I just finished reading the book ‘Everything is F*cked: A book about hope‘ which was quite intriguing. By Mark Manson.

There is a section on pain and suffering that was interesting to me. In regards to the fact with chronic pain we know pain and as a result we know suffering. How he talks in regards to society and sociologically is fascinating but, it got me thinking about chronic pain specifically.

Chronic Pain and an antifragile system

He talks about fragile, robust and antifragile systems. (Page 182) Referring to a theory by Nassim Taleb “some systems become weaker under stress from external forces, other systems gain strength under stress from external forces.” (pg 182)

Robust systems handle change very well. It has some serious endurance. Fragile systems, Obviously handle little stress before combusting.

Antifragile systems

An Antifragile system gains ‘from stressors and external pressure.’

He says the human body can go either way. If we seek out pain, such as when we do a crapton of exercise, it is an antifragile system, ‘meaning it gets stronger the more stress and strain you put on it.’ If you avoid pain and stress well muscles atrophy and you become weaker. Same with the mind. Use it or lose it. When we avoid pain and stress ‘and chaos and tragedy, we become fragile.’ Basically making us less resilient to adversity as he says ‘Out tolerances for day-to-day setbacks diminishes-‘ (pg 183)

I think with chronic pain we would be an antifragile system in theory but not reality. The pain is inflicted on us. We use the coping strategies life has given us- both the good and the bad to try and cope with the constant stressor on our lives. I think we start as a robust system or a fragile system and over time we adapt, we cope and we develop more resiliency as we do becoming closer and closer to an antifragile system… perhaps becoming one, I couldn’t say. I doubt if we do ever attain such a state and if we do, we don’t remain in it.

I do think I had both before started off differently. I started off as a Robust system and I powered through the pain and nothing would stop me from doing what I wanted to do, felt I needed to do, or any damn thing and damn the consequences. But the consequences was a Massive painload toll and emotional toll. And that flipped me over into a very fragile system where I couldn’t seem to take Any More stress at ALL. And I eventually crashed and burned out. But even when I recovered from that I was still a fragile system. I still couldn’t handle stress of any sort because I had obliterated my self-worth. I was extremely sensitive to any stressload Above my existing stressload.

Once I recovered That and figured some things out about myself and how my brain thinks, adjusting my belief systems some, and my values, I developed a massive amount of resiliency. And coping strategies that work quite well for me. However, I got rid of a lot of external stress by not working. So there is That fact. I have moved more and more towards what he could call an antifragile system… when it comes to physical and mental pain that is… but I don’t think when it comes to chronic pain it’s Entirely attainable. But maybe close to it. I mean the resiliency I picked up, that I didn’t ever have much of, is quite valuable since my health took such a turn.

He says pain and suffering would make us antifragile and I don’t think we are all the time. I don’t think we are of the get go. And I don’t think we make it there or get Close very quickly. I think it takes time, which varies with us all, to get close to that point and I don’t know if we stay there. His antifragile system is our acceptance to a point. One thing I know about acceptance is that it’s an awesome stage of coping but we do not always Stay there. Coping is a constant flux that depends on levels of illness, life stresses, external factors, and internal factors. One thing we know is that illness changes and downturns happen which can throw our lives into a massive chaotic flux, sometimes past the level of resiliency we have at that time, which throws off our coping for an indeterminate amount of time.

However, nothing is That simple is it? Because pain is biological and it does neurological things to the brain. If I thought coping were so easy, hell, we all would have nailed it by now. But we have to deal with a lot of neurological fallout at the same time. The more complicated examples of that are depression and anxiety. They are common comorbids that are complicated with pain. That have nothing to do with strategies for coping but sure as hell complicate them. Depression sure had a way of twisting every thought I had into a knot. But it also sucked every ounce of motivation and energy from me too. Made it harder to cope with pain I could cope with before.

So the suffering- the emotional and mental toll is brutal. And that is hard to get a grip on. As anyone would with any common sense would comprehend if they thought about it. It one has to deal with a massive painful stressor inflicted on them 24/7… yeah, it is going to take a toll on you. But, again, over time, who even knows how long, resiliency does grow stronger and stronger and we do cope better and better. So yeah we do become more antifragile assuming the chronic pain or illness doesn’t then Also get worse in a way that then makes us play catch up, as it often does. And assuming we do not develop comorbid conditions of any kind, which we often do. And assuming actual life stressors do not significantly compound that pain stressor and it sure can.

And he asks ‘Will you engage your pain or avoid your pain?’

Now this question is very valid even for us. I like it because it is important. We can’t avoid our pain, obviously. But we can sure TRY to. We can sure avoid a whole lot of things to avoid the possibility of increasing our pain. We can avoid socializing. We can avoid going out and leaving the house as much as humanly possible. We can choose to avoid activities and events because we fear the consequences. Because like he says we tend to avoid pain, as human nature. (Which by the way, this makes sense with completely unmanaged, untreated severe pain. So not entirely our fault when we have No effective, or Mildly effective even, treatment of Any sort. Just saying. There is such a thing as Unbearable pain.)

But if we do it, we avoid a whole lot of life. And that means a whole lot of isolation. And lack of activity which can lead to muscle atrophy. Which is an issue I am dealing with now- too much rest due to vertigo means more fibromyalgia pain and less muscle mass which means less mobility and Now I have to figure out a slow and painful way to Correct that.

Anyway, when I was severely depressed I was awesome at avoidance. I didn’t want to socialize. I didn’t want to do anything other than sleep for as long as humanly possible. And yeah I was extremely isolated. And friends disappeared. It made pain harder to cope with. It made the depression harder to cope with.

When I began to recover I made the decision to slowly put myself out there, within my limits and pacing, of course. And that level of modest socialization is what I do now and it does extremely boost life satisfaction and mood. I no longer avoid things. I choose based on what it is and my level of well-being that day. I choose based on the recovery time needed and whether I have that recover time available to me. Obviously, now, my functionality is very limited but that doesn’t mean I do not Do some limited things, for short durations… just means a lot less and shorter times. I just want some life in there somewhere. Like my psychologist once told me; I will be at pain at home and I will be at pain if I go play cards with some friends- might as well have some fun and enjoy myself for a short time, because pain will be there regardless. And I can always leave it becomes unbearable. No one said I can’t.

So avoidance can definitely be an issue. Not of Pain itself but of anything that might make it worse. The fear of making it worse even. I like to engage my pain so that I have a small life in there. Whatever I can get anyway. But all within limits. And Pacing is a Must. Not on severe days though-we are not insane. No one mucks about on severe pain days. Those are rest days. And this naturally presupposes some sort of pain management.

I have more thoughts on this book I will write in another post

Final thoughts on this… Chronic pain in the vast long term broke me. Then made me. And then broke me. Made me. Some people bend with pain and we do, we work with it, and bend. We are robust. But some of us break, because it is not managed and we push through it and the stress is out of control… we are in survival mode too long… and no one can last long like that, well we do last way too long like that… but then we just break down. And that too is a pretty predictable response to long term unmanaged pain when you are exceeding your limits. So maybe I think pain has a little more impact than some think… maybe we never achieve an antifragile state because the impact is so severe on our lives and bodies and minds that the best we can do is cope better than we did yesterday. And learn from the times it broke us. So we do not do that again.

I think this because neurologically and biologically pain affects our system. Which affects our coping. And I think we can never underestimate the Impact of chronic stress long term on the body. No matter what we do to cope or how we cope. It is a massive tsunami we try to ‘tame’ every single day.

See more posts on chronic pain

12 things I can tell you about chronic pain
Open letter from a person with chronic pain
How to understand someone with chronic pain

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8 thoughts on “Chronic pain and an antifragile system

  1. Very interesting piece on resilience and 24/7 pain.
    Over the years I’ve suffered I started as a very strong resilient pain thinking that pain would get better and eventually go. Sadly for me for the last two years pain has got worse. Now I have to deal with depression and anxiety and to be honest I feel like I’m stuck with this forever. I’ve lost hope that one day I’ll be pain free. I’ve lost my resilience and motivation too.

    Liked by 1 person

    1. The thing about resilience is we get it back and you will. My main problem with depression is that it killed my capacity to cope. It was a very dark place. But I did therapy and I was put on medication. Both of these worked for me. And that is the only reason I have the resiliency I have now. Depression doesn’t allow it. Or for me, it didn’t allow even motivation or energy or desire to change… it just was soul-sucking. If they had not treated that with my pain, I would not be coping well right now. Which is the flaw in his theory… pain has consequences on us. Biologically. Neurologically. And one is that is makes us far more likely to have depression and anxiety… and that makes it so damn hard to cope the way we used to.

      For me that lasted a decade before I got treatment for the depression. I thought it would always be that way. But eventually I found my way out with the help of others and for me, medication, was necessary. I know when we are very low it seems like it will always be that way but depression makes us believe that. Everything changes. And eventually so does that. You will come out the other side. And when you do then you will have the motivation, energy, and will you need again. And the resiliency.

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  2. I read his book The adubtke Art of Not Giving aFuck which influenced my article called The Dangers of Distraction. My family has a solid, unspoken rule that we don’t talk about the hard things of life; we don’t even acknowledge them. Instead we drink, play games, watch TV, anything to distract from pain. That’s how I grew up. However, I’ve always been the odd one, I can’t and won’t sugar coat things. I’m getting a bit off topic.

    Just wanted to say that I’ve found his books pretty interesting. I did read this one, but too. His take on hope, I’m still pondering…

    As always, I so appreciate your thoughts. I was like you, in that I totally ignored pain or really any of my needs, to do what I felt I needed to do. That worked for a long time in that I received a lot of ‘atta girls’. Now, after being broken, unable to handle the smallest stressor, I feel like I’m rebuilding.

    I look forward to your other thoughts on this book.

    Liked by 1 person

    1. Yes, I agree. Pain avoidance is pretty ingrained in human nature I think so we have to consciously teach ourselves to engage with it which I think is part of our coping process.

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