Pain is an incredibly personal experience and when we discuss our own pain problems we have to remember to hold off on judging ourselves against anyone else's pain experiences. Our own pain problems come from our own expectations, our thoughts when pain occurs, our feelings linked to pain and our early experiences of pain. Here is an illustration of pain as I know it and this image resonated with me when I saw it. The pain flares red, it shocks, it strikes, it tenses, it upsets and it stops the person in their tracks. However, our attitudes to pain come from many different places and can affect the way we handle our own pain.
Let's untangle this a little as we all approach pain differently. I will give examples of three fictional members of a fictional Pain Management group which I hope will explain more easily.
EXPECTATION: I always have pelvic pain. I am always in pain. If I move it hurts. If I stay still and rest I will prevent new pain
THOUGHTS: I'm fed up and nothing will help. My life is over.
FEELINGS: I'm anxious, sad and worried and depressed.
EARLY EXPERIENCES: I had to rest when I hurt myself and it always caused a huge fuss if I hurt myself. I was discouraged to take risks.
EXPECTATION: I have pelvic pain. I am usually in pain. I ignore it when I want to do something else. If I move I will loosen my tight muscles and nerves to prevent new pain.
THOUGHTS: I'm fed up. I need to fight this. I won't let the pain win.
FEELINGS: I'm sad that my life has changed. I want to go back to who I once was.
EARLY EXPERIENCES: I had to keep going until I couldn't do any more. I didn't let pain stop me.
EXPECTATION: I have pelvic pain. I am usually in pain. Activity increases pain so I have to decide when to do just it anyway regardless of the consequences, when to change the activity to fit the new me (such as use my chair or do less) and when to opt out.
THOUGHTS: I can take some risks. Some activity is a trade off and I'll have to rest afterwards.
FEELINGS: I worry about the pain I'll feel later.
EARLY EXPERIENCES: When I hurt myself, I either did activities differently or just did them later. No bug fuss made.
This session was a particularly difficult one as we were encouraged to open up and discuss our pain problems, our attitudes to our pain and our own early experiences of pain. As you can imagine, the ten members of the group all came from very different places. Everyone had different pain problems, different diagnoses, different feelings about pain and early experiences had formed quite concrete attitudes about what being in pain meant. Persons A, B and C may have different conditions and similar levels of pain but Person A is ruled by their pain while Person C is managing their pain more holistically.
It was then that the notion of compassion based therapy was introduced.