Sunday, June 16, 2013

Melzack & Katz, Pain. Part 8: Beyond the gate: Self as mayor

The paper, Pain

Part 1 First two sentences Part 2 Pain is personal Also Pain is Personal addendum., Neurotags! Pain is Personal, Always.

Part 3a Pain is more than sensation: Backdrop Part 3b Pain is not receptor stimulation Part 3c: Pain depends on everything ever experienced by an individual

Part 4: Pain is a multidimensional experience across time

Part 5: Pain and purpose

Part 6a: Descartes and his era; Part 6b: History of pain - what’s in “Ref 4”?; Part 6c: History of pain, Ref 4, cont.. : There is no pain matrix, only a neuromatrix; Part 6d: History of Pain: Final takedown Part 6e: Pattern theories in the history of pain Part 6f: Evaluation of pain theories Part 6g: History of Pain, the cautionary tale. Part 6h: Gate Control Theory.

Part 7: Gate control theory has stood the test of time: Patrick David Wall;  Part 7bGate control: "The theory was a leap of faith but it was right!"

I haven't lingered very long at the gate, or with gate control theory, because of how anxious I am to get into the brain. Really, section 7 should be huge, because there is so much information available about what goes on in the dorsal horn. One day I might revisit section 7 and flesh it out more.. but alas, a mental meander has diverted the flow and left section 7 behind, as an oxbow lake


"The original meaning of oxbow is a U-shaped frame forming a collar about an ox's neck and supporting the yoke (14th century). 
"Anything resembling the shape of such a collar is also called an oxbow. In the world of waterways, an oxbow is a bend - especially an extreme, semicircular curve - in a river or stream (18th century)." 

Beyond the Gate
I could not wait to get here. Here. HERE. Here is Melzack, sitting here, patiently waiting for everyone else in the world of pain research to arrive. 

He hasn't been idle - he's stayed very busy, even made his own forays down the spinal cord to do research with Wall about the dorsal horn, but gee, it's hard to go against one's own current, you know? I expect after Wall died he just didn't want to bother going there anymore, at all. He had already been working independently from Wall on his neuromatrix theory, anyway. 

The first sentence in this section: 
"We believe the great challenge ahead of us is to understand brain function."

Yes, I one-hundred-percent agree. To peek over the edge of one's own little life and take a look at the vast amount of research to do with the brain and how it operates, is to be entranced. It's like looking from an airplane down onto a busy city crisscrossed with 8-lane highways carrying large volumes of fast traffic in intricate cloverleafs, but you know that such a view doesn't even begin to account for all the subway trains racing around underground and beneath rivers, foot traffic, bicycle traffic, car traffic, bus traffic, taxis on all the little side streets, or personal interactions happening between shoppers and shopkeepers, bus drivers and passengers, couples strolling in a park, baseball/basketball/football/soccer ball games, babies crying, kids playing, cats prowling beneath bushes, dogs burrowing their way to freedom under fences, birds soaring between buildings, all the activity that really goes on, simultaneously, in each city every day and night all over the planet. 

Each human brain is like a city, itself. And every city needs a mayor. I like to think of the human sense of self as a mayor. It can't begin to fathom, all by itself, the very brain it is embedded within, but it does its best to run the city's affairs. Unlike ordinary real life mayors, however, elected to serve a term, being the mayor of a brain city is a life sentence. 

We, each of us, are our own mayor, dealing with our own city. 

We, as therapists, are mayors consulted by other mayors, who feel their cities or surrounding countryside are malfunctioning somehow. We're supposed to be able to advise other mayors on strategies to manage their cities more optimally. What's the clue? They have pain. And usually, they don't want to have to deal with pain. 

We, as therapists, are sometimes also teachers who try to help other therapists learn efficient ways of providing consultation. My own life has shifted quite a bit over into this other way of being a mayor, of offering service to other mayors, who offer service to other mayors, etc.. 

Pretty simple. We are all mayors who exist to offer help to other mayors, one way or another, no matter what we do in real life, actually: for example, my life as a therapist would not function if there didn't exist another mayor who knew how fix my teeth, or my gall bladder (may it never give me grief and need to be removed from the ecosystem that is my physicality), etc. It wouldn't function very well at all if there wasn't an internet service provider, a car mechanic, an electrical system continuously maintained, plumbing, heating, food import, all the services we all usually take for granted. These are all people out there, with senses of self, "mayors", who interact in specific ways to make their own livings and fill necessary niches in the lives of everyone else. 

And any one of them can develop a painful problem, including myself; I exist as a mayor of my own city, available for consult about such a problem, the same day, or day after, a simple phone call. 


I'll be meandering through this section, and the rest of the paper, probably for the rest of my life, as I scroll down through it and see how long it actually is! But what the heck, there are worse things to do than turn a single paper into a huge long meditation, right? 

Next: the three-ring circus of self. 

1 comment:

Anonymous said...

Hey Diane

Loving the journey - the meanders especially!

Keep 'em coming


Tim Cocks