Demystifying Human Pain: How the Secular World Needs to Address Heartbreak, Depression, and More

Demystifying Human Pain: How the Secular World Needs to Address Heartbreak, Depression, and More April 7, 2019


Let’s begin with a story. I recently submitted a book review for Anne Tambour’s The Road to Neozon, but didn’t have occasion to talk about a line that tugged at me hard in the reading. In “None So Seeing as Those Who’ve Seen”, a conversation between two artists arrives at this exchange (NB: this is from an ARC, so the awkward grammar might since have been fixed):

Kvak slides off his chair onto the floor glittering with fish-scale sequins, blackened with the stuff tracked in on rope-soled sailor’s shoes and hobnailed boots, greased from splashings of the tavern’s rich and smelly soup. He puts his head sideways to eyeball Munch. “Edvard, you turn priests’ hair grey, yet believe them? You think you have a soul?”

Munch picks up his head and straightens his back. His tidy little eyes, the eyes of a technocrat, sharpen to a point, his eyes darkly orbited by such unbearable sadness, they’re Prussian blue. “I feel so much. Why this torture if I have no soul?”

“Why this torture if I have no soul?”

Oof.

The real Edvard Munch was born in 1863, not twenty years after Ernst and Eduard Weber used the brutal practice of vivisection on frogs, as well as cats, dogs, and other small mammals, to note the impact of something called “vagal inhibition” upon the heart. The science of the nervous system had been explored for centuries by this point, but it would take a gradual accumulation of data from the likes of the Weber brothers before our collective understanding of the human body would explode in terms of both theoretical and applied knowledge.

Now, though, I can readily answer the fictional Munch’s question.

This week, after all, I know I gave my vagus nerve a serious workout while anxiously anticipating, then being disappointed by, a conversation with someone I love. This longest nerve in the human autonomic nervous system, called “vagus” after the Latin “vaga”, for “wandering”, has an expansive terrain in the human body, but is perhaps best known for its parasympathetic relationship with the heart, lungs, and digestive tract. Can’t breathe? Heart’s racing? Sweating profusely from anticipation? Have butterflies in your stomach? Feel ready to throw up? Feel like a 16-wheeler is crushing your heart?

Welcome to the mess of parasympathetic responses caused by vagal nerve activation!

Or, you know, all that complicated bodily pain that for centuries we chalked up to the existence of a soul.

De-Mystifying Emotional Pain

I’ve said in recent essays that we humanists need to construct secular narratives not by responding to pre-existing religious narratives, but by starting from the ground up. By going back to human-condition universals, like suffering, and working from there.

Well, what’s more universally human than heartbreak?

How many ballads have been written about bum knees and tooth decay? The difference lies in levels of human understanding of our own anatomy over millennia. Joints, bones, organs, and limbs are simply easier to see as concrete entities, so we haven’t needed to weave intricate tapestries of metaphor and myth to explain as much of their pain (although organs, I grant, have had a much smaller window of human comprehension than the rest).

One very common spiritual argument against atheism is also one I think atheists should be careful not to be tricked by in secular issues as well: just because human beings thought a certain way for thousands of years, generation upon generation, does not inherently make those longstanding beliefs correct.

And so when it comes to physical pain, including physical pain caused by emotion, just because millions of human beings used a different vocabulary with one another–with their children as much as their peers–doesn’t mean we can’t start being frank and technical ourselves with the same.

In fact, we have more of a responsibility to be frank, because our ancestors by and large had good reason not to use a more technical vocabulary: they didn’t have the option. They didn’t know as much as we do now.

The greater ignorance lies with those who have the knowledge, and choose not to use it.

So! Let’s rewrite the narrative.

I’ll start from personal example:

My vagus nerve is an infuriating rotter. Granted, I can attribute to its existence quite a bit of positive emotion–lightness in the heart, pleasure circuitry throughout my body, feeling sated after a good meal. But when I am afraid, when I grieve, when I feel abandoned, these feelings manifest in so tight a grip upon my heart and lungs that even trying to walk it off becomes an agonizing exercise is short, impossible breaths.

On the worst occasions, such chest constrictions affect my sight and hearing, too–and though I am not an expert in this field, the research seems to suggest that these responses occur because an overstimulated nervous-system can inhibit higher neural activity, limiting creativity and decision-making processes in favour of amygdala responses like fear and anxiety. It’s at those moments especially that I have sometimes consider suicide to be a merciful alternative to continuing to live with such pain.

Now, not everyone has such an active nervous system. Indeed, studies seem to suggest that my XX status has some role to play in a higher incidence of consequences from nervous-system response, including “temporary loss of consciousness” due to lack of blood flow to the brain, due to heart constriction, due to extreme vagal response: all of which is otherwise known as “fainting”. Oh! And we XXs might also have a higher incidence of bowel disorders and loss of bladder control, too. Bonus!

Children also have a tough time managing nervous response, which is why it’s less effective to think of a small child as having a “tantrum” or a “meltdown” and more useful to consider them in a state of nervous-system overload–something that they can be taught to manage better in time, but not something that can be stopped all at once, once it’s started. Once they’re in that strained emotional state, what you’re witnessing is literally little human bodies flooded with a variety of parasympathetic responses, and it’s going to take a bit for their biochemistry to settle the heck down again.

But what a great opportunity to test your empathy! When my eldest nephew was seven, for instance, a nervous attack gave him to feel such terrible heart-pain that he told me: “No, you don’t understand, this hurts more than anyone has ever hurt”–which, at seven, is understandable hyperbole. What struck me, though, was that he’d articulated something quite similar to what I believe when that much pain is directly upon me, too. It feels all-encompassing, far outside the range of normal human experience. And so, when he said this to me, my nephew made me realize how insufficient our language is for communicating so intensely personal an experience of pain to others. We are so often trapped in our own pain that we have difficulty imagining the possibility that every human being carries within them the potential to be devastated by similar.

(And oh my yes, a whole other essay will be needed to discuss how this translates to tribalistic assumptions about lesser pain-capacity in other demographics!)

A Life of Its Own

No wonder, then, that we as a species have so often tried to anthropomorphize our pain. To make it signify the existence of an entity within ourselves that is also somehow above and beyond ourselves. Sometimes demons. Sometimes the soul. And before modern medicine, how logical, too, to invoke whatever myths we needed, to develop a shared vocabulary that would allow us to work through our emotional pain. How reasonable, also (since we’ve only made truly staggering strides in medical science in the last few generations), not to expect widespread scientific literacy to follow quickly in the wake of new intel.

Heck, I only really understood the role of the vagus nerve myself a few years ago, and I’m a fairly well-read person in a few key areas. (I also grew up with a copy of Gray’s Anatomy in my household, so I’m sure I came across the basics–just, lacking for context cues to apply what I was reading.) But not only did I have to happen upon this key component of human behaviour on my own, it sure as heck wasn’t covered in any of the trauma recovery services I used in my twenties, or the outpatient clinic where I was treated for three months for a massive suicidal episode, or the day-hospital where I attended more workshops for three months thereafter. Indeed, I have to laugh even to think of human anatomy being discussed at that level in any of those places, because all those programs focussed on language that the staff felt would be most accessible to the widest client base possible–a client base that often included persons with tremendous bodies of addiction, histories of homelessness, extremely low levels of formal education, and of course, often comorbid medical diagnoses.

And yet… I don’t think any of those client profiles is sufficient excuse for the failure of our education system.

So let’s just make a case for doing better in the future, shall we?

Because here’s what we miss in the process:

1.

We miss the ability to fully understand the mechanisms by which our bodies are processing emotional input.

And that’s where superstitions come in. That’s where literary metaphor offers itself up. As mentioned above, historically we’ve had a far easier time understanding (at least the basic fact of) damage to our bones, our joints, and even to some extent all our internal organs. But “emotion” in our most widespread storytelling has consistently been treated as something above and beyond, mysterious and nebulous, even though nervous-system and neuroscience studies make plain as hell that emotion is a series of concrete, predictable, and recreatable bodily responses to both internal and external stimuli.

And so there is no reason that small children as much as adults can’t be educated to recognize emotions like fear, anxiety, and anger as bodily responses that tell us something about the state of our nervous system. It’s no different than our generation’s ability to recognize that sometimes we’re not “angry”–we’re “hangry”–and the moment we have food in our bellies all our higher rationalizations for being angry fade away. Likewise (with small children more than with ourselves sometimes), we’re already quick to identify a lack of sleep as the cause of hyperactivity and increased aggression.

In short, we know we’re physical beings. We just need to grow our everyday vocabulary to include the full range of emotions informed by nervous-system response.

2.

More critically, perhaps, it’s morally imperative that we talk about emotion in this manner more often, because when we don’t, we create a dangerous gap especially in discourse about depression, anxiety, and suicidal ideation. Mental health practitioners, after all, will often make abstract use of the idea that this pain will pass, because “this pain” is just one part of who you are, taking the rest of you hostage. But we all need to be more specific in this regard, because you’re darned skippy it’s just one part of you–the nervous system, acting out so badly it’s damaging the normal functions of surrounding organs!

We can’t get to this argument, though, if we’re still entertaining the idea that heart-pain (and heart-joy) is actually indicative of some deeper, truer, grander version of ourselves. What awful, counterproductive bunk that is. There was one woman in my day-hospital program, for instance, who insisted that her ancestors were speaking to her, soul to soul through the pain in her heart, and calling for her to join them ASAP. The staff member then had a dilly of a time trying to counter these voices without cutting through the “spiritual” component that the program (problematically) argued was necessary to find reasons to live. If she wanted to believe that her heart-pain was her soul crying out for her to join with the other souls in her family tree, mental health practitioners knew it was better to work with the patient’s narrative, rather than dismantle it entirely.

And I don’t disagree, in theory. But there’s no need to directly counter a person’s beliefs here. You simply need recovery workshops that respect the capacity of any patient to learn how their body functions… and in those lessons, teach the basic anatomy and neuroscience involved in the physical manifestation of human response.

Do not mention spirituality.

Do not mock spirituality.

Because doing so only creates a barrier to the patient’s ability to apply new knowledge without having to consciously give up on a core component of personal identity.

Trust the human instead. Trust that when given new vocabulary for pain–without being forced to choose between vocabularies–the human in need will naturalize the use of whichever is most useful for improving their access to genuine pain relief.

3.

Which brings us, again, to the empathetic component of this discourse–because, truly, an education in anatomy and neuroscience cannot be anything but an education in humanism, too. After all, it’s in the gaps of scientific literacy, in the wide remove between everyday observation of fellow human beings and a clear understanding of how the human body responds to its environment, that we as a species have upheld destructive notions of free will and coherent individual agency for centuries. It’s from this misunderstanding of how humans physically function that we have allowed ourselves to propagate narratives of “willfully naughty children” in need of corporal punishment, and addicts who somehow “choose” to remain addicts at every stage in their physical and social degradation. And people who have never known anything but hunger and displacement “choosing” violence, or ongoing traumatic responses. From this disconnect we also get our lack of empathy for people who are suicidal. And for people who have made terrible, societally disruptive decisions from a place of diminished mental capacity.

And I get it. I do. We want so much to believe that we are 100% coherent agents in the cosmos, because it’s a frightening feeling, to recognize instead that our supposedly independent reactions are informed every step of the way by a myriad of factors beyond our immediate control.

But when we deny the science we ensure–for ourselves, as much as for our societies–that there will always be more factors beyond our immediate control than there need be.

Because we have enough understanding of ourselves now to recognize that creating more social stability (by which I mean a clear sense of communal purpose and inclusion, as much as basic food and shelter) improves our capacity to make better decisions.

Is it really such a loss, then, to give up all our abstract stories about the cause of human heartache, of anxiety and fear and grief, when a concrete understanding of human pain provides us with far better tools to limit its presence and extremity in our lives?

A Personal Coda

My vagus nerve caused me a tremendous amount of stress-response for three days, and a whole lot of grief-response for one more… and then, life went on. But not all of a sudden, and not of its own accord. Rather, the bad news from a person I love was tempered a day after its initial receipt, and just like that, my nervous system began to stand down.

So, on the one hand? Hurrah for slightly happier endings!

But on the other hand, again, how frustrating the reminder that, for all the stories we try to tell ourselves, all the ways we try to impose our will upon the universe to receive the outcome we want (or at least to accept the outcome we receive), we remain beings whose internal states are informed–for better and for worse–by external variables.

Now, some folks want to ascribe this struggle for improved scientific literacy to a simple religious-nonreligious divide. To argue, that is, that religion alone teaches people to waste their time coming up with all manner of fanciful excuses for something science already plainly explains as a major cause of human suffering.

But if my personal example has taught me anything, it’s that this problem is far more basic to the human condition. The problem is that many of us–atheist and theist alike–still try to emancipate our “selves” from our bodies through appeals to higher reasoning or perceived external authorities.

And yet… though my vagus nerve is a rotter; though my vagus nerve sometimes holds many other parts of my body hostage… unlike one of my kidneys, or my gallbladder, or my uterus, I can’t live without my vagus nerve.

My vagus nerve is also me.

So either I buck up and have the humility to respect its pain signals the same as I would an injured knee or sprained muscle, or I go about my life in such a way that only compounds that pain–both for myself and for everyone around me.

And what a waste of life that, too, would surely be.

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  • wannabe

    Another thought-provoking article! Thanks!

  • Two things this brings up for me personally: The most encouraging one is how I see one of my sons and his wife deal with our granddaughter when she’s distraught over something, either something that has upset her or maybe a small physical injury that she seems to be overreacting to. The other day, during such an episode, she asked “Daddy, can you help me calm down?” He then in a very kind voice coached her through some breathing exercises. Not something I’d have ever known to do with my kids! Our daughter-in-law has an education degree, and she’s brought a lot of that into parenting.

    The other thing is that it may explain my wife’s increasing number of episodes where she begins seeing spots and then throwing up. Sometimes she thinks that GERD is the problem, and taking a PPI early enough in the process may help. Or maybe she feels like her blood sugar is low, so she’ll eat a little something. But sometimes it’s too late and the vomiting commences. Sometimes there doesn’t seem to be any external negative stimulus, but on several occasions she’s clearly extremely nervous (for known reasons) before it all begins.

    I don’t know that my family have ever attributed these things to anything spiritual. That’s one if the (very) few good things about Churches of Christ.

    As wannabe says, thanks for another thought-provoking article.

  • J Quasar D

    Brilliant!

    Thank you for this article.
    We need new vocabulary for many things, so that we don’t needlessly recycle and reinforce outdated ideas. This is one of the critical ones.

  • This article borders on life-changing. I’m going to try talking to my 4 year old about her vagus nerve & its influence on her.

  • tolpuddle1

    You will never eliminate human angst by blaming it on the vagus nerve.

    Why ? Because the underlying cause of the suffering isn’t the vagus nerve.