Leigh Cowart explores why people consent to experience pain in their upcoming book, Hurts So Good: The Science and Culture of Pain on Purpose. They take the science of pain and correlate it with a variety of intentional experiences from ballet class to eating wildly hot chili peppers, ultramarathons, and yes, BDSM. Cowart is unafraid to expose their own kinks, combining scholarship with intimate reveals and plenty of f-bombs.

Naturally, this isn’t the book for everyone. This is true of every book on the market, by the way. But for me, as a person with tattoos, piercings, and chronic medical pain, it’s a fascinating read. I connect with Cowart’s descriptions of ballet class because I did hot yoga for more than a decade in 110° heat and 60% humidity. Like Cowart, at the end of every class, I had a palpable high that no other exercise quite replicates.

Chronic pain can be isolating. But Cowart explains the science behind why collective experiences of pain bond people together and actually create less pain. Essentially, if I decided to run into the ocean on a Saturday night in January all by myself, the pain would likely be unbearable. But by taking part in a Polar Bear Plunge on a Saturday morning in January with hundreds of other people, as Cowart did, it would hurt considerably less.

And no matter what pain we agree to experience, the benefit is the endorphins our body releases. This neuropeptide, created by our nervous system, is the body’s own opioid. The name endorphin is actually a combination of the word endogenous (created by the body) and morphine (pain-relieving medication). So the payoff of pain on purpose is considerable, given the right circumstances. 

My conclusions

As a massage therapist, I say the phrase “good hurt” multiple times every week. I ask for consent and check in often with clients. I know that the most important part of a good massage is trust and open communication, not the depth of pressure or the specific technique. This all explains what motivates this grandma to read more about how humans have agreed to experience pain for centuries.

Cowart discusses the historical aspects of pain, as well as today’s related choices. For example, hair shirts and flagellation as a part of religious rituals connect pain to a desire for absolution or for religious bliss. The history of masochism and its initial diagnosis by the fledgling world of psychiatry is also interesting social history. The moments of levity that Cowart inserts here and throughout the book create a helpful balance too.

Yes, Cowart covers the science, including peer-reviewed studies and discussions of how our body’s complex system of pain works. There’s physiology and psychiatry, alongside discussions of what constitutes abuse versus consent. 

Blended all throughout is some very personal, vulnerable stuff from Cowart’s own experience. They become part of the book’s case studies, but I never felt they put too much focus on themselves. Still, a book like this cannot be effective without the author having a true connection to the material. And Cowart certainly has that. They delve into descriptions with true heart and emotion, as well as specificity.

Their writing style is sometimes quite casual. At some points, this reads like a blog or sounded like a podcast. Still, Cowart is legitimate in their scientific exploration of the subject. I expect to return to the concepts and revelations often.

If exploring the world of intentional, consensual pain intrigues you, then I recommend this book. 

Pair with Fierce and Delicate: Essays on Dance and Illness by Renee Nicholson for a memoir fully about life post-ballet. Or try Ask Me About My Uterus: A Quest to Make Doctor’s Believe in Women’s Pain by Abby Norman. Both are memoirs about primarily medical pain, but the correlation is logical.


Many thanks to NetGalley, Perseus Books / PublicAffairs, and the author for a digital advanced reader’s copy in exchange for this honest review.