My Ultimate Pain Coping Skills Part 4: Connection

Welcome to the fourth part of my 4-part series on coping skills for chronic pain! Of course, there are way more than these ones out there. The reasons I’ve been focusing on these is because I have personally used them, and there is a ton of research supporting them. This week we’re talking about connection. By connection, I mean social connection – spending time with others. I know this is a tough one for many warriors for a variety of reasons. Many of you may not have a good support network, you may have pulled away from friends or had friends pull away from you because of your pain. You may not be close with your family or they may not understand. This happens to a lot of people with chronic pain and illness. It is important for us to find ways to connect with others, so let’s talk about why that is.

I find it important and helpful to connect socially with my friends, even if I don’t see all of them often.

There is a surprising amount of research in this area. I did a search on Google Scholar and got a lot of results. One area the research has focused on is the actual neural pathways in our brains and there seems to be a connected between physical pain and social pain. What I take from this is that when we experience emotional pain – such as through the loss of social connections – our physical pain gets worse. I’ve touched in previous posts about the connections between physical and emotional pain (mind-body) and how that works. You can also listen to this podcast episode. Other research has found that people with chronic pain tend to perceive others as being hostile toward them. Because it’s perception it’s hard to determine if the others are actually being hostile, but this could be another reason for the increased physical pain when there is “social” pain.

Sometimes pain can make us want to bail on social outings, and yet having that connection can actually decrease our pain.

Okay so if that explains the connection between our minds and bodies in general, what are some of the things social connection does for us that are helpful?

  • Improves our self-esteem and self-confident
  • Increases our sense of control and empowerment
  • Improves our emotional wellbeing.
  • Decreases anxiety and improve mood
  • Changes our pain perception
  • Improves coping skills
I’m lucky to have great support systems, but sometimes we can look outside the box to find social conections.

How that we’ve settled what it does for us, what are some of the actions we can take? How do I get more socially connected when I have pain and illness and all the struggles that come with it?

  • Cognitive reframing, emotional expression, problem-solving, and distancing oneself from pain – this is literally what I work with clients on in therapy, and there are studies that show it increases satisfaction with your support systems, whether those are friends, family or your healthcare team.
  • Accessing pain resources – we’ve all heard the phrase, “knowledge is power” and even by just reading this blog, you may feel more socially connected with others, like myself, who experience pain.
  • Online support groups – even if you can’t find an in-person support group, having an online community is often very helpful for people. I’ve done a post on the pros and cons of these, but in general, if this is the only way you can socially connect with others, it can be enough.
  • Volunteering – if you are physically capable of doing any kind of volunteer work, I highly recommend it. There has been so much research showing that volunteering is good for all humans as it actually increases our happiness because we are helping others. And of course, we are interacting with others too!
  • Lovingkindness Meditation – the idea of this meditation is that we send out kindness to others, as well as ourselves. The others include people we care about, neutral people, people we don’t like, and all of humanity. Some of the benefits include stress reduction, being more compassionate, and better perspective-taking. You can find a version of this here.

I hope this helps you on your journey to be more socially connected and that it helps with your pain tolerance. Keep making the most of it everyone!

My Ultimate Pain Coping Skills Part 3: Compassionate Self-Talk

If you’re just tuning in this week, we’re halfway through a 4-part series on some of my favourite pain coping skills. Why are they my favourites? Well, for one, they all have worked for me so direct experience is useful. Two, they are all evidence-based – there has been scientific research on them (and yes, I’m nerdy enough to spend the time reading the articles published in scientific journals). Third, I see them work with my clients in my counselling practice. And as such, I thought it was about time I shared them all with you. This week we’re talking about self-talk and changing that from the harsh inner critic to something a lot more compassionate.

Compassionate self-touch is also helpful.

Recently I wrote a post about being kinder to ourselves, which seems to be quite popular, so we can think of this as an extension of that. Most people have a harsh inner critic, or voice in their heads, telling them that they aren’t good enough, or shouldn’t have done this or that, etc. The voice is there for evolutionary purposes (see the video below on the caveman mind) but it unfortunately isn’t too helpful in our modern world. When we have chronic pain, the voice often shows up as “you’ll never be able to do anything again,” “this is what your life is now,” “no one will ever love you if you’re like this,” etc. Sound familiar? If it does, know that you’re not alone. This is extremely common. But what if we could combat this voice somehow?

Dr. Russ Harris is my hero.

The great thing is, we can learn to respond to it with a compassionate voice. No, that inner critic voice probably won’t just go away (remember, we evolved to have it). But we can learn to respond to it differently. We don’t have to just listen to it, give into it, get hooked by it. This takes some practice though.

We can definitely learn something about compassion from our animals.

I recently went through the Mindful Self-Compassion Workbook by Kristin Neff and Christopher Germer. In it there is an exercise on developing your compassionate voice. You are supported to think about a behaviour you’re struggling with. Then notice what your inner critic is saying. So example, with chronic pain this might be getting up to go for a walk or clean the house, etc. Your inner critic might be saying “you’re never going to be able to do these things again.” Then you are to try out a few self-compassionate phrases. Such as “I am here for you, and will take care of you.” or “I know you are suffering. I love you.” And so on. It should be something you really need to hear. Then when that critical voice appears, we can use our new phrases to respond to it.

You can purchase this on Amazon.

What does this do for us? Well for one, it greatly improves our mood. The relationship between low mood and chronic pain has well been documented (low mood creates more pain, more pain creates lower mood). So by improving our mood, we may actually have less pain (I find this is very true for me). It is also more motivating to respond this way. Yes, it may be hard to engage in the behaviour, but by being here for yourself, supporting yourself, you may be able to take some steps (however small) toward doing that behaviour.

I hope this helps with your chronic pain coping. As always, keep making the most of it!

My Ultimate Pain Coping Skills Part 1: Self-Monitoring

I decided to do a 4-part series on some of my favourite pain coping skills. They are all either my favourites because I have found them to be particularly useful for me, or that reason plus I have seen them be useful for other people. I will also add that I always double check to see if there is any scholarly literature on the subjects I write about, and there definitely is for all of these coping skills. So, without further ado, lets start off with self-monitoring.

What is self-monitoring?

You might be asking, what is self-monitoring? It is a part of our awareness (executive functioning in the brain) that we all have, that tracks our behaviours and the impacts they have on us and our environment so that we can alter our behaviour in the future if we choose to. We all use this pretty often. For example, adjusting to social norms would be using self-monitoring. So would reviewing your work for mistakes (because ideally you won’t want to make the same ones in the future). We can break self-monitoring down into two types. Qualitative – or what I’ll call subjective monitoring – which is how our emotions, sensations and behaviours change throughout the day and during different situations. Then there is quantitative – or what I’ll call objective monitoring – which is the frequency, duration, and difficulty of our behaviours.

What the heck does this have to do with chronic pain? Sometimes people with pain over-self-monitor in that we overthink our pain and our behaviours which is typically not helpful (I’ll get to that in a minute). When done properly, self-monitoring can be used to help us accept our emotions and sensation, create some distance between us and our thoughts about pain, and get us to do behaviours/actions/set goals/whatever you want to call it, that will improve our lives or just in general fulfill us! And this is what I see is often difficult for chronic pain warriors. For example, if I notice that a certain activity causes me more pain than normal, I would mentally note that as well as the frequency, duration and difficulty of the activity so that I can make adjustments in the future (i.e., not to the activity, do the activity for less time, do the activity less – or more, depending on the situation – often, or do a similar activity that is less difficult). A few years ago I did a pole dancing class. Super fun and a great workout. However, I did notice that my hip pain increased, especially after the class was over. I decided that while though it was fun, the friend I went with and I have lots of other activities we can do together and I exercise in other ways, that maybe this wasn’t the workout for me. I adjusted. Another example is hiking. I know how long a hike I can do (about 75-90 minutes max.) before I have expended too much energy and/or crossed my pain threshold. What does that mean? I still hike because I LOVE hiking, but I do it for 90 minutes or less, followed by rest.

I knew how much hiking I could handle on my Costa Rica trip.

Earlier I mentioned that when we over-self-monitor we often do things that aren’t helpful. This also happens when we don’t self-monitor our pain at all. Let’s tie it into that pain cycle I wrote about a few weeks back. In the pain cycle we see that being less active leads to a loss of fitness, weak muscles, and joint stiffness. If you self-monitor and notice that if you lay on the couch all day this happens but if you go for a (short) walk it doesn’t lead to these specific symptoms, that might lead you to do the walking. Pain cycle again says that then we create lists of “no go” things we cannot do, and this leads to sleep problems, tiredness, and fatigue, which also leads to stress, fear, anxiety, anger, and frustration. Okay, so doing less isn’t necessarily helpful even though our brains say it will be. We can also skip ahead in the cycle and go to negative thinking and fear of the future and how that leads to depression and mood swings. Monitoring our thoughts is helpful at this stage. And then there is time off work, which inevitably causes money worries and often ties into relationship concerns. And then everything leads back to more chronic pain. I want to point out with the activity portions of the above paragraph, that pacing is essential and I did a whole post on that a few weeks ago.

What can we do to start self-monitoring in an effective way? First thing is to keep track of your pain. This can be mentally, but if you have brain fog or just tend to forget it can be more effective to write it down in a journal. There’s a few ways you can track it. Just a general 1-10 score for the day and a list of what you did during the day. Or, if you want to be more effective with your activities, you could write a score before and after each activity you did to track changes. That will also tell you when there was no to little change so you know if you can keep doing the activity the same way, for the same amount of time. The other important thing to track in the journal can be other triggers to pain. For this one, I would suggest tracking emotional pain (sadness, anxiety, anger, etc.) as much as physical pain. Why? The body-mind connection. Often the more depressed we are, the more pain we have (and vice versa). Same with anxiety. It’s easier to make adjustments when we know what’s going on.

Find a way to track your pain AND activities AND emotions.
Image from: https://www.templateroller.com/template/39579/pain-tracker-form.html

Okay, longer post than I anticipated but I hope that it’s helpful for all of you warriors! Keep on making the most of it!