Danea Horn is an author who wrote a book called Chronic Resilience: 10 Sanity-Saving Strategies for Women Coping With the Stress of Illness. She speaks often about chronic pain and chronic illness in a way that is aimed to both sympathize and inspire. She spoke recently at the Women in Pain Conference in Los Angeles. Ms. Horn lives in Sacramento, California and recently was interviewed by the National Pain Report.
National Pain Report: We’ve seen several stories recently on chronic pain and resilience that have been surprisingly controversial. Some of our readers find the inspirational. Some find them insulting-thinking that it reinforces the ugly stereotype that people think pain is “all in your head”. What does that reaction tell you?
Danea Horn: There needs to be better communication between patients and the research community about the experience of living with pain. Intentions on both sides are pure: patients want to feel better and researchers want find strategies to help them. The results of the research are valid: resilience does improve patient outcomes, but creating resilience is not about changing thoughts. Pain is real and biological. Being in pain is like running a $%*(# marathon. Negative thinking, frustration and anger are all natural reactions to being in pain. No one should be made to feel guilty for being pissed that they are in pain - it just causes more unnecessary stress.
The huge emphasis we place on controlling our thoughts toward the positive is a big pet peeve of mine. Positive thoughts are great, but it is almost impossible to control our thoughts consistently, especially when you’re running the pain marathon. I’m not sure where ‘positive thinking’ got lumped together with resilience, but I think we need to separate them again.
Resilience is a willingness to consistently take action in your situation. To get to that place, you need to decide that you are going to take ownership of your health. You didn’t cause your pain, but you are going to manage it as best that you can. Being in pain feels 100% out of control - and humans hate not having control in their lives.
National Pain Report: Many pain professionals think that the government emphasis on opioids and their addictive qualities has blurred the line between appropriate use to manage the pain and inappropriate use leading to addiction and is actually hurting pain sufferers. What do you think?
Danea Horn: This is a tricky double edged sword. Professionals don’t want to see their patients in pain - and patients don’t want to be in pain, but the prescription solution has increased the incidence of opioid dependence. I do think that out of concern for people that struggle with opioid dependence, pain sufferers who appropriately use the medication have had their care made more difficult. No one who isn’t an addict wants to be made to feel like one because they get a prescription pain medication, a situation many patients find themselves in.
The solution is complex and involves better recognition of addictive (and non-addictive) behaviors, improved care for people who struggle with opioid addiction, more pain management options and closer doctor-patient relationships where communication and concerns are openly addressed so that pain can be better managed.
I would love to see the default reaction to a patient who uses an opioid medication change from the ‘addict’ or even ‘potential addict’ label, which drips with suspicion, to seeing the patient as a human being who has very real pain. Shifting this viewpoint would improve partnerships between patients and doctors toward the common goal of improving pain management while minimizing risk of dependence.
National Pain Report: You are a gifted speaker and your book received good response. What are your own plans? Is there another book coming from you? What else will you be doing in the public sphere?
Danea Horn: Writing Chronic Resilience was very personal experience. I put everything I had into that book: stories, tears, reflections, embarrassments & insights. Before the next book, I feel like I need some more life experience. I’m currently working on a post-graduate degree in economics with an emphasis on health. I have a lot of curiosity around the health systems & policies that guide our national care. I have a feeling my next project will be related to how we can improve patient care from a broader economic perspective.
Editor’s Note: More of our interview with Ms. Horn will be published later this month.