Pain Is a Very Clear Teacher

I have rheumatoid arthritis and have lived with it for several years now. So far, I’ve been lucky. The disease has shown up in my shoulders, my back, and my ankle, but with treatment I’ve been able to keep going.

When I was first referred to a specialist, she was skeptical. Rheumatoid arthritis, she told me, doesn’t usually manifest in the shoulders. Tests showed that, in my case, it did. Treatment followed, and the pain in my shoulders eased. Then the disease shifted to my back. More medication helped. Now it has settled into my ankle, and I’m waiting for surgery.

In the meantime, I still get around, just more slowly, and with a noticeable limp.

My wife jokes that I have my own pharmacy. I laugh and agree. The truth is those medications allow me to function. Physical pain is something we can name, measure, and explain. It shows up on scans and blood tests. It has protocols and prescriptions. Other people understand it without much explanation.

And because it’s so clear, we tend to respect it.

Emotional pain is different.

My father was killed in an accident more than fifty years ago. My mother died over forty years ago. I still feel the pain of those losses. I see how my wife continues to carry the loss of her mother. I see my daughters living with the grief of losing their best friend. Emotional pain doesn’t fade with time; it changes shape, but it stays.

My adopted daughter lost her sister a few months ago. On the day before her birthday, we were talking about her sister, and she suddenly broke down in tears. She apologized, instinctively, as though grief needed permission. But there was nothing to apologize for. The loss of a family member never truly leaves.

Unlike physical pain, emotional pain is harder to locate. It doesn’t limp. It doesn’t show up on an X-ray. People understand it in theory, but often struggle to express it; or to recognize when it has crossed from sadness into strain.

Cognitive pain may be harder still.

We are starting a program for caregivers of people living with dementia because there are so few resources to help them manage the constant mental and emotional load they carry. The vigilance. The worry. The grief that arrives long before loss. This kind of strain is exhausting, yet largely invisible. And because it doesn’t announce itself the way joint pain does, it is often ignored, by others and by the caregivers themselves.

Physical pain teaches us clearly. It draws a line we can’t cross without consequence. Emotional and cognitive pain whisper instead. They ask for attention long before they demand it.

Self-regulation, then, isn’t just about responding to what hurts most loudly. It’s about learning to hear the quieter signals before they overwhelm us. Wisdom lies not in enduring everything, but in knowing when something needs care, support, or rest; even when there’s no limp to point to.

If physical pain is a teacher, emotional and cognitive pain are subtler instructors. The lesson is the same, though harder to learn, ignoring discomfort doesn’t make us stronger. It only delays the moment when listening becomes unavoidable.