There is no despair so absolute as that which comes with the first moments of our first great sorrow, when we have not yet known what it is to have suffered and be healed, to have despaired and have recovered hope. –George Eliot
When was that moment when you buried your old body? When you set her aside and stopped wishing for the days—those normal glorious pain free days? How do we accept our new normal without losing hope? Is there a place inside us where we can come to terms with the chance that tomorrow may bring pain but also wonderful experiences? This is the dilemma of the chronic pain sufferer. We have to make plans for the future, live in the here and now; and, at the same time, face the uncertainty of what our body will feel like tomorrow, ten months from now, and ten years from now. Acceptance is a dynamic non-linear process and it involves both emotional and intellectual understanding. Acceptance does not mean retreat or a surrendering to pain nor does it occur all the time. There may be flares that we recognize as fleeting moments in time and at other moments we are so immersed in the pain flare that we question what the future holds as a result.
At the heart of coping with chronic pain and illness is the idea of grief. At times we grieve for our present and the unknown. What is grief? In their article “Making Room for Grief: Walking Backwards and Living Forward” Nancy J. Moules, Kari Simonson, Mark Prins, Paula Angus and Janice M. Bell (2004) discuss grief as a mutable experience that cannot be fully resolved but livable. “Livable” does not mean tolerated in this context but blossoming. Out of grief, there can be great hope for the future. It is a remaining part of life that transforms over time. The authors suggest that grief is a relationship with yourself—building channels through sorrow that blends acceptance, creativity, and clarity. Grief is the mark of the living and with this mark comes challenges and meaning making. I once had a conversation with an occupational therapist and he told me this story that I carry with me in times of great pain. He told me he has this friend who struggles with chronic pain and loss of mobility in his shoulders. This friend also loves to golf and one day they went golfing. They spent the whole day in the sun golfing and he asked his friend, “Aren’t you in pain?” His friend replied, “Yes, a great deal; but, I am so happy.” The occupational therapist told me that life involves happiness; and, sometimes, pain is merely our sunset.
So, the question remains that if we accept pain as a companion in our life does that bring a loss of hope or “giving up” on finding treatments that alleviate our symptoms. In the article, “Attempting to Solve the Problem of Pain: A Questionnaire Study in Acute and Chronic Pain Patients” authors Geert Crombez, Christopher Eccleston, Guido Van Hamme, Petra De Vlieger (2008) studied whether coping through finding a “cure” for chronic pain caused greater distress and catastrophic thinking than patients who do not view pain relief as their primary goal. They hypothesized that patients that cope with pain by searching for a “cure” experience greater distress and sensitivity to pain. Their findings were that there is no straightforward answer to whether catastrophic thinking about pain influences pain duration and coping. They also found that chronic pain patients attempt to resolve their pain to the same extent as acute sufferers and suggest that finding a “cure” for pain is a defining characteristic of being a patient with chronic pain. Could it be that these two styles of coping are fluid? Perhaps, a defining aspect of experiencing pain on long-term and routine basis is to live our lives with the hope and futuristic thinking of a non-pain sufferer, while at the same time, being an active participant in alleviating our suffering.
Living with chronic pain bears the mark of resiliency. It is not a psychological weakness but the ability to continually recover. What we recover is as open and as beautiful as we want it to be and to recognize that we fall back into that grief and that it is a piece of us—our sunset—is a part of our humanity and a place for growth and hope.
Tell me your story. How do you cope with chronic pain?