Chronic Pain is Psychedelic

Enforced Presentism & Illness

( image by Ramon Gonzalez Teja, ca 1980)

“Enforced presentism is a term coined by anthropologist Jane Guyer during the pandemic to discuss the experience of being dislocated from linear time, yet stuck in the present moment without recourse to imagine a future or romanticize the past. Events that disrupt our sense of justice, fairness, and hope rupture us from time. While many people identified with this type of rupture for the first time during the uncertainty of quarantine, those with chronic pain and incurable conditions were already intimate with this flavor of agonizing temporality.

In moments of extreme pain, physical or psychological, we become stitched to the present moment. It becomes impossible not to be radically present. We can no longer count on a future. And our bright-minded, able-bodied pasts don’t feel like they belong to us anymore. Often the pain is so intense that there is no escape in any direction.” – Sophie Strand excerpted from The Body is A Doorway: A Journey Beyond Healing, Hope, and the Human forthcoming from Running Press Winter 2025.

Often these days when I hear someone proselytizing the ego-destroying effects of plant medicine/ psychedelics/ meditation, I give a weary sigh.

More and more I want to offer that most people don’t get the privilege of ordering their initiation off the menu. And many people don’t survive their initiation. Many people don’t have to pay hundreds of dollars to go on a boutique silent meditation retreat. Mindfulness isn’t some sterile, packaged experience of transcendence, or Costa Rican “shamanic plant ceremony”.

Those with chronic pain or illness, those with psychological anguish and PTSD, experience ego-destroying trips every day when they lie on the floor next to the toilet and try to pass through the needle’s eye of unbearable pain. When they decide to stay alive for just one more minute.

I think chronic pain (psychological and physical) stitches us to the white-hot present moment in a way that radically exceeds our ideas of good or bad medicine. There is no boat to bring you through the dark ocean of your anguished body…but your body itself. Storm and vessel are the same. Present and future drop away from that agonizing 1/8^th of a second that is the human instant. Over many years of experiencing a spectrum of symptoms and physical break downs, I’ve come to believe that pain- even very intense pain - is manageable if you know it will end. But for those with incurable or terminal conditions, you don’t know if it will end. Instead, chronic pain becomes the uncanny syntax of a new grammar. One without nouns or pronouns. One without selves. It’s a language of verb, verb, verb. Now, now, now. You can only bear it one moment at a time. To project forward into a future of uncertainty is impossible.

I’ve done plenty of meditation and I’ve experimented with psychedelics. I do think they are helpful tools. Absolutely. But I have never come close to the sheer drop-off, the cliff dive, of extended physical (and mental) illness with them. My greatest mindfulness teacher is not a human being or sacred text or therapeutic model. It has been my own nausea, the tides of which have repeatedly washed away any contours of a self I thought were stable. My greatest psychedelic trips have happened totally sober, stitched by the needle of my own ailing body into the present moment again and again without recourse to memory or fantasy.

I want to offer that we do not all need to order our trauma, our psychedelic initiation, our “medicine” or mindfulness, off a bespoke menu. Many of us are doing the work with our glitchy bodies and immune systems. To live in a body right now in a world deranged by genocidal technostates, is psychedelic. To survive, moment to moment, in a sea of chronic pain, is a feral and hard meditation practice I wouldn’t willingly wish on anyone.

I love you all. I love you who take the trips you don’t want to go on. The trips that don’t come in a cup or pill or a fancy retreat setting. The seasick-endless trips that take place in our own bodies.

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I am overwhelmed with gratitude by how many of you have showed up here to support my work and widen my thinking. Right now you are literally keeping me alive and funding the out-of-pocket medical expenses that allow me to receive IV nutrition and connective tissue specialists.

I am grateful in a way that is wide and deep and low. I hope you can feel some sonorous note of it - the hum and grind of ice relaxing under the sun - in your body. I am sending the song of my thanks your way. I love you all so much.