Champagne for my real friends and real pain for my sham friends. Tom Waits
What is real pain?
I guess we live in a lucky time in history, one in which pain relief has saved us from the true grim nature of suffering from things such as tooth decay, dying a horrible slow tortuous death or unassisted child birth. It is so much harder therefore to endure pain at any level now our expectations are higher than ever and pain is not something we expect to have or endure.
Three things that make our pain harder to bear:
- If we rail against it
- When we worry about the meaning of it
- How we allow it to dictate our behaviours
Pain is there for a reason so it is vitally important to understand what the message is. For example the pain of burning is there to tell us to take our hand out of the fire, however once we understand our pain and know that we will attend to the message if we need to, how do we move on with it and live a full and engaged life even though it is there?
Three things to try as experiments
1. Schedule daily activities to pace yourself
Many people who experience chronic pain wait for a ‘good day’ and then go for it doing jobs or activities until they are worn out and have to take days off to get over it. Experiment with pacing through a realistic schedule of things you would be able to accomplish each day. Make sure you include pleasurable activities not just difficult jobs. Keep it very realistic and maybe to start with scheduling far fewer things than you might normally attempt. You can adjust it based on the results of the experiment.
Write out your schedule the evening before and record the results in the evening. Rate how tired/in pain you are on a rating scale eg 1-8.
2. Be mindful
Mindfulness enables us to become observers of our own experience. So when we are inside our body looking out of our eyes we experience pain/emotion/feelings fully. As such when we are mindful we are able to observe ourselves.
Sit / stand / lie quietly and imagine yourself drifting out of your body and looking at yourself, now start to observe the pain as someone who is looking in rather than someone inside of your body. Notice the sensations, name them, see how they change. Do they ebb and flow? Are they constant? How would you describe the pain.Now observe other things around you. Try to observe any sounds in your environment and focus on them for a few moments. How many sounds can you notice at once?
By practicing this each day you will become better at switching your attention and not focusing solely on one thing. When we focus on one thing it grows in our conscious awareness so if you focus on an external sensation (sound/heat etc) then your attention will be focused away from your pain.
3. Become aware of the meanings to attribute to your pain
Meaning is everything in CBT. You may like to do the experiment of exploring what your pain means to you. It will be different for each person so you cant guess what another person’s pain means to them.
- I will never be able to live a good life because I am in pain
- I am old and useless
- I really went for it in the gym and am building muscles
- People are judging me
These are beliefs not universal truths, just like someone who believes that the earth is flat, your beliefs may not be true or only partly true. Just like the flat earth we need to provide evidence that the belief is incorrect. Maybe you are avoiding doing things or interacting and this is helping to confirm that your belief if true. Are there any steps you could take to disconfirm your belief? What things are you doing or not doing that confirm your belief?