Surprising Argument Over Chronic Pain Resiliency Erupts

Surprising Argument Over Chronic Pain Resiliency Erupts

Being resilient to fight chronic pain seems like a fairly gentle topic. A story on it earlier this month set off a debate among our readers on the National Pain Report website and our Facebook page that is worthy of follow up.

Afton L. Hassett, Psy.D.

Afton L. Hassett, Psy.D.

The story quoted a Michigan psychologist, Afton Hassett, Psy.D. who told the 8th annual Women in Pain Conference in Los Angeles a number of ways that positive emotions can help people fight their chronic pain.

Her message was quite simple–resilient exercises aren’t going to make your pain go away, but they can increase the quality of life.

“When you feel happier, you do more and it puts you on an upward spiral.”

A number of readers saw the story and were dubious.

On Facebook, Priscilla Reese wrote: “How can life be enjoyed while you’re in continuous pain? It’s not considered living a full life.

In the comment section on the National Pain Report site, a woman identifying herself as Patti shared,  “This is the kind of thinking that’s the undoing of the treatment of chronic pain. You’re just not “resilient” enough so therefore your pain must have an emotional cause; here, take these dangerous antidepressants.

A woman named Misti reacted even more negatively: “Doctors who want us to channel our good thoughts are not sharing our pain, or have not worn our shoes or they would be advocating other doctors and the government to treat us as humans with legitimate issues of pain that should be treated correctly and enough of under treating us or not treating us at all.”

In a follow-up interview with Dr. Hassett in Michigan, she said she was surprised by the chasm that seems to exist between those embrace the resilience argument and those who see it negatively.

“Everyone is resilient. It is a matter of how we can build it,” she said. “It is not a substitute for medication or intervention, but there are some things that every person can do.”

One of our long-time readers is Michele Gillen Thompson who both suffers from chronic pain and formerly worked for a chronic pain company. She shared on Facebook her observations during a recent visit to her pain management office. It reflects the diversity in how people deal with their pain.

What amazes me is the differences in attitudes: the person with all the operations and broken bones was still optimistic and cheerful and making great strides towards recovery, while the CTS patient was nothing but “woe is me”. Attitude is EVERYTHING when it comes to pain management.”

Step one, she said, is to stop identifying yourself as a “chronic pain patient.”

“That’s giving the pain all the power.”

Terri A Lewis, PHD

Terri A Lewis, PHD

For Rehabilitation expert (and mother of a chronic pain patient), Terri Lewis, Ph.D., how you fight chronic pain is a process.

Persons who have chronic pain go through stages of grieving.  How they come out the other side has a lot to do with resilience.  Early in the process there is a clear notion that they have suffered great loss that they are not responsible for choosing, and may perceive  conversations about resilience as being told to ‘suck it up and get over it, get on with it..’  Understanding the context of grief and loss in relationship to resilience is important.”

Cynthia Toussaint founded For Grace, a non-profit that focuses on the unique issues facing women in pain. Her organization sponsored the Women in Pain Conference which focused on resiliency and where Dr. Hassett shared her thoughts.

What I’ve learned is that many people are unable to accept that their pain will most likely be with them for the rest of their life. They understandably want a magic pill to make the nightmare go away. They don’t want to think about having to manage or cope with their pain like exercising, positive thinking, healthy diet, building a support system – all of these practices are aspects of resilience over the long-term.”

Dr. Hassett knows that chronic pain sufferers often have to deal with feelings of isolation, hopelessness and helplessness.

What’s key, she believes, is a patient committing to it and try to identify something good that has happened each day.

“Everyone has bad days,” she said, “but little by little you can start to see good things happening which can put you on an upward spiral. It won’t cure your chronic pain, but it can help your manage it better.”

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Authored by: Ed Coghlan

There are 9 comments for this article
  1. Annette at 8:00 pm

    On the days when the pain is 11 of 10 and you cant even cry because it makes it worse and you literally crawl to the bathroom and you know tomorrow will be the same because you didn’t get the prescription the doc promised you there is nothing positive!

    Yes it’s important to think of what you can on the days that you can do something other than wish for a quick death, but the whole industry of thinking positive has done so much damage, esp for women. Basically you are told if you can’t handle it you are not trying enough, you are not doing enough and the underlying message is that you have only yourself to blame for not feeling better, not getting better, that you are just not a good enough person.

    It doesn’t matter how strong you are, sometimes medication is necessary but women are less likely to get proper pain management compared to men. “Because we all know women are weak and exaggerate”.

    The idea of positive thinking as a healer has brought health care back decades for women.
    The sad part is that it is not only medical personnel that have this attitude. Many women judge other women if the feel they are not positive enough or even being grateful for being sick and happy for the lesson it’s teaching them.

    I can take more pain today than I could 27 years ago when I became ill (resilience) but I need pain medication to be able to have happy moments. I suffer from not one but 5 illnesses known to cause extreme pain, the kind that makes you throw up and faint. Yet I was offered to be weaned of all my meds and learn to cope only with positive thinking. That was all the pain clinic could offer! That’s how strong the message of positive thinking has gotten. That you can think away the body’s physical response to pain.

    The stats say that patients who take the mindfulness course get less pain and a better life. But that’s only because no one that’s the least bit sceptical are allowed to take it. Of course you get good results if only the ones that to one hundred percent believes it will make them better get to take the course.

    Although newer studies have shown, five years on, that the patients have the same pain and still use the same amount of pain medication, even after the “think your pain away”-course. So it didn’t become the money saver they were sure to have found.

    Annette in Sweden

  2. David at 6:39 pm

    I think the resiliency issues reflects a need by professionals to see a silver lining in the negative accounts of being in pain provided by some pain sufferers. It think it can be offensive and insensitive, at times. Pain can, for some people, be quite oppressive- as if they are under siege-and many professionals may not have the training or emotional availability to accept people who are not as resilient as professionals wish them to be. It is not dissimilar to the issue of people in pain being labeled as “catastrophizers” by pain specialists.This label, from my point of view says more about professionals then it does the person in pain.
    So whether it is resilience or catastrophizing- I believe both terms reflect professionals difficulties with people in pain much more then the people in pain.

  3. Elle C. at 2:10 pm

    Patti & Pamela, I could not have said it better myself.

  4. Kamy at 5:40 am

    I feel that chronic pain patients can not be lumped into one group. What people and doctors need to realize is that each persons situation with chronic pain is different. And every aspect of there life is different. Of course pain patients that have been silently battling there excruciating pain with no support and criticism from the numerous doctors that did not believe that they were truly in pain, are going to have a very different outlook on the thought process of resiliency. Personally I do believe that to a point it makes sense that the happier a pain patient can try to make there daily life, the easier it makes getting up to fight another day.

  5. Patti at 12:34 pm

    Since you quoted part of my comment to Dr. Hassett, I feel it only fair to point out you missed my point entirely, and that point is that the very people who could, with a kind word or a bit of encouragement, bolster our faltering resilience are instead “shaming” us and making us feel like criminals and addicts for taking pain medication! Besides what you quoted, I also said,

    “I saw a new person the other day at my neurologist’s office. She listened to me, did an actual physical exam, came up with some creative solutions and even got me to agree to a course of treatment I’m not crazy about because I didn’t want to disappoint her (a wheelchair; a new medication). Weirdly, I left in the best mood I’ve been in for a long time. The point is, a lot of us have run out of resilience. We can have it recharged easily enough, just a little validation and some empathy from the people charged with our health care. It takes the same amount of time as scowling at us and inferring we’re just not trying hard enough.”

    The other day you posted a comment by a man who summed up by saying everyone who wasn’t him should just “quit whining.” You declined to post my response to that, as I’m sure you’ll decline to post this. I’m beginning to wonder just what your agenda is.

    Oh — one more thing. You also skipped the part about me being newly wheelchair bound. Do you suppose I should be joyously happy about that? Probably in time I will be happy about it, because I’ll have more freedom. But right now I just see the final and total loss of my legs. Does that make me a negative person? Because I’ve been that person in the waiting room cracking jokes and being cheerful too – when I wasn’t completely overwhelmed by pain. How can anyone make such generalizations from observations in a waiting room? Does she understand that the cheery people with “all the broken bones” are going to get better? I have a spinal cord injury, and every single time it gets manageable for a short time, it gets worse.

    I found this site and rejoiced in the opportunity to read new developments in pain management, spinal injuries, and – very importantly to me – interact, contribute. But you purposely misquoted me, misconstrued what I was saying, inferred I was “negative.” You have a real opportunity to do something good here. People will embrace positive thinking, but first you have to get through their front door, and that requires showing that you understand what they are going through is real. And just assume, for starters, that many have cycled through just about every “cure,” positive thinking included.

  6. Kristine at 11:21 am

    Pamela, I am in your position too and have been for 32 years. I completely agree with what you wrote.

  7. LouisVA at 10:59 am

    I do not disagree that positive thinking can be of some help. Getting your mind off pain by doing other activities can help. So can a placebo. This type of thinking; however, leads many pain patients to believe they are not strong and increases their feelings of hopelessness. We are all different in our reactions.

  8. Pamela at 8:47 am

    I have been “CRPS” patient since 2007 after much research on my own, not with a doctor helping me I found out the horrible truth that I was going to have this for the rest of my life. I also believe that someday this horrible illness will eventually kill me! Only because there is just not enough research! I wake up every day with a positive attitude I goto the dr”s with some sort of hope and positivity that maybe something has changed this month. I read article after article on ways to help my pain rather then hinder. I have books on the Tapping Method, The Chronic Pain Workbook, etc…and these solutions are all well and good and maybe that is my resilience but it’s not enough! Why you because this illness robs you of everyday things that people take for granted. I can’t have anyone touch me not that I don’t want to be touched my illness prevents it I have such burning when I give hugs or get hugs the pain is no longer worth the feeling anymore. I am 46 and have to use a walker right now which just shreds my complexion of who I once used to be and no longer am to my friends that no longer come around. When you see me on the other hand I always have a smile on my face that’s because I try to forget what this illness is doing to me. I goto the hospital now weekly because of this illness, I have no friends because of this illness, I can no longer care for myself because of this illness. Resience you may think helps your mind and body not think about the pain but I tend to think not. I agree if you walked in our shoes may just maybe you might understand only because there is so many different layers to this illness! Just like in the grief process.