I’ve had chronic pain since October 2008. That’s a hell of a lot of days in pain! I’ve learnt a lot since my condition began on how to manage pain psychologically and I want to share what I have learnt this with you in case it helps you cope with your pain a little better!! Chronic pain often has great psychological and emotional effects on a person. In fact, living with constant pain can lead to such problems as depression, anxiety and helplessness, all of which can exacerbate pain and disability. But there are things that can help people deal with the pain and disability and can enhance quality of life for those affected.
I am not ashamed to say that I’ve seen a pain psychologist to help me manage my condition. Prior to this I was very angry, distressed and fearful of the future. I was also in denial that my condition was chronic and didn’t want to accept any help to manage it. I believed learning to manage it would mean giving in to it, and accepting that I had a long term condition. I didn’t believe I did even though I’d been in pain for years. Me and my Mum were still searching for answers to my mystery illness, and I thought we’d eventually find those and someone to fix me. It was incredibly emotionally exhausteing going to see specialist after specialist, so many different ‘ologists,’ and consultants and having so many tests, from standing MRI’s, to lumbar punctures and pars blocks, I had it all! After a while it all became too much, I didn’t want anymore false hope, let downs and doctors telling me I was a ‘rare and puzzling case’ that they couldn’t solve, I was ready to stop all of the investigations and learn to manage the pain. And it was around Febuary 2013 that I finally went to see a pain consultant and pain psychologist to help me with this. Best decision I ever made!
At first I really didn’t warm to the psychologist. She came across slightly patronising, as a lot of them do, and in the first session she was preaching to me about how amazing such psychological theories as Cognitive Behavioural therapy, Mindfulness etc were, which at that point I thought were a load of ‘mumbo jumbo’. I just wanted someone to talk to about all of my issues surrounding my chronic pain that I couldn’t talk to anyone else about. We quickly came to a compromise though which worked wonderfully – each week when I saw her, I’d tell her the things I had been worrying about or things that had happened to do with my chronic pain that week, and she’d help me deal with those using some psychological theories but also by giving advice and listening. It worked brilliantly and I really came round to mindfulness! Below are some of the techniques I’ve learnt to use when I’m feeling emotional, stressed, anxious etc…
1. Find evidence for an against negative thoughts about the pain
Living with a chronic illness is tough emotionally as well as physically. You are often faced with unhelpful thoughts such as, “this flare up will never settle down,” “this is all my fault”, “I’m not coping very well”, “My future won’t be as I’d hoped” etc. When these thoughts pop up, recognise that you are jumping to conclusions and perhaps catastrophising things. Then find evidence for and against the negative thought. So, for example, evidence for “this flare up will never go” would be; its lasted longer than my normal flare ups, it’s a really bad flare up – the worst in a long time, there is no sign of the pain lessening and its a condition that is unpredictable. And evidence against would be, that you don’t know how long it will last – its an unpredictable condition therefore equally the flare up could go soon, to date the flare ups have always settled down and i am following pacing advice but also stepping back so I am being sensible. Challenging unhelpful thoughts by finding evidence for and against the thoughts, can help you to remain calm and positive, stay relaxed, help you feel better about yourself and put you in control rather than the pain. I find this technique so useful when having a bad day emotionally, it really helps me see that sometimes my thoughts are not helpful and aren’t 100% true! They are only thoughts after all, not facts!
2. Defusion (a mindfulness technique)
Defusion is about letting difficult thoughts and feelings freely flow through you, without getting caught up in them or pushed around by them, and without getting into a struggle with them. This technique can effectively help you to reduce the impact and influence of painful feelings, let go of distressing or unhelpful thought and break the grip of self-defeating habits. So, when having negative and stressful thoughts, think to yourself “this is just another pain thought,” and let it pass by. Count your thoughts, sing them, thank your mind sarcastically for bringing more thoughts into your mind. Basically make light of the thoughts and they will soon pass.
3. Turn negative thoughts around
Turn an unhelpful negative thought into a positive one e.g. “I hate chronic pain” to “I like chronic pain”. I always used to curse my condition, but dwelling on it was making me feel depressed, frustrated and isolated. So, I’d turn it around and and find reasons why having chronic pain has changed my life for the better, e.g. It has changed my perspective on life – I am now grateful for every small thing I am able to do and achieve, it’s brought me and Paddy closer than ever as we’ve come through so many difficult times together, it’s also allowed me to rekindle my love for art and craft which I had pretty much given up beforehand as I didn’t have the time, and it’s meant I live a healthier lifestyle-my diet before was pretty poor, but I now only put foods in my body that are natural and useful to my body!
In this context, acceptance is generally viewed as “a willingness to experience continuing pain without needing to reduce, avoid, or otherwise change it.” My consultant really helped me to finally accept that I was likely to have chronic pain for the rest of my life, not matter how much more searching I did for answers, or what treatments I tried to reduce it. I learnt that accepting it, doesn’t mean I am giving into it. No one chooses to have chronic pain. Having to accept physical limitations is not easy to do. It is difficult to accept your body is not functioning as it should. Despite the frustrations and grieving for the old self, I learnt to lead a new, although different life with persistent pain.
5. Rest and distraction
For me, when I’m in horrendous pain, there is nothing better than distraction. I know it’s very difficult to be fully distracted when the pain signals are so strong but even being slightly occupied by something else can help give you a lift and get you through difficult times. Activities that you can get really absorbed in are the best, for example, art, crafts, a good book, talking to a good friend etc. For me drawing was the ultimate distraction – see my post on how Art Therapy really helped me. Unfortunately since my new symptoms started in January this year, I am now unable to draw due to problems with concentration and brain fog but I plan to go back to it one day as it helped me so much!
Rest is also incredibly important and you mustn’t feel bad about taking time out! I used to feel really guilty when resting but learnt it’s so important to be kind to yourself and give your body a change to recoup some energy.
Reflect on how well you’ve done to date and what you’ve achieved! That should help you to see you can get through anything that comes your way!
So there you have it, my pain management tips, I really hope you find some of them useful please do let me know how you get on with them. Now I just need to learn to manage all of my other horrible symptoms!?!