One of the most powerful strategies we have seen in treating pain is when we don’t allow patients to discuss their pain with anyone – expect with medical providers. People can become so wrapped up in their pain that they lose themselves in it. They become their pain.I had no idea how much time patients spent discussing their pain until I asked them not to. For some, it felt like I had just dumped a bucket of ice water over their head.They’ll say, “I feel shallow and phony by not sharing what is really going on with me.” That is a sure sign that he or she has become their pain.We have witnessed several things occur when people successfully stop discussing their pain. The pain may not immediately abate, but they feel lighter.Wallowing in pain
Now I do not wallow in pain. I ruminate. And maybe that is just semantics. But communication about our pain is necessary. So I do not understand this don’t talk about it at all thing.
When pain is high…
I know when I am in high levels of pain… those peak levels where you are utterly non-function… I cannot get enough distance from the experience. It is about getting through. And distraction is impossible. So you are immersed in the experience and it impossible not to think about how horrible it is.
And when I was immersed in my depression I would think myself into a sinkhole of despair when it came to thinking about pain. It compounded the pain experience so severely that I suffered more mentally and emotionally. Thinking, then, became dangerous. Again, I had no real distance from the pain experience to get perspective on it because the pain was unmanaged and the depression wasn’t treated.
When pain is moderate…
When our pain is moderate, or baseline average for ourselves, we engage in a lot more coping strategies. Such as distraction. Put your mind on something else so you do not focus so intently on the pain.
And I think of this experience: There were times when I would be in a support group for people who also had fibromyalgia or chronic migraine where it was detrimental for me. People, like me and so many others, have difficult times with pain management and treatment. We can be discouraged. We can be hopeless. And when I spent a lot of time with people who were as frustrated, as hopeless, as me it was difficult to distance myself from my own suffering. So I do limit that now.
However, do we ‘wallow’ in pain on a more everyday level?
When pain is more managed for portions of the day we have our ways of coping. And this includes proper self-care and rest to manage the intensity of the pain. Distraction so we do not get too immersed in the pain. Because thinking about it always seems to make it darker and deeper.
But, man, well, pain is demanding. It is constantly insisting you pay attention to it. and we are constantly finding ways to cope with it insisting we focus on it. Not to mention the problems it creates with focus and concentration. And the mental and emotional suffering it causes. I can ruminate on this. I can catastrophize this. I have a difficult time thinking about even the future with chronic pain. The present is hard enough to cope with without thinking about endless pain.
Maybe we give to much time for it. Maybe if we talk about it a lot we focus on the reality of it more.
However, I do complain when it is severe. I can’t help it. I feel like I need it to be acknowledged. I need others to understand that day is a real struggle. And there is nothing wrong about that. Saying ‘Hey, this is a bad day. I cannot function.’
And in this, we have the idea of how much of our attention and focus is allocated to discussing or thinking or complaining about the pain experience.
But I have found it is healthy to only give a certain amount of time to think about illness and chronic pain. To not give it too much space in your head. To not consume too much of our thoughts.
There is a distinction between coping and wallowing
When I ruminate about pain I can really sink into the horrific reality of it. About how hard it is to function. About how hard it is to do anything. How it is just endless. And my worries over the future. And sometimes pain swallows us whole and we are incapable of thinking about anything else. It can consume. And even when it is our baseline pain it is extremely hard to think through and function. Thinking about it happens. Like just thinking about how hard it is going to be getting through that day of work. Or the next day of work when you are in too much pain to sleep.
When I cope with chronic pain I acknowledge the pain. It is there. And I have to deal with that reality. I have to adjust accordingly. Severe high pain is complete rest mode. And every other day is based on intensity. I consciously pace my activities. I am careful with my time and energy. I rest when I need to. I respond to every migraine with a strategy (Ice, migraine balm, meditation, maybe medication that day, or maybe it is a non-triptan day). And my level of functionality adjusts to the level of pain. I do try to engage in things that I use for distractions; writing, blogging or reading. All sorts of things.
Fact is, we are aware of pain all the time
We are aware of it. And that is how we adjust to it.
I do not honestly know if verbalizing our experience frequently causes that distance we try to keep from the experience to be narrower. If it makes us dwell on it. Or ruminate more. Maybe it does. And maybe that does mean we need some sort of journal to just complain in once a day. To get those frustrations out that we always have. I don’t know. But I don’t think complaining about it when it is severe is a problem. I am stuck in a four-day migraine right now. Today the intensity has gone down. But day one was severe. Day two was epic pain levels. I was laid flat out by it. I made the entire house as dark and quiet as humanly possible. I did everything I could to manage the pain. Nothing touched it. I just lay on the couch all day, enduring it. Telling my spouse about it makes him understand I am not functioning. It enables him to understand what I am doing to get through it as necessary. No light. Quiet. When pain is that high up there my management of it alters to ‘just get through it’ mode. And making others aware of that mode means they are less inclined to turn on a light or make a lot of noise. And they know activities just are not going to happen. Plans not achieved. No accomplishments or productivity possible.
So maybe informing is a good idea. Maybe not complaining, or wallowing as the article suggests, but informing. My psychologist had told me my stoic nature didn’t help my spouse understand where my limits were that day. And that I had to communicate more. I am very into suffering silently apparently. There is still a part of us that wants people to comprehend the depth of the experience. I like the idea of a complaint journal, for like mid-day, and then my gratitude journal in the evening. So yeah, I don’t want to wallow in it. But the reality is that sometimes it does consume us due to its very nature.