These bits jump out at me:
other-guy: My doctor was giving me an infusion to treat my rheumatoid arthritis, and I had a terrible reaction to it. Put my whole body in the worst pain ever and affected my muscles. I had a hard time moving my arms, and my legs became really weak, so it's really hard for me to walk now. I can use my arms better, but sometimes it's like my mind won't connect with them. Lost about 20lbs of muscle in almost two weeks. Couldn't work because of it, so that's why I'm broke, and I just keep going to physical therapy to try and get better. It's been a long battle.
...
Jimmy: What's the pain issue, exactly? What happens if you don't take the pain meds?
OCT 13
other-guy: ... If I don't take them, then pain from the Parsonage-Turner syndrome it caused gets a lot worse. It's basically a pain in my chest, almost armpit area, and down my arm into my hand that feels like road rash or like I burnt my whole arm. Pain from drug-induced neuropathy gets worse—it’s like pins and needles everywhere but way worse than when your foot falls asleep—and mostly a deep muscle pain becomes terrible in my legs and arms. It's like when you're working out and trying to get one more rep in, but the muscle hurts so bad like it's gonna tear or pop....
other-guy: ...It's hard to trust anything they say these days. The Dr. that told me to get the infusions literally dropped me as a patient after it happened. Prescribed something, told her it's not working, and she said, "Well, it should be." I told her it's not, I need something else, and she dropped me, said I was too difficult, and canceled my appointments with her.
This seems, to me, like horrifically irresponsible behavior by the doctor, in violation of intellectually coherent standards of "informed consent". Before the treatment there should have been a list of possible consequences like "5% of Parsonage-Turner syndrome" and if there wasn't, then I think the Doctor should lose her medical license.
That's what jumps out to me, reading this for the first time just now, before reading the next installment.
I have no thoughts in particular on the assigned homework, but I'm looking forward to reading the second half.
In the last post I took the seemingly-naive stance that "pain is just information" and "can't actually be a problem", implying that painful situations can be dealt with without suffering by just looking through the pain towards the reality at which it points. I did give an example of how this allowed me to quickly resolve an episode of pain-induced-suffering when others couldn't, but that one is admittedly a bit of an outlier and most cases aren't so simple. Today, we're going to start looking at a case that isn't so simple.
I was talking to someone through private messages on a forum for a shared hobby, and his chronic pain issue came up. Rather than acute pain from a burned hand, this was incessant pain from a medical procedure gone wrong a year prior. This procedure resulted in nerve damage, and therefore pain that feels "like every kind of pain all at the same time". The pain was so intense in the first day that the nurse was crying from seeing how much he hurt. They ended up prescribing him so much pain killers that his teeth literally started falling apart. Even still, that amount of pain drugs was only enough "for a little bit until [his] body got used to it".
The question, is why he didn't just respond to the pain by saying "Oh wow, something is wrong. Okay. What's wrong?" -- and then, once he figured out the answer to that, pivoting to "Ooh, neat sensations that don't mean much of anything. Anyway..."
The obvious but mostly worthless answer is "Because it hurts!". It's easy to empathize because we've all been there, but until we learn to square that experience with the reality that we don't have to suffer just because of pain, we're not going to be able to help people reconnect to reality -- and might be those people unwittingly gas-lighting others into suffering unnecessarily.
So what exactly is stopping him (and ourselves, when we feel similarly) from simply facing reality? Where does this desire for pain killers come from, given that they aren't exactly healing his body? Why is he suffering, rather than simply mourning loss?
What do we have to say, and how do we have to say it, such that we can navigate from here to where he can and does simply face reality? Until we can use our understandings to navigate successfully, they're not worth much. So how do we do that?
Like the last challenge, we know that it's a solvable problem because it was in fact solved. At least, partly. He described the change as "a huge improvement" and "Light-years ahead of where I was". His pain killer use dropped overnight from "norco+crazy strong stuff 3x/day" to "norco and the crazy strong stuff at most once a day". I didn't get a complete resolution here, but that has a lot to do with the fact that he lost motivation to work further on reducing his suffering, and instead started doing things that made the pain worse -- but the reality better, in expectation.
First, I'll share the beginnings of the transcript, then give some more hints about what to look for and where to look. The neat thing about this one is that because the entire intervention is in text, I can share essentially all of it and there's no hidden body language working behind the scenes.
The following transcript has been lightly edited for obvious typos and had some parts snipped/redacted for anonymity/privacy, as well as pulling out the interspersed unrelated conversation about our shared hobby. Nothing has been reworded or summarized, and what is left represents and essentially complete and raw depiction of the whole thing.
Okay, so how do we go about this?
The insight that suffering is distinct from pain is important, but what happens if you just tell him "Suffering is distinct from pain"? What if you tell him "You need to accept the pain, then you will no longer suffer!"?
I think it's pretty clear to everyone that "accept the pain" is easier said than done, and that "intellectually knowing"[1] that suffering is eliminated by acceptance is not in general sufficient.
It's insufficient because it presupposes that he should stop suffering. What if we don't presuppose that he should, and instead, notice why he isn't -- despite having a brain which seems capable of processing information and making decisions. What might happen if he did "just" accept the pain? What about from his perspective? Might he know something we don't?
He actually tells us why[2] he can't accept it. Did you catch it?
If it was just from him doing something stupid, then he could accept it. It wasn't, therefore...
Accepting that he could do "everything right" and still end up whacked like that is a terrifying thought. There is no safe defense, not even science. Until he learns this -- which is not at all obvious, hence the need for the post -- then going on with his life like "Oh well, shit happens, nothing to see here!" would be missing something very important -- and setting himself up for being blindsided again. It seems pretty reasonable to want to avoid that.
It doesn't seem like much, and it wasn't much, but putting to words this "worst part" and validating the idea that "Yeah, that does suck, and it's actually not your fault, and here's what you can do to try to deal with this newfound aspect of reality", is actually active ingredient here. We're confirming "No, you're not missing anything, yes, this really is how it is, and here's how to get started orienting to it" -- and once he knows that, he no longer has that reason to postpone accepting the situation for what it is. By negating that reason, we've already taken a big chunk out of the problem by the time he's finished explaining what the problem is.[3]
He says a few other things in this section of the transcript which give clues to where he's coming from and why this might be a tricky situation for him to navigate. Don't worry if you can't articulate exactly what these things tells us, just pay attention to the sense you get when reading over the transcript. Where would you have to be coming from in order to say these things. Do you notice a few lines jumping out as "important", in some way?
There are multiple things going on here and it's not realistic to expect to see them all in advance (I didn't), let alone plan a step by step intervention, so don't worry about getting everything. What can you see? What might be there? Or if you don't think you see what the answers are, what questions might you ask, in order to figure out what is happening?
Next week, I'll share the rest of the transcript, along with annotations showing where I was coming from and how I chose what to say when.
What we refer to as "intellectually knowing" differs from what we call "alieving" in meta level.
When you're afraid of ghosts and "believe ghosts aren't real", you might say that you "intellectually know" that ghost aren't real which is to say that you think the belief that "Ghosts are real" is false -- and perhaps silly.
When you say you "alieve" in ghosts, that's another way of saying that you sure act like you believe ghosts are real -- and dangerous -- but you don't want to say that you believe ghosts are real and dangerous, because that would be stupid. And I mean... we can't believe anything stupid, right? That would make us stupid!
We don't actually need two different terms once we recognize that 1) sometimes we actually believe stupid things, and that 2) "intellectually knowing" a thing refers to a belief about what beliefs are true -- and that this is distinct from believing the thing.
Later in this sequence we'll go through an example of how keeping track of this meta level distinction and noticing when we're believing seemingly stupid things can resolve "irrational" fears.
Well, one of the reasons why.
The rest of this conversation takes longer in significant part because I wasn't able to immediately intuit what the other big block was.