilariously wrong. 😜