I read an significant book entitled Pain: The Gift Nobody Wants , which sets out the value of pain in human life. The author of this book is Paul Brand, a doctor, who was born in India in 1914 to missionary parents. He studied in England and worked as a doctor in India among lepers. He was “a pioneer in treating leprosy in India” and “demonstrated that the lack of a sensation of pain was what caused the characteristic deformities of leprosy. Later in the USA he confirmed his findings on diabetes and other illnesses. This important discovery led him to the conclusion that not only should pain not be silenced, but it also constitutes one of the body’s most effective ways of communication.”
One of the chapters in his book is called ‘Pleasure and Pain’, and it records many of his interesting ideas about pleasure and pains as twins.
At the beginning of this chapter he refers to the opinion expressed by Jeremy Bentham, the founder of University College London: “Nature has placed mankind under the governance of two sovereign masters, pain and pleasure. It is for them alone to point out what we ought to do, as well as to determine what we shall do.” Afterwards he notes: “I have critiqued modern society for misunderstanding pain, for muffling it rather than listening to its message. I wonder whether we have also misunderstood pleasure.”
Analysing this subject, Paul Brand writes: “By medical instinct I tend to consider first the body’s point of view when I analyze a sensation. Freud stressed the ‘pleasure principle’ as a prime motivator of human behavior; the anatomist sees that the body gives far more emphasis to pain. Each square inch of skin contains thousands of nerves for pain and cold and heat and touch, but not a single pleasure cell. Nature is not so profligate. Pleasure emerges as a by-product, a mutual effort by many different cells working together in what I call ‘the ecstasy of community’.”
Finally, he emphasises that pleasure and pain are twins, but they differ from one another. They take place within our mind, and are partly dependent on “reports from the sense organs.”
He cites a definition from the Oxford English Dictionary relating to pain and pleasure, according to which pleasure is “induced by the enjoyment or anticipation of what is felt or viewed as good or desirable…the opposite of pain.” He states that for much of his life he would have classified “pleasure as the opposite of pain”, in accordance with the Oxford English Dictionary. Due to his later research, however, he reached the conclusion that the truth about the relationship between pleasure and pain is better expressed by the Renaissance artist Leonardo da Vinci, who saw things differently.
This famous painter actually sketched in his notebooks “a solitary male figure splitting into two, about belly height: two torsos, two bearded heads, and four arms, like Siamese twins joined at the waist. ‘Allegory of Pleasure and Pain,’ he entitled the study, commenting, ‘Pleasure and Pain are represented as twins, as though they were joined together, for there is never the one without the other…They are made with their backs turned to each other because they are contrary the one to the other. They are made growing out of the same trunk because they have one and the same foundation, for the foundation of pleasure is labor with pain, and the foundations of pain are vain and lascivious pleasures.’”
Pleasure and pain, therefore, have the same root and alternate in our life. Paul Brand uses various examples from medical science to illustrate this mutual link between pain and pleasure, including the results of consuming refined sugar, which does not exist in nature and is an industrial product processed in concentrated form, and which opens “a Pandora’s box of medical problems.”
The same can be seen in society, as various forms of enjoyment create problems for the body. This also happens to those who sit “slouched in plush theater seats watching a movie.” These false adventures do not satisfy, although they produce side effects that doctors can observe, such as “sweaty palms, a racing heartbeat, tensed muscles, an adrenaline high.”
This is also evident in the use of narcotics. Paul Brand writes: “Drug abuse shows the logical conclusion of a misdirected sense of pleasure, for illicit drugs grant direct access to the seat of pleasure in the brain. Not surprisingly, the short-term pleasure that comes from such direct access produces long-term misery.” He refers to the opinion of the writer Dan Wakefield, who said:
“I used drugs the way I think most people really do, not primarily and habitually for ‘kicks’ or glamor but for blotting out pain, the pain of that interior or psychic void… The irony is that the very substances – the drugs or alcohol – that one uses to numb the pain in this chemical, artificial way have the real effect of enlarging the very void they are seeking to fill, so that more and more booze and drugs are always needed in the never-ending quest to stuff the hole that is inevitably made larger by the increasing efforts to eliminate it.”
This mutual link between pleasure and pain is familiar to the Fathers of our Church, and is the basis of Orthodox asceticism. We can find this in all the Fathers, but here I shall emphasise in particular the teaching of St Maximus the Confessor, a saint of the seventh century, who played a major role in the issues of his time, but also in every age.
In Various Texts on Theology, the Divine Economy, and Virtue and Vice, St Maximus alludes, among other things, to the mutual link between pleasure and pain. We shall now refer briefly to this, so that we can see that the Fathers of the Church are very modern with regard to this subject, because they touch upon the timeless existential problems of human beings.
St Maximus begins by referring to the fact that, when God created human nature, “He did not make the senses susceptible either to pleasure or to pain; instead, He implanted in it a certain noetic capacity through which human beings could enjoy Him in an inexpressible way.” This is “the natural longing of the nous for God.” However, man did not follow this natural movement of the nous towards God, but the opposite tendency. He transferred this natural movement of the nous towards God to the senses and acquired an initial impulse, namely, “pleasure that acts upon him through the senses in a way that is contrary to nature.” Then God, Who is concerned for our salvation, “implanted pain next to pleasure as a kind of chastising force.” He rooted “the law of death in the body, thus setting limits to the manic longing of the nous, directed, in a manner contrary to nature, towards sensible objects.” 
Thus, “pleasure and pain were not created simultaneously with the flesh. On the contrary, it was the Fall that invented pleasure to corrupt man’s power of choice (freedom), and that also brought upon him, by way of chastisement, the pain that leads to the dissolution of his nature. Thus, because of pleasure, sin became the freely chosen death of the soul; and pain, by means of this dissolution, brought about the disintegration of the flesh.”
This means that, after “meaningless pleasure…a purposive pain, in the form of multiple sufferings, also gained entrance. It is in and from these sufferings that death takes its origin. Such pain drives out unnatural pleasure.” In this way, “the invention of voluntary sufferings (which is asceticism) and the onslaught of those that come unsought (in other words, illness and death) drive out pleasure and allay its impetus,” but without destroying “the capacity for pleasure which resides in human nature like a natural law.” Every “unnatural” pleasure is followed by “natural suffering.”
We see this in the way in which human beings are born, as pleasure comes first and pain follows. “After the Fall, everyone’s birth was naturally preceded by pleasure, and absolutely no one was naturally free from impassioned and pleasurable generation. On the contrary, as if discharging a natural debt, all underwent sufferings and the death that comes from this birth.” “Unjust pleasure and the justly deserved sufferings consequent upon it pitiably brought about man’s disintegration, since his life originates in the corruption that comes from his generation through pleasure and ends in the corruption that comes from death.” . Because Adam “introduced this unjust pleasure-provoked form of generation, he deservedly brought on himself, and on all those born in the flesh from him, the doom of death through suffering.” “After the Fall, human life was generated by means of pleasure-provoked conception and birth through a father’s sperm; and it ended in painful death through corruption.”
Human beings could not free themselves from the link between pleasure and pain, and they suffered greatly. Christ brought about the cure through the way in which He was born as a man, and by His death. Christ accepted “a birth which did not originate in pleasure (without seed and intervention by a human father) to liberate the human race from the birth that came from condemnation.” “In His love He deliberately accepted the painful death which, because of pleasure, terminates human life, so that by suffering unjustly He might abolish the pleasure-provoked and unjust origin by which this life is dominated.” With the incarnation of Christ everything changed, “for, just as Adam’s life of pleasure gave birth to death and corruption, so the Lord’s death on account of Adam, being free from the pleasure that originated in Adam, was the father of eternal life.”
On account of our birth, we are naturally subject to suffering and death, and for that reason, pleasure is linked with pain in our nature. “For the dominion of pleasure and pain clearly applies to what is passible in human nature. And when the natural penalty of pain intensifies, we seek to console ourselves to some extent through pleasure. For in our desire to escape pain we seek refuge in pleasure, and so try to bring relief to our nature, hard pressed as it is by the torment of pain.” The example of a wound makes this clear. The pain of the wound prompts us to scratch it, which brings us pleasure, but the pain increases. The same can be seen in the case of drink and drugs. We drink to soothe the pain, but this new pleasure brings new pain. “Through trying in this way to blunt pain with pleasure, we simply increase our sum of debts, for we cannot enjoy pleasure free from pain and suffering.”
Since Christ’s birth was not associated with pleasure, and He voluntarily took pain upon Himself in order to defeat it, he gave human beings power to be victorious over both pleasure and pain. We see this in the saints who are united with Christ. “The pleasure of generation inherited from Adam is no longer active within them, but only the pain that arose because of Adam, which brings about death in them, not as a debt payable for sin, but according to the economy of salvation, because of their natural condition, for the purpose of destroying sin. For when death is not born of that pleasure whose chastisement is its natural function, it begets eternal life. For just as Adam’s life of pleasure gave birth to death and corruption, so the Lord’s death on account of Adam, being free from the pleasure that originated in Adam, is the father of eternal life.”
It is clear that, since the Fall, human beings move between these two realities, pleasure and pain. Pleasure causes sin and distances them from God, and afterwards come remorse, guilty feelings, and sometimes physical illnesses. Subsequently, in order to escape from pain and suffering, they sample pleasure again, but this new pleasure gives rise new unbearable pain, and in order to deal with this, they are led to new pleasure. This situation continues, creating a vicious circle. Through His incarnation, Christ made it possible for us to be delivered from this vicious circle of pleasure and pain. He assumed a mortal and passible body, without sin or pleasure, in order to cure both pleasure and pain.
The tradition of the Church consists in this transcendence of the mutual link between pleasure and pain. This is not a matter of prohibitions and deprivations, but of setting people free from these Siamese twins. According to the patristic tradition, as expressed by St Maximus the Confessor, purification of the heart overcomes pleasure and pain. There is a passage in which he writes that someone who has liberated his flesh from pleasure and pain has achieved practical virtue; someone who has banished forgetfulness and ignorance from his soul has properly attained natural theoria (vision); and someone who has freed his nous of many impressions, in other words, images and fantasies, has acquired the mystery of theology.
Within the Church it is possible for us, through theology, the Sacraments and asceticism, to break the link between pleasure and pain, to cure pleasure and to bear trials, suffering, illnesses and the fear of death, but also to reach exalted spiritual states that liberate someone from all ties and make him free.
St Maximus, interpreting the Lord’s Prayer, and specifically the petition “And lead us not into temptation”, says that there are two kinds of temptation, one pleasurable and the other painful. The first kind of temptation, which is pleasurable, is the result of our deliberate choice and our freedom. It is voluntary, as we want to enjoy it. The other kind of temptation, which is painful and linked with illnesses and death, is involuntary, as we do not want it, but it comes into our life. Pleasurable temptation gives birth to sin, whereas painful temptation, when we patiently endure it, cures us of sin.
I shall finish where I began, with the title of Paul Brand’s book, Pain: The Gift Nobody Wants. Physical, psychological and existential pain is a gift of God to human beings. It is God’s gift to the fallen state in which we find ourselves. It is associated with the “garments of skin”, which have a twofold function: they are part of our fallen state, but they have been blessed by God, and we can overcome them with His help. Every kind of suffering brings the possibility of rebirth. Just as a woman suffers pain while giving birth, but this leads to the birth of a new life, so every kind of pain leads to a birth, if we are able to make good use of it.
This is how we should interpret the classic phrase from Dostoyevsky “I suffer, therefore I am”, which can be linked with the quotation from St Silouan the Athonite, “I love, therefore I am.” And both can be contrasted with the phrase from Descartes: “I think, therefore I am.” Human existence is not identified absolutely with reason, but is expressed by overcoming pain and experiencing love. Our attitude towards these three sayings indicates the level of culture and lifestyle that prevails in us.
 Dr Paul Brand and Philip Yancey, Ponos, ena doro pou kanenas den thelei, trans. Antonis Papaiannis, University Studio Press, Thessaloniki, 2006; Pain: The Gift Nobody Wants, HarperCollins, Zondervan, New York 1993, (repr. as The Gift of Pain 1997)
 Maximus the Confessor, ‘Pros Thalassion’, Philokalia ton Ieron Niptikon, vol. 2, 6th Century, (33), pub. Perivoli tis Panagias, Thessaloniki 2006, p. 215; cf. ‘Various Texts on Theology, the Divine Economy, and Virtue and Vice’, 4th Century (33) in The Philokalia, vol. 2, trans. G. E. H. Palmer, Philip Sherrard, Kallistos Ware, Faber and Faber, London 1981, p. 243