Understanding pain and setting goals
Chronic Pain and Physiotherapy
The choice of whether to look back or forward will greatly affect your mood and the motivation to follow a pain self-management plan. By focusing on the good old days before chronic pain, it is easy to act if life is unchanged. Are you pushing through daily tasks and obligations without considering the effects? Repeatedly attempting to live life as before is an open invitation to disappointment and painful flare-ups. With this focus, the tools of successful pain management – careful planning and pacing of life – seem frustratingly controlled. Hanging on to the past is like driving a car looking only through the rear view mirror. It is impossible to see any way forward, let alone a path that might lead to satisfaction.
What makes it so hard to stop hoping that life will return to the way it was before pain? What stands in the way of adjusting your lifestyle to achieve meaning and contentment? Grief is often the issue.
Grieving involves adjusting to the loss of something that has great personal meaning. Perhaps you have lost the ability to take part in activities like a career or sport. You might grieve the ability to look after yourself or your home. Or you feel you are not fulfilling your role in life – being a good and involved parent, spouse or friend.
The loss of physical functioning that comes with chronic pain can reduce your ability to fulfill meaningful tasks, roles and relationships. Grief arises from a conflict between the way life is now and the way we think it should be – how it was before. You are not who you once were.
With some types of losses, as when a loved one dies, we recognize that there is a struggle to adjust. Grieving in response to death is well publicized in pamphlets, magazines, movies, music, and television. Most people understand this type of grief. Our society recognizes grief through social traditions around funerals, periods of mourning, counselling programs, and bereavement leave.
In contrast, grief connected to losses from chronic pain is not always recognized. There are no ceremonies to formally acknowledge your emotional reaction to having more physical pain, being less carefree, or having a restricted diet and lifestyle. There is no bereavement leave to allow adjustment in being less able to carry out everyday tasks. To top it off, there is still a myth that chronic pain is not even real pain – 'It's all in your head.'
Those living with chronic pain may not recognize that many thoughts, feelings and actions are part of the grieving process. They may not have words to help others understand and respond helpfully. They lack a map of how to let go of unrealistic hope and move forward to a life that can still offer optimism, contentment and meaning.
Without realizing it, they may resist the reality that life will likely never be the way it once was. They may unintentionally work against the treatment plan that should be a source of realistic hope. To complicate matters, there is often a very real dilemma in accepting a changed role in life. Fears accompany such change – of disappointing others, of being vulnerable, or being seen as lazy and needy.
However, accepting this hard reality can help you take control of pain instead of letting pain control you. It is the first step in moving forward with realistic hope for meaning and contentment in life. Certain actions can help you move along this path. The following techniques allow you to let go and move forward with hope.