What is the best way to handle pain?

Other than medications and stuff. I mean how to emotionally handle being in pain 100% of the time when meds haven’t worked.


Control what you can. Accept what you cannot.


When one speaks of pain, one focuses on the physical embodiment. Aches and hot knives and prickled skin. This is natural. Pain is our body’s way of telling us something is wrong. But, my dear, you have hit upon another very critical aspect of pain - emotion. While many say that the mind and body are two separate beasts, they are actually very much intertwined. The neuronal tendrils that write your life experience wind together in many ways. Those wriggling vines inside your head that spell out “pain” are the same that stab you when your feelings are hurt. Physical pain and emotional pain are, in our minds, the same [1].

Because of this your long term pain is likely dragging your emotions down to its dark level as well. While dulling physical pain through medication is useful, it is equally important to look after your psyche. Many of those who suffer pain also descend to melancholia [2]. Part of this is due to those tangled neurons, but our minds have the remarkable strength to quell the physical symptoms of pain as well.

A second reason pain is so hurtful to our psyche is the impact it has on our lives. Pain strips us of control. It dictates when we sleep, what we eat, where we go, and how long we venture out of doors. Pain is a selfish companion who demands all your time. It robs you of the activities you once loved and drives a wedge between you and the people you are close to. And through all this, pain plays a very talented sleight of hand. It waves its right hand wildly, keeping you focused on the aching, the piercing, the burning in your flesh and bones. Meanwhile, it’s the left that steals from you and controls your life. It is not until you are well into pain’s show that you realise he has successfully picked your life’s pockets.

There are ways to play pain’s shell game with your eyes wide open. Medication will dampen the right hand’s rapid gestures by reducing your physical symptoms. But you already know that. You want to know how to pay attention to the left. You want to keep control of your life and stop pain from taking from you. Here are some suggestions, in no particular order:

Maintain your lifestyle–as best you can

We are happiest when we spend our time doing what we choose. Pain loves to take this control. It is the first thing he looks for in your purse. Bury those things deeper, inside hidden pockets. Continue to do the things you still can as often as possible. This may be as simple as having a cup of tea in the sunshine or reading a book in a hot bubble bath. If you cannot do something you once loved, try adapting it. If you loved hiking in nature, go for a drive in the countryside. If you can no longer stand for the length of time required to bake, bring your cooking implements to the kitchen table and work sitting down. Search for new activities that you may enjoy - Pain cannot steal something that you haven’t got yet.

Seek support

Have you noticed you don’t see your friends as often as you used to? This is another common theft that pain engages in. He wants you all to himself, and is very adept at convincing you to stay at home and restricting what you can do. He grins to himself as he watches your friendships drift apart. Often friends don’t understand what you are going through. You may even have kept your chronic pain a secret in order to feel normal. Talk about it. Tell your friends about pain and how it affects your life. If they are good friends they will understand and work with you to sidestep pain, so you can remain close.

Practice mindfulness

You said that your medication doesn’t always work. This can make it hard to keep your emotions in check. Recall those intertwined tendrils of neurons? When you physically hurt, your mind is also feeling emotional pain. But all is not lost. Mindfulness has been found to be useful at reducing the intensity of pain and the melancholia that often comes along for the journey [3]. To be mindful:

  • Place yourself fully in the present moment.
  • Pay attention to the details of what is around you without judgement.
  • Take in everything that is happening - The sounds your house makes while settling in the cool night air. The smells of night jasmine drifting in through the window. The texture of your linen dressing gown brushing against your leg.

This intense focus allows you to control what thoughts enter your mind. And when you control your thoughts, you control your lived experience. That is a very powerful thing. There are many books on mindfulness available to you. This has some techniques you may find useful. But as always, it is best to seek a psychologist to work with on mindfulness techniques and acceptance therapy. Many psychologists are very experienced in helping with the negative emotional impacts of chronic pain.*

Accept what you cannot change

I’m guessing that you would dearly love to banish pain entirely from your world. To get back your life before the pain, or the life you dreamed of having. Unfortunately life is often unfair and never entirely in our control. If you learn to accept the ways pain impacts on your life that you cannot control, many negative thoughts will unravel from your mind [4]. Acceptance is closely tied with being mindful. When you live in the present moment, you understand it is only a moment, there is only now, right now. The pain you felt a moment ago is gone. The pain you may feel later has not yet come. Everything passes. This moment too will pass. And you will be okay.

Living with Pain is difficult. But I believe in you, my dear. Remember - control, talk, attend, accept. Follow these words and you will be a step closer to keeping pain’s tricky fingers out of your purse.

Good luck, fortune seeker.

– A. L. –

References:

[1] Eisenberger, N. I. (2012) Broken hearts and broken bones: A neural perspective on the similarities between social and physical pain. Current Directions in Psychological Science, 21(1); 42-47. doi: http://dx.doi.org.ezproxy.library.uq.edu.au/10.1177/0963721411429455

[2] Williams, L. J., Jacka, F. N., Pasco, J. A., Dodd, S. and Berk, M. (2006), Depression and pain: an overview. Acta Neuropsychiatrica, 18: 79–87. doi: 10.1111/j.1601-5215.2006.00130.x

[3] Reiner, K., Tibi, L., Lipsitz, J. D. (2013) Do mindfulness‐based interventions reduce pain intensity? A critical review of the literature. Pain Medicine, 14(2); 230-242. doi: http://dx.doi.org.ezproxy.library.uq.edu.au/10.1111/pme.12006

[4] Veehof, M. M., Oskam, M, Schreurs, K. M. G., Bohlmeijer, E. T. (2011) Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. Pain, 152(3); 533-542.doi: http://dx.doi.org.ezproxy.library.uq.edu.au/10.1016/j.pain.2010.11.002

Once again, Mme. Liddell humbles the Advice Fortune Cookie with her well-researched expertise. Exploring the wondrous lands of the mind since 1865, her words are no less timeless. You can read all her other Fortunes here.

* Note from the AFC Science Adviser: Ask your GP for a referral if possible - they should be aware of the vast body of research showing the effectiveness of psychotherapy on pain management. And check with your insurer - you won’t know if therapy is covered unless you ask.