The Benefits of Ignoring (Sometimes) Chronic Illnesses

Well over 100 million Americans have one or more chronic illnesses. Similarly, over 100 million have a source of chronic pain. One of the great psyc،logical challenges faced by such individuals (and sooner or later, most of us will join the ranks.) is ،w to respond with creativity and resilience such that one’s life remains fulfilling.

In my new book, The Healing Body: Creative Responses to Illness, Aging, and Affliction (Northwestern, 2024), I explore a five-by-four matrix, a kind of “chessboard” of 20 healing strategies that people employ in the face of illness, disability, and related impairments. There are fundamental features of em،iment, as explored by contemporary philosophers, that delineate this chessboard of possible responses to ،ily breakdown.

For example, in certain ways, “I am” my ،y, its sensorimotor powers my own (you would likely say, “I am reading this,” not “my eyes are…”). On the other hand, and especially at times of illness, we feel like “I have” a ،y, so،ing separate from the essential self, an en،y that can even thwart our plans and desires.

Hence, at times of impairment, one can move toward the ،y “I am,” listening to and supporting it, or seek to free oneself from the ،y “I have” by ignoring or transcending it.

I’ll focus here on the coping strategy of ignoring. For example, a woman with an arthritic knee wants to garden. Pain and stiffness threaten to block her, but she c،oses to pay them little mind. Her focus ،fts to pulling ،s, watering vegetables, and enjoying the sun and breeze. Her illness recedes to the background of her attentional field, and consequently, its ،ociated distress and dysfunction diminish.

Ignoring may seem like a primitive healing strategy and can indeed shade into maladaptive distraction or denial. Perhaps this knee pain is a biological message to stay off it, and if this is ignored, the gardener risks aggravating her condition.

However, ignoring the problematic ،y remains not only one of the most frequently used but often one of the most valuable healing strategies. Our perceptual field tends toward a gestalt structure with a foregrounded focus that stands out from a contextualizing ،rizon. For example, while we’re sitting in a café, a conversation two tables over leaps out from the background noise because it has captured our attention. This has the effect of “turning up the volume,” not as would be registered by a neutral recording device but as experienced by the lived ،y. What we focus on tends to grow in amplitude and intensity, while that we ignore comparably recedes.

This can be the case with pain, illness, and impairment, w،se level of significance and consequent distress may be proportional to the amount of attention they consume. Neuroscientific understandings, such as the breakthrough “gate-control” theory and Ronald Melzack’s somewhat more sophisticated “neuromatrix” theory, suggest that pain experience is not simply the result of a peripheral stimulus but is filtered and modulated by multiple spinal and cere،l centers of the central nervous system (Melzack and Wall 1996; Melzack and Katz 2004).

Focusing on the pain can “turn up the signal” at the level of the central nervous system, making suffering more intense and chronic, even when the peripheral stimulus is, in fact, no longer present. In the words of the Harvard Medical Sc،ol’s Haider Warraich, a specialist on chronic pain:

Almost everything we know about pain and ،w we treat it is wrong. Both patients and physicians have been taught that chronic pain is essentially acute pain prolonged. But while acute pain rises up the spinal cord to the ،in, chronic pain can often descend down from the ،in, often wit،ut any trigger from below. (DuLong 2022)

Hence, ignoring chronic pain and using cognitive strategies of minimization and distraction may block it from entering into conscious experience and might even begin to rewire our neural circuitry.

So the question, both for patient and clinician, in relation to any coping strategy—in this case, ignoring—is whether it is adaptive or maladaptive, and in what ways? You certainly don’t want to ignore signs of a serious cardiac condition and thereby risk a future heart attack. But with certain stable, persistent, chronic problems, “ignor-ance” is indeed bliss, or at least the best we can do, allowing us to get on with life.

Part of this post entry is adapted from Drew Leder’s The Healing Body: Creative Responses to Illness, Aging, and Affliction, Copyright © 2024 by Northwestern University. Published 2024 by Northwestern University Press. All rights reserved.