How has pain been a complex problem in your life? How has pain interacted with your movement, energy, sleep, social life, finances, identity, memory, and mood?

Mastering Pain Institute

After listening to and reading the materials in the 1st leasson of the Pain Mastery Class it asks the student to answer the above questions.

Movement

How has pain interacted with my movement? As pain from various causes has increased over the past few years I have observed that my ability and willingness to move has undergone an uncomfortable metamorphosis. Simple tasks like walking, bending over, picking up items, getting dressed, doing my toe nails, making the bed… etc. have all become much more difficult.

Neuropathic pain has combined with arthritis to make steering the car for long periods increasingly painful. I alternate from my left to my right hand constantly as I drive, because the pain builds up in each as it is used. Eventually the pain is too great in both hands and I have to take a break. The pain in my legs and feet make driving hard as well, and certainly limited my pleasure from doing so. Driving a car is one of my great pleasures, or, it used to be one of my great pleasures and it represented a kind of freedom that is now gradually disappearing from my life.

The same can be said for a lot of routine physical tasks, all the way from making the bed to cleaning the mirrors in my bathroom. I didn’t used to mind housework or gardening but it is now so painful to mow the lawn that I’d rather let it grow twice as long as I used to. These type of restrictions have inevitably reduced my freedom of movement, and my interest in and willingness to do routine, simple life tasks.

How has pain affected my energy? Anybody who suffers from chronic pain will attest to the fact that constant, unrelenting pain is exhausting. There is almost no time when I’m not tired and so sore I feel like I really just want to lay down and sleep for a while. Even a nap would seem like a relief, if I can sleep, that is.

The net available energy is a function of pain in my body. The more severe the pain becomes, the less energy I have. And not only to do life in general, but in having the interest and energy to participate in the things of life. A lack of energy is behind so many other deficits experience by people with chronic pain that it tends to blind us to how serious it actually is. Without sufficient energy to function properly nothing actually works the way it is supposed to work. How the hell am I supposed to do my job at work, when I hardly have enough energy to get there in the first place every day?

How does pain affect my sleep? To most of us with chronic pain sleep is seldom deep or really very restful. Not a single night of sleep goes by without being disrupted, again and again by waking fully or partially because of pain in the body. For me it is all sorts of different parts of the body and different types of pain, but it all hurts, and it all makes me awaken at some point during sleep. If I wonder why I’m so damned tired all the time, I simply have to remind myself that I really haven’t had a decent night’s sleep in years.

I’ve been diagnosed with sleep apnea, but sleep apnea really isn’t the reason I’m awake half the night. It’s the pain, the pain. Snoring is a part of it. Blocked airways aggravates it. But pain causes sleep interruption, over and over again, every single time I go to sleep.

How does pain affect my social life? What social life? Who really has the energy to maintain a social group or friendships when you’re in constant pain? It takes energy I don’t have and mobility that is a constant struggle, simply to get out and visit with people. I’m no longer the happy go lucky guy I used to be. I try not to spread my pain around, or make my kids and grandkids suffer from my experience of pain. But I wonder if my increasing isolation from them is at least partly because I do longer know how to overcome my pain for long enough to actually properly engage with people.

And being socially isolated also increases my experience of pain, because lacking real human contact with others is not only uncomfortable, but it’s also actually harmful physically because it encourages inactivity and passiveness. Instead of getting out and doing things with the people I love, I stay at home, watching television, at least partly because it’s less painful than the alternatives of getting out of the house, and doing the things necessary to have a life.

How does being in pain affect my finances? This is one of the things that is most humiliating about being in pain. Instead of being vibrant and capable, I’m tentative and withdrawing from challenges. I used to love going to the office and taking on new challenges, meeting new people, creating new financial opportunities for myself, and for my staff. Now I have no staff, and I’ve been afraid for years of taking on jobs that I know I’m qualified to do because I’m afraid that I’m going to let them down, or worse, prove myself to be incapable of handling the physical and emotional demands of the work.

In addition, my increasing health problems cost a lot of money, which I am now having to pay with a lot less income, due to my reduced employment capabilities. I struggle to manage my prescription deductibles and copays. And that’s for the prescriptions, which doesn’t actually include any pain medications I can trust. Nothing the doctor has prescribed for pain has actually helped very much, if at all. I know that opioids would be more effective than OTC drugs but I also know that they are highly addictive, and have major other problems that I don’t need to add to my pain.

And being chronically short of money, as well as in pain, means that I can’t take advantage of one of the things I used to do a lot, which was going out to nice restaurants and have good meals with friends. Shortage of money means that I’m socially isolated by it, as well as by my resentment over finding myself in this situation. I never wanted to be dependant on anyone else but I find myself in a situation that make this every more a fact of life.

How does pain affect my sense of identity? Truthfully, I don’t really recognise myself any more. I no longer feel like the man I used to be, and I certainly don’t have the confidence I have always had. I’ve always thought of myself as a highly charged, somewhat hyperactive and oversexed Type A personality. If I had faults they were likely the faults of thinking that I could do anything, be anybody, accomplish anything. A little bit of humility probably wasn’t a bad thing for me to learn, but pain has driven me to distraction. The amount and persistence of pain has now reached proportions that are disabling my sense of self to a point of no return. I don’t actually know what it would look like for me to be me, the way I have always been. So damage to my sense of identity is a real cost of being a victim of chronic pain.

How does pain affect my memory? My partner says that I’ve become a lot more forgetful than previously. I’m not sharp anymore, and I don’t automatically pick up on things so quickly. I don’t think I’ve lost my marbles, but I get confused more easily and mix things up, despite my best efforts to not do so. It means I slow down, because I can no longer count on my memory for important information. I’m a lot more cautious than I used to be, if for no other reason than I hate being unable to remember even the simplest facts or common words.

I’ve always been a prodigious reader, at one point reading more than a book a day, not to mention newspaper and magazines. Now it takes me a week to read a novel, and a month to work through a non-fiction title, no matter how interested I am in the subject. I don’t remember names very well, I never did, but I’m also losing the ability to remember what books I’ve read or which ones I liked or didn’t like. I find myself half way through the first chapter of novels only to realize that I read the damned thing six month ago. So yes, memory is being affected negatively, if only because I’m so distracted by the constant pain interrupting the flow of my thoughts and feelings.

How does pain affect my mood? I was diagnosed as being bipolar when I was about thirty years old, after a major breakdown and depression. After being hospitalized for six months I came out of the hospital with somewhat better emotional management tools than I had previously. Relatively quickly I abandoned the prescriptions for bipolar I had been given, because they made me feel like I was living in a fog. And I reconciled myself to living with vivid emotional ups and downs. So depression and mania have long been a part of my nature, and my life. I’ve done well in managing to live a full life despite these problems, but now it feels like depression stalk me, without the accompanying manio to provide any balance to it.

There are two kinds of depression with which I struggle, one of which is a direct result of serious and chronic pain. It’s tough to get out of being depressed when you feel like you’re under a constant pressure cooker caused by physical and mental pain. This past weekend, in addition to chronic neuropathic pain in my hands and feet, arthritic pain in my shoulders, fingers, hands, I was also slayed by a serious migraine headache. I haven’t suffered from migraines on a regular basis for years, ever since I started practicing a form of self-hypnosis that seemed to be effective at shortening their duration, and eventually led me to being able to predict and prevent the worst of them.

Even that ability seems to be beyond my control these days, because it’s pretty hard to meditate when I’m in so much pain that I can hardly sit still.

I don’t know if this exercise in counting the ways that pain affects me is supposed to make me feel better, but it hasn’t yet. I also suppose that to defeat an enemy I first have to understand the enemy and all the territory it has staked out in my life. This is the exercise from Chapter 1 in my program to begin to manage my pain. I hope the next exercises don’t leave me here.