Pain

In a recent bout of physical pain, I realized that physical and mental pain feel almost identical, if of the same extremity. This theory may only work on the ‘extreme truly horrible’ end of the scale, but at least in that context, the sensory experience is almost indistinguishable.

Both physical and mental pain have left me rolling around, holding my damaged body part, clawing at my own skin in the desperate hope that I might either exorcise the feeling or distract my tortured senses. I have literally tried smashing my head against the wall to get the pain to stop. I have adopted the fetal position. I have smushed my face into the floor while my eyes rolled back in my head. I am fairly certain that my outward appearance is the same: crumpled face, teary and pleading eyes, roving hands, flailing limbs, slumped shoulders, moans and screams.

The mental pain I have described elsewhere on this blog. Typically brought on by extreme anxiety, self-hate, frustration, and just plain awfulness. The physical pain I have recently experienced is that of my period. Some of you may say, ‘ha ha’, or ‘I’ve read this before’ and roll your eyes. ‘Girls!’ some of you (and not just boys) may sigh, and groan. Fuck you. You can leave, now. …

My menstrual cramps have become a hated beast from Tartarus. For two days each month, I am woken with pain. I will take codeine, because it is the only thing that has any effect. Until it starts to work, I spend my time experiencing the pure antithesis of ecstatic pleasure. I have never felt so much pain in my life. I am truly, literally in capacitated. I can barely breathe. I am reduced to tears, reduced to a starving wretch bleeding to death in a muddy rut, with no help available. I’ve wanted to die with absolutely suicidal fervor. I do not know how to express in a serious fashion how much pain I was in last week. Humourous pop culture references come to mind, like chest-bursters from movies and video games. It was not humourous. I have no interest in being funny about this. If I could have gotten myself to a hospital, I would have sucked the cock of the first nurse to promise me morphine.

With that charming image in mind, which will probably be a bit devastating to my mom if she’s still reading (sorry!), let’s return to mental pain. Once the painkiller finally kicked in, and I fell down in exhaustion, it hit me how similar my experience was to mental pain. My brain processed it as the same feeling. My body expressed it in a very similar way. It was primal, dark, and agonizing. There is something about the word ‘agony’ that captures it better; the feeling is one that requires immediate action, the imperative to do something now, and the desperation to escape hell. There is a wrong being inflicted, something wrong beyond reason, rationality, or sense – wrong in the deepest and most instinctual, incontestable manner.

The Wrongness Monster appears both in my crises and my painful episodes. I cannot deny its presence. I cannot escape the ring. It’s a champion boxer and I am not able to dance like a butterfly-sting like a bee, thank you very much. Interestingly, with both cramps and crises, the WM is invisible, and frankly everyone else finds its existence dubious. If my bone were snapped in two and the femoral shaft were sticking out of my quadriceps, arteries spurting blood and fat tumbling to the ground, the WM would be kind of announcing its presence with authority, having a rave with other WMs on my body. That kind of activity is ‘real’. It’s easy to see why I’m reacting so violently – there’s a fucking WM on the scene! Danger! Call 911! Get the Ghost Busters!

The WM that causes my anxiety meter to burst the mercury exudes some kind of spores or hallucinogenic gases, which then blind all passers-by to its presence. ‘What’s wrong?’ ‘CAN’T YOU SEE THE MONSTER?’ ‘No…uh…’ So everyone thinks we’re mad, and then we get locked up in some room in a hospital, where the WM can wreak havoc, break things, poke us with branding irons, and then we take all the blame for the damage! Convincing people that there is something deeply, truly wrong when there is nothing to see but blinding pain without an obvious cause, this is next to impossible. The WM’s spores make other people’s wrongness sensors go numb.

But ultimately we feel the same. We feel the pain as if we’re on an endless tundra, stabbed with frostbite again and again, but nowhere to hide, no way out. It’s all unspeakably wrong, impossible to describe, but it’s real.

Why aren’t you listening, madam? I am not crazy! The pain is real!

My perhaps-cryptic post of a few weeks ago is the most current medical experience I am having. Most of my posts about CBT or DBT refer to therapy groups that have happened in the past couple of years, but that I am not currently in – I’m at the ‘go free, child, and attempt to live with these diseases using the Jedi mind tricks you have learned’ stage. But I wanted to include my experiences with vestibulodynia because they are now involving medical treatment, as well as both physical and psychological pain.

As usual in this country, getting an appointment with a specialist can take a long time. When I finally brought this to my family doctor, he sent me to a obstetrics clinic not too far away, to a woman he said was supposed to have knowledge of vulvar pain, as a sort of specialty. Next time I go back to him, I will inform him that he is very much mistaken in her interests. She was perfectly professional, but she said (as many people who have vulval pain symptoms will hear time and time again): ‘There’s nothing wrong with you.’ She said I take a normal sized speculum without difficulty (she apparently did not look at my face), and my tissues are healthy. That’s great, I said, but is it supposed to hurt? To my shock and disbelief, she said yes. First she said it’s supposed to be uncomfortable, and I said, no, but actually painful, really painful – and she still said yes!

A message to every woman feeling this pain (and frankly every person who feels pain despite having ‘healthy tissue’) – don’t give up!

I actually started tearing up at this point, unable to believe that four months of waiting had led to this. This seemed to give her a clue that I wasn’t kidding or some child complaining of discomfort. She asked, ‘Ok, well where does it hurt?’ I pointed to her diagram, explaining that it was just at the ‘entrance’ (I hate that word. It feels so gross. I do not wish to think of my vagina as having an ‘entrance’, especially since it doesn’t have an ‘exit’. It is inherently a sexualized term, reminiscent of erotica and images of penises ‘entering’ a vagina and so forth. I do not like the idea that I have an entrance. I am not a thing to be entered. I don’t care of vestibule means essentially the same thing in Latin – it is medicalized instead of objectified.).

TANGENT ASIDE. The doctor said she would refer me to a vulvar clinic, if I wanted, but there was a 6 month waiting list or longer, etc, etc – YES PLEASE. She disappeared without dismissing me or saying goodbye, and I was left uncertain if I was supposed to wait or leave. She clearly wanted to get back to the pregnant women in the clinic who deserved her attention.

Six months later was the post from a few weeks ago, at a downtown clinic in Toronto. With my previous experience and the doubt of my family doctor, you can see why the words ‘ you are not crazy’ were invaluable.

By this point I had tried: dilators, increasing the frequency of having sex to try to ‘get over it’, more lube than is reasonable and of many different kinds, relaxation techniques, speed changes, 2 hour long foreplay, and (with my family doctor) hypnosis (oh dear god). Remarkably, almost none of this was what Dr. R thought was the best starting point. Instead, I am now: having a daily dose of topical lidocaine overnight, learning pain mindfulness techniques, doing couples therapy exercises, and am supposed to stop the pill soon – and then subsequently to try estrogen suppositories. Oh my goodness! Talk about multi-pronged attack!

I would like to keep posting about the mindfulness training. I feel as though mindfulness training for depression and anxiety and borderline have all been different – cultivating a general awareness, like an alarm system that will help deal with floods before they get bad. Mindfulness for pain seems harder, at least in practice these last couple of weeks. I feel like I am trying to ignore a flaming sword waving around and jabbing me. Although the point is not to ignore the pain – it is to relax in the presence of pain – it still feels like willing oneself to lie on railroad tracks and wait. When I was successful with other forms of mindfulness, it meant a big reduction in the extreme moods and crises. When I’m successful with pain mindfulness at the moment, I feel like nothing is changing.