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Pain can be described as piercing, drilling, burning, grinding, throbbing, stinging, squeezing, and so on. Each ofthe descriptors implies the presence of a weapon or weapon-like object that can injure the body—the drill that drills, the fire that burns. And since most patients have never been stabbed or shot or are not being stabbed or shot at the moment of pain, they are using these terms figuratively toobjectify what would otherwise be difficult to pin down and represent;now they could see pain and describe how it feels by talking about knives and guns and the damage they can do the body. People with psychological pain use the very same metaphorsto describe their experiences. Dan Vento, silenced for so long by the incapacitating pain of loss, will eventually open up to a psychiatrist. It felt like a bomb, he explained, that exploded insideof him, obliterating everythingin his body. At other times, he feltthe damage was occurring more slowly and methodically, as if there were a swarm of parasites eating away at his organs. But either way, the result wasthe same for Vento: he was being emptied out from the inside—“gutted” was the word he used—until all that was left was a big, raw gaping wound. When her husband died and she was flooded with grief, Joan Didion saw giant waves. In her memoir, she writesthat she felt as if she were being battered by “destructive waves, paroxysms, sudden apprehensions that weaken the knees and blind the eyes and obliterate the dailiness of life” (Didion 2005, pp. 27–28). For Kay Redfield Jamison, a psychiatrist who suffers from manic depression, the weapon is a giant centrifuge, containing tubes of her blood. It spins around her mind faster and faster, out of control, until it explodes, splattering blood everywhere (Jamison 1996, p. 80). Listening to the language of pain of all
kinds, we discover a shared felt structurethat the weapon metaphor effectively captures(Biro 2010, pp. 79–96). Whether triggered by grief and depression or kidney stones and spinal injury, pain reads like a story in three parts: Weapon--> [to] Injury--> [to] WithdrawalIn pain we feel as if there must be some weapon-like object(bomb, swarm of parasites, giant wave, centrifuge) that is moving toward and threatening us; that when it strikes, it will injure, possibly even destroy us; and that we must get away from it orshield ourselves at all costs. Even when there is nothing coming at us, when there is no injury, when we remain motionless, we feel the movement, the injury and the desire to run. Whatever happens that makes us feel these things—the loss of a loved one or the physical destruction of cancer—we experience pain. New Objective Evidence The subjectiveevidence for the existence of emotional pain is compelling, especiallysince there is no objective way to verify and characterize someone else’s pain. Although we can attach a person to a functional magnetic resonance imaging (fMRI) device, observe the blood flow to pain centers in the brain and then infer its presence, the only definitive test is a person’s word: I feel pain or I don’t. Actually, most experts