When managing your pain feels like a full-time job
I was recently talking to a colleague about how much time it can take to manage chronic pain, especially in the presence of multiple pain syndromes.
It can seem like there is a never-ending routine of medical appointments, physical therapy exercises, self-care practices, and diagnostic testing, not to mention the time it takes to manage and recover from heightened stress and pain.
When this goes on for a long time, you might start feeling trapped in this time-consuming cycle, particularly when you’re not getting adequate relief from your pain. You probably feel frustrated by the amount of time, effort, and money you’re sinking into managing your pain, but at the same time, you’re afraid to stop any of these efforts for fear that your pain would become even worse.
So, how can you get out of this pressure-filled, vaguely threatening process? Here are some ideas from a pain psychology perspective.
Practicing non-attachment to getting out of pain
We’ll start by considering how you feel during each pain-management activity, as well as how these activities enhance (or take away from) your quality of life.
But here’s the catch: It will be best to focus on emotions, sensations, reactions, and benefits other than pain.
Right from the start of this examination, we want to practice non-attachment to the outcome of getting out of pain. That doesn’t mean that you are no longer aiming to get out of pain. Of course, that’s everyone’s primary goal (and that’s my goal for you too!). What it means is that we’re going to spend some time looking at other things and asking ourselves other questions.
Why?
Practicing letting go of the outcome of getting out of pain decreases hypervigilance to pain sensations, allowing you to be less reactive to pain. Less reactivity to pain means less pain over time.
It helps you attend to other important messages that your body and mind may be sending you, so that you’re less likely to override your body’s true needs with ineffective strategies that are “supposed to” help, but don’t actually do so.
A spirit of outcome independence helps you move away from the anxious state of “Is it working yet?” and toward a calmer confidence that you are capable of knowing and responding to your needs intuitively and effectively.
In the spirit of outcome independence, instead of asking “Does it work?,” we will ask the questions:
“How do you feel about each of your pain management strategies?”
“How do each of your pain management strategies impact your quality of life?”
Your pain management strategies
Start by making a list of all the things you do in a typical day or week to manage or treat your pain. Making a list can help you remember things that might not immediately come to mind.
Anything that you’re primarily doing to treat, manage, or recover from pain and which requires an investment of time, effort, or money can go on the list.
Examples include:
Scheduling and attending medical appointments
Somatic tracking
Yoga
Acupuncture
Acupressure
Physical therapy exercises
Foam rolling
Scheduling and undergoing medical procedures
Scheduling and undergoing diagnostic tests (and following up when no one calls you with the results)
Laying on the couch with an ice pack or heating pad
Ordering, picking up, and taking medications
Researching new approaches, providers, and treatment options
Preparing special meals (e.g., for elimination diets)
Benefits and drawbacks of pain-management strategies
Once you have your list, consider how you feel when you’re doing these activities and how they contribute to or take away from your quality of life. For now, set aside the question of whether each activity increases or decreases your pain.
Positive feelings and benefits might include things like:
Relaxation
Liking or feeling safe with the provider
Bodily pleasure
Enjoyment
Learning a new skill
Liking the routine
Taking a break from other daily tasks
Feeling hopeful
Negative feelings and drawbacks might include things like:
Frustration
Disliking or feeling unsafe with the provider
Time-consuming
Feeling drained
Expensive/unaffordable
Crowds out other important or enjoyable activities
Feeling like you can’t stop doing it despite the presence of one or more of these negative experiences
Best approaches for treating your pain
Now, take a look at your evaluations and think about how you may want to change your routine as a result.
For the approaches that you mostly feel good about:
You may want to keep engaging in activities that offer other benefits. However, you could try experimenting with shifting your focus from their impact on decreasing your pain to the immediate and tangible benefits that you are already getting each time you do them.
For example, instead of framing your yoga practice as “I have to do it so that my pain stays away,” try thinking about the other things you like about it, such as “I do yoga because I like the way it feels,” “I do yoga because I like checking in with my body,” or “I do yoga because I love my instructor.”
This shift may feel unnecessary for the things that are actually working for you, but an appreciation of the process (immediate benefits) rather than the outcome (reduced pain) can help you stay focused on your pleasure and enjoyment, rather than the absence of something aversive.
It can also make it less threatening if pain does arise in the context of that activity, since you have many life-affirming reasons for doing it.
For the approaches that you mostly feel bad about:
First, consider why you’ve continued to engage in a treatment or approach that mostly makes you feel bad or detracts from your quality of life. In many cases, you’ll find that the fear of increased pain is motivating you to continue despite everything that it’s taking away from you.
Of course, there are life-threatening, painful conditions (e.g., cancer) where unpleasant treatments are necessary for staying alive. But in cases where you can stay alive without the treatment, and where the effect on your life is mostly negative, it’s worth asking what is keeping you so committed to doing it.
It will be up to you (in collaboration with your treatment providers, if applicable) to decide whether to experiment with stopping or scaling back on a particular activity. If you do experiment with stopping/cutting back, try simultaneously shifting your focus from anxiously waiting for your pain to increase to appreciating what you’re gaining from no longer doing the unpleasant activity (such as feeling less drained, having more free time).
When fear arises, remind yourself that you had good reasons for taking this action. Validate that it’s natural for you to have fear around making a change.
You could also try using the resources that you free up from stopping one activity toward another, more enjoyable, self-care or social activity.
For the approaches that are neutral or mixed:
Deciding what to do with activities that are neutral or mixed will largely depend on the precise make-up of benefits and drawbacks.
For example, if you’re enjoying some things about a daily hypnosis practice, but you’re finding it time-consuming and effortful, can you experiment with doing it less often, while shifting your focus away from the fear that your pain might increase as a result?
If you find acupuncture helpful, but you’re struggling to afford it, can you look into self-administered acupressure, while also learning about the unique benefits of treating yourself (e.g., feeling more empowered, greater flexibility in when you do it)?
If you know you’re supposed to like meditating, but you’re indifferent to it, it’s OK to stop and do other things that you like better!
Take-home points
It’s easy to get stuck in a grueling rut when it comes to managing long-lasting pain. And it can be scary and overwhelming to figure out how to get out of that cycle.
All too often, we can discount our own feelings about the treatments we’re doing, instead doing what we think we are “supposed to” do or desperately trying anything and everything without addressing our underlying fear of our pain and how it is stealing our life away.
Shifting our focus to our here-and-now feelings about each approach can help us remember that our experience does matter. It sends a message to ourselves that it might be possible for us to carve out a better quality of life and that attempting to do so, even when it’s scary, just might be worth it.
If you’re feeling stuck with your current approach to pain management, the Slow Down and Soothe coaching program can give you a fresh perspective. Get more details here and request to join the waitlist today.
The content shared here is for informational purposes only and is not intended as a substitute for professional medical advice, diagnoses, or treatment. Always seek advice from your physician or other qualified healthcare provider before making changes to your health regimen.
