If it were easy, it would already be done

By Michael Booth

3 min read

Is our mind separate from our body? Do we have mental control over the prognosis of disease? Have you ever been told that rheumatoid arthritis is all in your head?

If you take a philosophy 1010 course in college, you are likely to run into a pretty hip Frenchman named René Descartes. Descartes was a philosopher in the 1600's who had some interesting things to say, and contributed to mathematic and scientific thought. Many consider him the father of Western philosophy. Cogito Ergo Sum is the phrase most commonly associated with him, and most will recognize it as "I think therefore I am." The fancy name for this is Cartesian Dualism, and it is the foundation for the idea that mind and body are separate entities. Descartes' Meditations are wonderful treatises, particularly from a historical perspective, but they are generally used as a gateway to discussion about the role and early method of philosophy, and not taken as logically accurate.

There are some immediate examples of how our minds are not separate from our bodies. Millions of people wake up every morning to wash down a hot beverage containing a stimulant that will increase awareness, mental energy, and focus. Later in the day, millions will drink a beverage containing a depressant that will decrease mental awareness, decision-making capacity, coordination, focus, and so on. Psychiatric drugs can alter all kinds of mental phenomenon, and recreational drugs can too. If our minds and bodies are totally separate, then how does this occur?

Years ago and before I developed rheumatoid arthritis, I crashed on my road bicycle while descending a beautiful and scenic alpine road traveling over fifty miles per hour. I had been racing at the highest level of amateur cycling for years, and such speeds were commonplace, though admittedly very dangerous. The crash was a freak accident. My rear tire exploded just as I was turning into a corner, and I hit the ground in a high-speed slide losing massive patches of skin as friction brought me to a stop. It would be hours before I made it to a hospital.

I had third degree burns, and horrific road rash with dirt and gravel wedged deep in my skin. In the emergency room I was quickly put on an IV and given medication for the pain. When the nurses began scrubbing my wounds, I shouted out in agony, and begged for more painkillers. They stopped at some point, and consulted with the doctor while I trembled. Burns are a pain that defy description. I have never felt anything that comes close though I have broken many bones, punctured my lung, ruptured my spleen, and had numerous surgeries. The E.R. doctor felt I had been given enough pain medication, and that I needed to calm down, and try to get through it.

The nurses continued to scrub and I continued to shout and fight for a while longer. Every brushstroke of the sponge was an excruciating hell. I made it through the scrubbing, and hours later was beginning to thrash, scream, and go mad in total desperation as the searing and relentless pain overwhelmed me. I was eventually taken by ambulance to the burn unit at a University hospital where I would reside for a few nights. When I first arrived, the doctor on the unit walked in, reviewed what I had been taking for pain, and then shook her head. "This won't touch it,” she said, "we will fix that." I thanked the nurses profusely as the syringes entered my IV and I drifted off to a much better place. The next few months of my life would be a weekly nightmare of bandage changes, as patches of newly grown skin would rip off with the gauze. I still shudder thinking about it. After experiencing that kind of agony, I have always been skeptical when people talk about "mind over matter," in reference to overcoming pain. It seems to me far more complicated than that.

We feel pain, exhaustion, fatigue, and malaise for a very good reason: we have an autoimmune disease, and when our bodies become inflamed as the immune system attacks the synovium of the joints, it is experienced as the sensation of pain, stiffness, fatigue, exhaustion, and so on. It is a real objective biochemical process.

Some audacious people giving unsolicited advice have told me that RA is all in my head. This type of "mind over matter" seems a gross oversimplification, and blames people for their suffering. If I could think my way out of rheumatoid arthritis, it would already be done. If there were easy answers, I would already know what they are. If it were a matter of will, the battle would already be won.

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Wren Moderator & Contributor
Hi, Michael! Excellent post! I agree. The pain caused by rheumatoid disease may be "subjective," in that my pain tolerance may be different than yours, and that both of us may have difficulty describing it to an ER doctor who's jaded by seeing patients of all types and levels of honesty day after day, but it *is* still real, physical pain caused by a biological process within the body. To be told that it's something we can simply manage or control with our minds--or that it's "all in your head"--is insulting and, I believe, stunningly cruel. And that's not to say that practicing mindfulness, meditation, and useful techniques such as CBT don't help. It's just that they're not the only answer to pain management. Instead, they're a tool we can use along with others, like diet, exercise, and yes, even narcotic analgesics. Thanks for giving all of us RD and chronic pain patients a vote of confidence. We do know our pain--and if thinking it away worked, we'd no longer be patients at all.
Michael Booth Moderator
Hi Wren, thank you for the compliments on the article. It certainly seems the blurring of subjectivity and that fact the we must report what we feel, can lead some down a slippery slope into cruel statements towards those with chronic pain. I agree on the mindfulness, meditation, and CBT. Of all of them, CBT I personally find most helpful, especially for keeping my stress levels low and depression at bay. As I try to explain to others who are skeptical of CBT, it is really just applying logic and critical thinking to one's own thoughts. I'm a fan of applying that to my mental battles with RA or any other subject. For mind over matter, it is a bit more complicated than I could flush out in this article. Like you have said, there are tools to use along with others. If I could phrase what I think shortly, it would be that mental habits are necessary, but insufficient. Or that our mental control is neither total nor totally absent. I think you hit the nail on the head the way you phrased it. Thank you again for the comments!