One of those darkest thoughts I have in high pain is this concept of ‘no end to the pain’. Of forever. The chronic nature of chronic pain. I magnify that moment of pain and extrapolate it into the future. I think about how difficult it was to cope with all the years, decades, of chronic pain in the past… and therefore how every difficult it will be in the future. And it feels so very Heavy. So very exhausting to me. And insurmountable. I get locked into this horrible feeling of the pain infinity spiral. Where all I can think about is all that damned pain I have to look forward to. How difficult it will be to cope with. And it is based on all the experience I have from coping with all my pain in the past. What predicts future experience? Past experience. What do we know about chronic pain? It Does Not End.
Why do I torment myself with such thoughts? And the infinity spiral? It spirals to infinity. Dark thoughts about the misery before me and about how horrific this pained existence is a spiral down and down and down.
Unless I stop them. And the only way to stop them is with contrasting rational thoughts. But we Know this to be true, right?
But here is the thing, pain isn’t survived by years and decades. I didn’t get through the decades of pain I have in one massive block of pain. I did it by moments. And all I have to do is get through the moment I exist in. That is the task before me. This very moment. It feels intense and insurmountable because we are thinking about The Past and The Future and not about the moment we actually live in… and that is what is actually the point here. How we are actually coping in the moment. What is important is a) getting through that very intense level of pain without spirally into a depressive state and b) that overall my coping with pain is better than it was in the recent past, such that every day I improve how I cope with my pain.
Pain is also variable. When looked at in high-intensity times it looks massive and insurmountable and immense. Yet I know logically I had lower intensity days in there. In fact, I know in my history I had years of lower pain before the pain got worse. I had years of lower migraine frequency. I had years with just the FM before the migraines even were a factor. Pain changes. It ebbs and flows. It isn’t The Pain. And it certainly isn’t The Pain in my worst pain moment. But in those highly charged emotional pain moments it when I reflect on how horrible my pain is. When I am coping great and on low pain days… I certainly don’t do this.
Forever is never forever. Indefinite is what I actually mean. We do not actually know our future pain. We do not know future treatments for pain. We do not know due to the variability of pain if it might actually improve. We do not know if factors that made it difficult to cope with the pain might in fact change, and that will in itself make it easier for us to deal with (adapting work, retirement). Chronic migraines are an example because there is a new potential treatment on the pipeline within the next few years that could, in fact, have an impact on frequency and intensity in a way many of us have never experienced before. Also, people can, sometimes, experience a decline in migraines after menopause if they have hormonal induced migraines. Any number of factors can bump someone back down into episodic. We cannot know this won’t ever happen. We cannot know there will never be a treatment for any of our chronic pain when research is being done continuously.
So when I think those thoughts I want to smack myself. The logic isn’t there. But the emotion certainly is. That no end date factor for chronic pain… is frustrating, draining, exhausting. And when I am in a great deal of pain suffering from painsomnia it is defeating to feel confronted with the impact of many, many more years to this battle. No amount of logic is going to lessen this blow. But nevertheless, I Need to use logic to confront the thoughts. Otherwise, the negativity spirals me down into increasingly more depressive thoughts. Like, what sort of life is this chronic pain life anyway? What worth does it have? And I just spiral downward because when I am in intense pain, the pain tends to make every thought much more intense, dark and cynical.
Why should I have to endure this hell forever? I will wonder. Because it is my Life. And it is a life. And I will live it moment by moment. So don’t listen to the lies your pain tells you. Just reason your way out of them in whatever way you can. This one? It is difficult. The emotions behind the lack of an end date to our pain are actually pretty much always there. It is a real, true, raw frustration for us. Add in some intense pain and some insomnia and this isn’t going to help our thinking on the matter. So we cannot know the future. It is lived by moments. Endured by moments. Pain is variable. And change does happen.