Seeking Balance for Effective Chronic Pain Management
Posted on Saturday, July the 16th at 3:28pm
By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II
To find a balance point you must be able to identify what the extremes are that you need to balance. Below you will see each of the target five balance points you need to strive to obtain in your life. In the remainder of this article you will see what the extremes of each point are and why it is important to find the healthy balance point in each of the five areas.
• Positive Self-Talk
• Appropriate Emotional Expression
• Healthy Support Network
• Spirituality/Humility
• Effective Pain Management
• Appropriate Emotional Expression
• Healthy Support Network
• Spirituality/Humility
• Effective Pain Management
Most people pay little attention to all the random thoughts that go through their head each day. Unfortunately, this is not the best way to go through life if you want to thrive. Here is a quote by the Dalai Lama that I especially like: Watch your thoughts, for they become words. Choose your words, for they become actions. Understand your actions, for they become habits. Study your habits, for they will become your character. Develop your character, for it becomes your destiny.
Balance Point One: Positive Self-Talk
Balance Point One is positive self-talk. On one end of this continuum is repressed self-talk. When you are at this end you do not pay attention to your thoughts, and eventually they will create your destiny. It is important to monitor your thinking patterns so you do not create negative consequences for yourself.
At the other end of this balance point is negative self-talk. You covered some of this type of thinking earlier when you learned about anticipatory pain and pain versus suffering. Another way this plays out for people living with chronic pain is the negative thinking can worsen depression or self-hatred. Both ends of this spectrum put you at risk of hurting yourself. Some people hurt themselves by trying to medicate this condition while others go for the long-term solution to a short-term problem—suicide.
The premise for striving for this positive self-talk balance point is; if you change how you think, it will start changing how you feel. If you can change how you think and feel, it will change the decisions you make and the actions you take. If you change your behaviors to more positive habits and make them habitual, you will feel better about yourself and obtain a more positive way of life—your destiny. Some people need to start by thinking their way into positive behaviors while others might need to behave their way into healthier thinking—I recommend doing both.
Balance Point Two: Appropriate Emotional Expression
A trap I see some people fall into is labeling feelings or emotions as either good or bad. I do not believe in “good” or “bad” emotions. I do believe that many emotions can however be comfortable or uncomfortable. Some emotions such as happiness or joy are sought after, while other emotions like fear or loneliness are to be avoided at all costs. This type of paradigm can lead to going to one dangerous end or the other of this spectrum.
As with the first balance point appropriate emotional expression also has a continuum of extremes. One end of the spectrum is becoming emotionally numb. For some people this numbness is chemically enhanced or induced. But for most people the numbness is more of an acquired defense mechanism due to a constant barrage of living with extremely uncomfortable emotions in addition to high levels of physical chronic pain. This numbness can lead to pushing friends and loved ones away or becoming hopeless.
Then there is the other extreme—emotional over-reaction. The example I like to explain this one is to imagine being in a situation that triggers anger. The trigger might be getting cut off in traffic or having someone cut in front of you when waiting in a line for services. For most people this might trigger two pounds of emotional response—getting mad or frustrated. Unfortunately, people at this end of the spectrum might react with twenty pounds of pressure—rage or even blind rage. So it is with other uncomfortable emotions like fear, sadness, loneliness, anxiety, etc.
Another problem with this balance point is that some people can vacillate between the two extremes and never stop at the balance point. The first step toward appropriate emotional expression is being able to recognize, articulate and rate your emotions. Once this is accomplished the next step is learning how to appropriately express your emotions. Making better choices on what to say and do when you experience emotions, especially strong uncomfortable emotions, will lead to much more positive outcomes for you and those around you.
Balance Point Three: Healthy Support Network
It is extremely important to build a chronic pain support network for yourself. This balance point of a healthy support network also has two dangerous extremes—isolation and enabling. Let’s start with the isolation extreme. This is usually fueled with the belief that I have to do it myself. Sometimes this is coming from a power position because of a mistaken belief like “I can’t trust/depend on others.” While for other people the mistaken belief might be “I have to do it myself because I’m no good; or nobody is there for me.” Either way you lose the chance to have someone in your corner when it really counts.
The other end of this continuum is enabling. Some people at this end have developed a system of “support” where they overly depend on others—even when they can and should be doing things for themselves. The denial pattern of Fear of Change, usually leads to this type of system. I’ve seen some of my patients recognize this and want to change and gain their power back and the old enabling support system goes crazy. The enablers are also stuck in the Fear of Change defense pattern. Again that is why you have had many opportunities in this book to learn about building a healthy support network.
People are not enabling you if you really do need support in achieving a goal and you do not in fact have the ability or means to do it by yourself. You need to do this chronic pain management journey for yourself—but not by yourself. It takes a collaborative team approach to obtain the best chronic pain management plan. This team must be comprised of professional healthcare people along with other guides and coaches in order for you to obtain true freedom from suffering and move on to thriving.
Balance Point Four: Spirituality/Humility
The next balance point of spirituality/humility also has problematic extremes. Here too people can vacillate between the extremes and never stay in the middle. On one end of the spectrum people are at risk for moving into pride and/or arrogance while at the opposite end is shame and guilt.
As mentioned in one of my earlier articles, spirituality is a complex and multidimensional part of the human experience. It involves beliefs, perceptions, thinking, feeling, experiential and behavior aspects. The thinking or belief and perception aspects include the search for meaning, purpose and truth in life and the beliefs and values by which a person lives their life. The experiential and emotional aspects involve feelings of hope, love, connection, inner peace, comfort and support. The behavior aspects of spirituality involve the way a person externally demonstrates their individual spiritual beliefs and inner spiritual state.
When people are at either end they close themselves off to the spiritual energy that will enhance their quality of life and improve their pain management. When in pride and/or arrogance the mistaken belief is I am in control. Well sometimes that can be a good thing; however, when people mistakenly believe they are in control when they really aren’t they can experience a lot of trauma and drama in their lives as well as pain and suffering. False pride—or arrogance—also keeps you from reaching out to others for appropriate and healthy support.
The other end of the spectrum has its own negative consequences if you get stuck in shame and guilt. I believe that healthy shame and appropriate guilt have a place in our lives. This problem I’m talking about here is toxic shame and dysfunctional or paralyzing guilt. Healthy shame lets us know we have limits. Toxic shame leads us to seek dangerous cover-ups to cope with it. Appropriate guilt lets us know what our behavior needs modification. Dysfunctional guilt leads us to becoming over-responsible and accepting blame that we really don’t merit. In addition, shame and guilt also keeps us from reaching out to others.
Balance Point Five: Effective Pain Management
This last balance point of effective pain management is what this article is all about. The two extremes here are ignoring pain or suffering. I believe that there are times when ignoring pain—or avoidance by healthy appropriate distraction—can be a good thing. I don’t believe it is ever a good thing to be in suffering from your pain—freedom from suffering is your right and your responsibility.
Ignoring pain becomes a problem when you are not listening to what your pain is trying to tell you. When you’re not listening it is impossible to take appropriate action. In fact, ignoring pain will often lead to suffering—sometimes quickly and sometimes it may take awhile. One common reason many people ignore their pain is the mistaken belief that if I ignore my pain, it will go away. Another reason is that sometimes your ignoring the pain is because you don’t know what else to do about it.
Effective chronic pain management is often a challenging and sometimes frustrating journey. Achieving these five balance points can help smooth out your journey and lead to more hope and happiness. I want to end with my favorite Sanskrit Proverb below.
