It Is Opinion

“It is according to opinion that we suffer.” – Lucius Annaeus Seneca, 4 BC – 65 AD.

The common – and outdated – view of pain and fatigue is through what is called a “Cartesian” model.

This centuries-old model views the mind and body as separate entities, and sees pain as a direct, linear process. Somewhat like an electrical switch sending a signal down a wire to illuminate a light bulb.

Likewise, this view of fatigue sees it as another direct process, sort of like a gas gauge telling you how much fuel you’ve got left in the tank.

The problem here is that this way of looking at pain and fatigue is misleading and inaccurate. It fails to account for the complexity and adaptability of our minds and bodies, and the fact that it’s nearly impossible to define where one begins and the other ends.

 

Biopsychosocial Pain and the Central Governor

The modern medical establishment now views pain through what is called the biopsychosocial pain model and fatigue through the central governor model.

Put very simply, these theories view pain and fatigue as complex, predictive emotions involving a constant interaction between the mind and body. They’re not just about what’s happening in the present moment, but what your brain predicts could or will happen in the future.

What’s happening in your mind can alter your feelings of fatigue, and these feelings have direct physical impacts on things like stress hormones and power output.

As an example, think of the endspurt phenomenon, in which athletes have a surge of power during the last 10% or so of an event that returns them to almost the same level of performance that they had at the beginning of their race.

They’ve been exhausting themselves at maximal effort for the entire event, have been feeling more and more fatigued, yet once they know that they’re almost done their brains do a calculation that predicts how much more effort they can expend without damage by the end of the event. Suddenly the brakes are taken off. This is how marathon runners finish the last few hundred yards of their races at a sprint.

Pain is another predictive emotion that only very loosely correlates with tissue damage. It’s more a matter of attention and opinion than a direct connection to trauma or danger. For example, many people with chronic back pain have no observable damage in their spines when viewed through an MRI, while many people with no chronic pain can have things like bulging spinal discs, stress fractures or other damage that is visible on MRI’s.

For a great explanation of how this works, check out this TED talk from the pain researcher Lorimer Moseley.

 

Pain and fatigue are fluid strategies, not gauges on a dashboard

Thus, pain and fatigue are largely an emotional response created by the strategies your mind uses to get through them. Your beliefs about the perceived difficulty of something color how you feel during an activity.

Fortunately, your perceptions of pain and fatigue can be trained and controlled in much the same way that your strength can be developed in the weight room. This is not to say that you can become invincible, but you can train in a way that alters your perceptions, much like how a heavy deadlift no longer feels heavy after a few months of strength work.

 

Example: Step-ups for 15 minutes vs. hiking a 14,000 foot mountain

Imagine throwing on a weight vest and doing non-stop step-ups in the gym for 15 minutes.

Then imagine throwing on a backpack and hiking a 14er on a sunny day.

The hike may take 4 hours or more and involves almost the same physical action, but the step-ups will be far less enjoyable. That 15 minutes of step-ups will drag on seemingly forever, and you’ll notice every bit of fatigue, boredom and achiness that your brain parcels out.

Meanwhile, you’ll finish a 4-hour hike feeling great, and as if time had flown by. Minutes blended into hours, and you only noticed the sunshine on your face and the awe-inspiring views.

The only difference in the outcome – in how you feel – is in the perception of the event. What’s happening in your mind drives what’s happening in your body, which feeds right back into how you feel.

When you’re at the gym you’re there for a set period of time, it’s supposed to be hard (or so you think), you’re going nowhere, you have nothing pretty to look at, it’s easy to focus on how hard something is or how much it sucks, and the list goes on.

When you’re climbing a 14er you’re doing it for the sake of the activity (you enjoy it), so you don’t focus on how long it’s taking or how fast you’re going, or how much it sucks, or anything else other than the task at hand. By changing your environment you’ve changed your expectations of the activity and thus how hard it’s perceived to be.

 

Hurting vs. Suffering

Let’s take a closer look at two different types of pain and fatigue: Hurting and suffering.

 

Hurting: Short term discomfort

I’m pretty good at enduring “pain” or things that “hurt.”

I’ve had a bunch of surgeries, broken a lot of bones, torn my share of ligaments and played sports that required the ability to live with pain on a daily basis.

I’m also one of those people who generally enjoys crushing himself with workouts and adventure sports.

I’ve been developing the skill of “hurting” for over 20 years. For me, it’s pretty familiar territory. In some way, you could call it my comfort zone.

 

 

This is an example of a gym workout meant to test your ability to hurt.

It’s short, but it really, really sucks. It took at least an hour to feel ok after this, and the smoker’s hack lasted for much of the day.

Question: How do you do with very short but extremely high intensity activities? How hard can you really push your body during them?

 

Suffering: Long term discomfort

Suffering, on the other hand, is long-term discomfort. Not acute, my-soul-is-being-crushed anguish, but the particular brand of struggle that comes from slogging your way through deep snow to the top of a mountain, only to realize that you’ve just crested a small ridge and the summit is still hours away.

It’s when the light at the end of the tunnel turns out to be a train.

When what you’re doing really sucks, and the only way to make it stop is to keep going and finish it.

Suffering, for me, is a relatively new skill that I’ve been working on for the past eight years. That’s right, eight years. And I’m still learning, a lot.

 

Here’s an example:

Last year I skied a couloir with a few friends. We started from the trailhead at 6:30 a.m. and planned to be at the top within about 3 hours.

Six hours and about six miles later, we still hadn’t made the top and were at the bottom of a 2,000 foot, 45+ degree couloir. Looking up at the ground still to be covered, I was totally beat; mentally and physically.

 

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The hike in to this point was demoralizing. We zig-zagged all over looking for a path that would provide respite from the constant need to remove our skis and crawl over deadfall in snow up to our waist for 50 feet, put the skis back on, skin for 100 feet and repeat. For 6 hours.

One of the skiers I was with was a cyclist. He had an extraordinary ability to suffer. He was certainly more fit than me, but that’s not what impressed me. His ability to suffer through the seemingly never-ending slog on the flats to the base of the climb was humbling.

Once we reached the bottom of the couloir, he strapped on crampons and led the boot pack up the entire face. It was as if he never got tired. He never complained; he just endlessly put one foot in front of the other until he reached the top.

Just.

Keep.

Going.

It wasn’t until we got back to the car another 5 hours later that I learned how badly he was struggling the entire time – he just never showed it. His suffering stayed beneath the surface, in the background. No big deal.

I followed behind him that entire day, cursing under my breath and waging an internal war not to quit the entire time.

I lost all ability to control my internal dialogue. Negative thoughts and feelings flowed without restraint, and time slowed down as I held a private bitch-fest in my head. I searched for reasons to turn around and call it a day.

My friend’s persistence won out. I stayed in his tracks and finished.

We both made it to the top that day, but he led (without complaint) and I followed (miserably).

I learned more that day by observing from the back than I did the entire ski season by leading in other groups.

What I learned: your weakest moment is typically your greatest opportunity to learn -if you’re willing.

As Marcus Aurelius put it in Meditations: “Does what’s happened keep you from acting with justice, generosity, self-control, sanity, prudence, honesty, humility, straightforwardness, and all other qualities that allow a person’s nature to fulfill itself? So remember this principle when something threatens to cause you pain: the thing itself was no misfortune at all; to endure it and prevail is great good fortune.”

Question: How do you do with long, grinding physical (or mental or emotional) activities?

 

 

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It’s all data

Pain and fatigue are information, nothing more. Sometimes that information should be used to change form, stop, or treat something. When it relates to fatigue, it can typically be ignored.

  • When to ignore pain: When it relates to fatigue and continuing only results in pain that doesn’t cause long-term harm.
  • When not to ignore it: When there is an obvious issue that can to be resolved with immediate attention or you’re causing permanent or serious physical harm.

Ask yourself in these moments: Is what I’m feeling the result of real physical damage? Will this kill me or cause long-term harm? How much of this is opinion?

 

Wrap up

Fatigue and pain are constructs of the brain meant to protect us. Like any information or emotions, they can be used to our benefit or to our detriment.

Spending some time thinking about whether the pain or fatigue you’re feeling is real or an opinion created by your brain will do more for you than any workout or experience.

Consider that in moments of hurt or suffering you can have racing thoughts about the pain you’re feeling, about wanting it to end, or just bitching in general.

And you can also stand back and observe these thoughts flowing forth.

It’s in this dichotomy, in knowing that one part of our mind can produce a reactive stream of thought while another part of our mind can observe and evaluate those thoughts, that we have power and the potential for control over ourselves.

At Ethos, we call this mindfulness.

Mindfulness is a means of assessing the strategies that we all use to get through life.

Feedback from this mindfulness is not positive in nature, and it’s not negative. It’s just data. Neutral, objective data used to make adjustments to psychological strategies.

I’m not worthless because I’m weaker than other people when we’re suffering, and I’m not awesome because I’m capable of hurting more than many of my peers.

The relative comparisons in themselves are meaningless. There will always be someone stronger or weaker, faster or slower. They just provide data that I can use to orient myself and continue developing as a person.

Mindfulness isn’t just meditating or thinking about how you feel. When utilized within the right context, it can be a powerful process for developing psychological skills that are useful in every arena of life.

 

by Jonathan Pope