In Part 1 of this post, we looked into some of the tough parts of living with chronic pain – and some ways you can help yourself through it all.
We ended up talking about pacing as being a way of still being able to do the things that are important to you, without having to hurt yourself to do them.
Pacing is one of the core ideas of a pain management system (ADAPT) set up by the University of Sydney Pain Management and Research Centre.
Pacing can help overcome a couple of cycles that many people with chronic pain get locked in:
Pain > leads to rest and frustration > and when the pain eases again > you’re tempted to do way too much all of a sudden (because you finally can) > which takes you back to pain again.
When this cycle keeps happening, it can lead to another one, where:
Pain > leads to more and more rest over time > which gradually leads to a loss of muscle tone and flexibility > which itself can create more pain.
And though they might feel protective at the time, both of these cycles can be really unhelpful. They can make things harder than they need to be. So it’s important to stop them. And pacing can do exactly that.
For instance, pacing yourself to do some regular, really gentle exercise and stretching. Something that you can do even on the bad days. And sticking with it. Resisting the urge to “push it” too much, but gradually, gradually building your strength and flexibility over time. (And if you want to learn more about this approach, I’d highly recommend their book, “Manage Your Pain: Practical and Positive Ways of Adapting to Chronic Pain.“)
Another approach worth looking at is a thing called acceptance and commitment therapy (ACT). As its title suggests, acceptance is at the forefront here. So instead of resisting the pain or wishing it wasn’t there or painfully pining for a life that you may have had long ago, it encourages you to just be where you are now. And just accept what you can’t change about your pain.
And then ACT encourages you to take the actions you can take to bring vitality and light back into your life today wherever possible. To do what’s meaningful and possible to build a life that you love again – even with the pain. In that way, ACT is a bit like an embodied form of that well-known serenity prayer:
“… grant me the serenity
to accept the things I cannot change;
the courage to change the things I can;
and the wisdom to know the difference.”
Some of those qualities – courage and wisdom and serenity and acceptance – can also be enhanced through another powerful technique in pain management: mindfulness meditation.
Mindfulness meditation is profoundly simple. And extraordinarily effective. In the western world, we’re only just beginning to cotton-on to it. Yet, already, there are astounding research results about its effectiveness in managing pain and supporting you through illness.
Jon Kabat-Zinn has done some incredible work integrating mindfulness mediation into mainstream medicine in collaboration with clinics and hospitals – because it works. And he has a great mindfulness meditation CD for living with pain.
But you don’t need a CD to get into mindfulness. You just need you. You – here – now. Coming to really focus and remember to be present in this moment right here. This one.
Even in pain. Even in frustration. Even in the hard times you’ll face.
Just remembering to come back to yourself. Again and again. And perhaps finding a counter-intuitive sense of curiosity about the pain – what does it actually feel like?
You might have spent such a long time resisting it, that the idea of deliberately walking into the pain might seem a bit mad. But it can be a really liberating tool… So maybe just see what that’s like for you.
And speaking of what the pain’s actually like for you, there’s a helpful new phone app that can help you track that. So you can keep tabs on all the related factors and perhaps get to know the pain’s rhythms better, and find out what seems to be helping or hindering things. It’s called Chronica and it’ll let you track your pain’s intensity as well as any other related elements you’d like to record (like maybe sleeping patterns, or nutrition, or activity, or medications, or mood).
I, personally, live with a level of chronic pain, and I’ve found some of these techniques really helpful.
- To look at thoughts.
- To look at actions.
- To start pacing.
- To try and accept what I can about all of this.
- And to be mindfully present to one moment at a time whenever I can manage it.
And one of the most soothing things I found I could do early on is to remind myself that I still have choice. That if I’m not doing something, then it’s because I choose not to. Yes, I have pain. But it’s me that decides how I want to be in light of that, not the pain. It’s not that I “can’t” do something, but that I’d rather not right now, thanks. Just that one simple re-frame brought huge relief (and still does).
So even though your pain may not abate, even though it may travel with you for the rest of your life, you still get to decide where you want to go with it.
You still have a say.
You still get to build beauty and meaning and purpose into your life. And, with a few of these tried and true techniques, maybe you can go places you thought were no longer possible for you.
May you travel well…