Does it seem like you lack the oomph to achieve long-term goals? You have motivation… just maybe not consistently or for the long haul. Aside from the obvious reasons of the pain and fatigue, the lack of motivation with chronic pain has neurological reasons, even when the pain is Managed. So even when pain is not the issue with chronic pain motivation still will be due to changes in the chronic pain brain.
There was old research done on rats that suggested “that persistent pain causes changes in a set of nerve cells in a deep-brain structure known to be important in reward-seeking behavior: the pursuit of goals likely to yield pleasurable results.” (Check out post: That motivation thing, lack of, and what to do about it)
Basically, chronic pain does affect our motivation because it affects our reward system in the brain. We are less motivated to do things and get less of a punch to the reward system when we Do.
Current research agrees: Chronic pain and reward processing
“Chronic pain negatively affects various aspects of daily life, such as by decreasing the motivation to work and reward sensitivity, which may lead to difficulties in daily life or even unemployment. Human and animal studies have shown that chronic pain damages reward processing; the exploration of associated internal mechanisms may aid the development of treatments to repair this damage. Incentive salience theory, used widely to describe reward processing, divides this processing into “liking” (reward-induced hedonic sensory impact) and “wanting” (reward-induced motivation) components. It has been employed to explain pathological changes in reward processing induced by psychiatric disorders. In this review, we summarize the findings of studies of reward processing under chronic pain and examine the effects of chronic pain on “liking” and “wanting.” Evidence indicates that chronic pain compromises the “wanting” component of reward processing;”Reward Processing under Chronic Pain from the Perspective of “Liking” and “Wanting”:
Where “Liking” is the pleasurable experience gained from sensory input, usually dependent on reward stimulus’ properties and then the “wanting” is the internal motivational aspect related to the acquisition of reward stimuli. So this study suggests chronic pain messes with the reward system as well but in the desire, the internal motivation, to gain the reward. Not the pleasure from achieving the award. But Both are diminished in the research.
Based on evidence accumulated to date, we conclude that chronic pain reduces “wanting” behaviors. Bursts of reward-seeking behavior involve cognitive processes such as attention, working memory, and associative memory retrieval. Patients with chronic pain are sensitized to pain-related information, and pain management occupies their attentional resources [77, 78]. As a result, long-term chronic pain-induced attentional impairment might conflict with reward-seeking behavior, leading to the adaptive reduction of “wanting.” In addition, some studies have shown that chronic pain can decrease “liking” behaviors.Reward Processing under Chronic Pain from the Perspective of “Liking” and “Wanting”:
So pain de-motivates us. Meaning we have to find ways to wire back in motivational habits in order to achieve our specific goals.
That sounds easy peasy. No, actually that doesn’t. Sounds like I am fighting my own brain there. Pain may beget pain, wiring the brain for more and more pain- making it more sensitive to it. And then leading to these changes. But the brain isn’t set in stone. Thankfully, it is a malleable little meatball.
Step 1: the tips and hacks
I have some simple tips and hacks to boost motivation. Just simple little things that help every day that I do to keep my motivation going. From getting dressed every day to get into ‘productive’ mode. To setting small achievable goals. To always avoiding multitasking to help you focus. Things like that.
To start off with here are some simple Productivity and Motivational Hacks I have.
Step 2: some things to remember
Fact is, we know motivation isn’t going to be continuous because we are going to have bad days. Therefore, the first steps in helping maintain motivation are:
- Knowing motivation fluctuates day to day
- Accepting bad days and knowing those are days for rest and self-care
- To not feel guilty for days we cannot function due to pain
- Know that the next day is a new day and we can simply continue onward with our plans and goals, not feel defeating due to missed days from coping with high pain. Those will happen. We know it. We simply have to cope with those as usual and acknowledge they are part of coping with pain.
- Remember to have self-compassion
Step 3: Pacing
The Fine Art of Pacing is the next step in motivation because it teaches is to monitor our Pain and our Fatigue levels to then figure out what we can do that day, when to rest and take a break, and what our limitations are that day compared to other days.
It isn’t just what level of pain that day and what we can do or not do with that… it is definitely what level of fatigue and energy that day and how that limits us. Mental and physical fatigue because both of these definitely impact motivation as well.
Sometimes we need to consider management of our fatigue as much as our pain in order to boost our motivation. And when we look at fatigue levels there are things to consider. Medications can increase fatigue so having your doctor review your medications is a good start. Some moderate exercise can help boost energy levels if this is something you can do or want to consider as a goal. Even a 20 minute walk outdoors can boost mental and emotional energy. One thing I use is the supplement Rhodiola Rosea for fatigue levels.
Step 4: Reframing and our thinking
A more long-term treatment to help with motivation and our reward system is to work on our thinking and behaviours. This is all a part of pain management and will help with overall coping but also helps us with our motivation.
We want to try and re-wire the system and over time we can do that with a lot of work. Some of the methods to do that are:
- Cognitive Behavioural Therapy (CBT)- This helps us with our negative thoughts and maladaptive behaviours. With a psychologist we can alter how we think about pain and alter how we behave with our pain and, hopefully, this will help us cope with the pain we cannot manage with medication or other methods. It encourages us to do things out of our comfort zone and this over time will help re-wire that meetball of a brain.
- Reframing pain- When you learn about pain and how it works in the brain it can actually help us to reframe how we think about it. And the more we learn about how it is more about the brain and less about the body, the less fear and anxiety and negative emotions we can have about the pain experience.
- Being aware of our thoughts- being aware of our thoughts and emotional experiences with pain can help us understand how they may be impacting our behaviours. How we may be avoiding certain things instead of trying to find different ways to do things. It also means working on self-compassion, forgiveness, and gratitude- all of which help us accept our current state of being.
In the end, motivation is definitely affected by chronic pain and like everything affected by chronic pain (our mood, our thoughts, our behaviours) it takes work to begin to shift this. So any tips and tricks you can use to get your brain on board is awesome. And any way you can get your mind to wrap its head around pain helps motivate you to live with pain and cope better. While accepting our limitations and the bad days that do and will happen.