A skilled torturer’s goal is to break someone but to keep them alive while doing so. To bring them to their knees yet keep their heart beating and lungs pumping. Chronic pain will not kill a person, yet it can bring them to their knees wishing for death. For those who live with chronic pain it is living with a torturer within their own body.
Chronic pain comes with the agony and limitations of a lost limb, but is invisible to those that don’t know it’s there. In fact, many with chronic pain long for a physical representation of their internal misery, so people understand they’re hurting. Chronic pain results in the loss of ability to function as one normally would; and this can spiral into a loss of Self and a cloud of grief. The pleasures and thoughts that used to carry one through the day are now clouded and consumed with the current state of limitation, pain, and disability. Typical ways of managing and coping don’t bring the same relief. Mindfulness brings one intimately aware with the extent of their suffering; so mindlessness is preferred. Yet mindlessness doesn’t work either; it lacks color and depth, fueling hopelessness and thus creating a turbulent paradoxical storm: mindfulness connects to misery and mindlessness feeds misery.
Chronic pain is all consuming. It is always there. A wound that won’t heal and reminds you of its presence everywhere you go. For survival purposes our body is meant to alarm us when we have an injury, releasing chemicals to mitigate the pain; but dissipate over time. Yet, chronic pain does not come with relief, so the body keeps is in a constant state of alarm and continues to release these chemicals, to the point of depletion. These chemicals are crucial in regulating mood, appetite, and sleep. So not only does the physical pain disrupt these areas but the depleted brain chemistry does as well.
Chronic pain is blurry and sharp, hot and cold, hardened and frail. Life goes out of focus and chronic pain becomes the point of convergence. Surviving chronic pain becomes the purpose of life, and without a worthy purpose we just exist. Acute pain comes with aches, anxiety, and frustration. Chronic pain comes with dread, despair, and depression. According to the National Institute of Health, those with chronic pain are twice as likely to attempt suicide, and more likely to be successful. This is not just due to the disabling aspects of chronic pain but the isolation and perpetual double binds people with chronic pain find themselves in: Moving hurts but not moving leads to more pain. People don’t want to talk about it, but staying quiet leads to pent up emotions and isolation. Isolation is preferred but is emotionally worse. Nobody asks you how you’re doing when you’re alone. Nobody shares their advice on what their cousin’s oldest daughter did for their ailment. When alone you don’t feel like a burden. But isolation is dangerous. It may not be the spark that starts the fire but it is the fuel source that feeds depression and misery. Isolation is a state we are not meant to be in and impossible to thrive in.
At our core we are pack animals. I read somewhere that one of the reasons Neanderthals did not survive and Homo Sapiens did was because Homo Sapiens embraced tribal communities and Neanderthals were more isolated and independent. We are not meant to survive in isolation. There is a reason solitary confinement is one of the worst punishments we inflict on someone. We need Others, especially healthy Others. The field of Interpersonal Neurobiology has proven that our brains and minds actually calm and organize in the presence of other healthy brains. Here in lies one of the many double binds of chronic pain: “I am in pain around others and I am in pain alone.”
For those living with someone with Chronic Pain it can be much like living with a porcupine. You pet them the right way and all is good, but one miscalculation and out comes all the needles. One minute they need you to do everything and the next they want you to just go away and leave them alone. The typical reciprocation that comes in a relationship becomes unbalanced. You’re having to do more and receive less. The unpredictability of “will today be a bad day or a really bad day” leaves a lingering since of anxiety and dread. Powerlessness, sadness, anger, confusion, frustration can be felt any given day and any given hour.
It is easy to be consumed by Chronic Pain. Like a skilled torturer it will bring people to the brink of despair but lacks the mercy to finish them off. So how does one survive this?
- Compassion, Compassion, Compassion: When our body is ill it is in a turbulent discord. Responding with hatred and negativity towards your body and self is only adding more tension. Respond as you would to a wounded animal or child; compassionately and lovingly. Remember that your body is suffering and needs words of loving kindness and the touch of a healing hand. Be gentle.
- Let go of egocentric thinking: It is easy to get so wrapped up in our misery. We start to think we are the only ones in pain, that nobody understands. The reality is whatever you are suffering from there are many more like you out there. Go to them. When we can find people who understand our experience it can be soothing, even in the absence of a solution. The feeling of being seen and understood biologically releases opiate endorphins…our natural pain killer.
- Be a verbal instruction manual: The reality is, if you have not experienced something then you won’t deeply understand it. The other reality is when we love someone our heart aches when they are in pain; in turn making us want to try and help them. It is only natural. However this often leads to the wrong kind of help: unsolicited advice, smothering, and pity; which drive the desire to repel from them. Isolation will only create more suffering so instead tell people how to “operate you”; they don’t know. Speak your truth. “The truth is I am not doing well but there is not much to say or do; I mostly just need you to know how I am doing so I don’t hold it in.” “I would appreciate it if you would check in on me, but only once or twice a week, more than that will make me want to shut down.” This will bring tremendous relief to those who don’t know how to help you and you will notice relief as people will respond in a way that is more
Chronic pain may never go away; a path that is always uphill. There are ways however to navigate it that are better than others. It is for this reason specifically that we need to find some sort of support. It is a storm that will challenge your desire to fight. Remember, just because it’s raining and we might get wet doesn’t mean we abandon the umbrella and go sit in a puddle. But just because not all strategies bring relief we don’t want to abandon them completely. Unfortunately, people living with chronic pain have to work harder at staying dry than others. It’s a battle worth fighting.
Curtis Buzanski, LMFT, LAADC