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!

How to Self-Esteem & Self-Worth Effect My Chronic Illness?

Back when I was first diagnosed with an autoimmune disease, I noticed that my own self-esteem dropped. The person I was in a relationship with at the time didn’t help that, but then again, it wasn’t really up to her to help it. The disability I had from my illness was also very intense at the time. I missed a lot of work, I couldn’t go on long walks, I felt a lot of pain, and that all definitely hurt my self-esteem and self-worth. And that’s where my story ends…

That was then (June 2016).

Just kidding, if you’re reading this then you know that is not where my story ends! Actually, it’s where it begins. I was reading something a few weeks ago about self-esteem and chronic illness, just a brief paragraph, and it got me interested in doing a little more research on the topic, because, well, I noticed a correlation between my own self-esteem and self-worth and disability in my illness. I can’t be the only one, right? First of all, let’s define self-esteem and self-worth so we are all on the same page.
Self-esteem: our individual universal positive and/or negative feelings about ourselves.
Self-worth: basically another word for self-esteem.
In general, self-esteem effects our quality of life, which includes our overall life satisfaction as well as how much positive and negative affect (emotion) we experience.

On the journey (June 2017).

When we are looking at chronic illness, there are some important considerations. First, how we evaluate and view our own bodies is important, often because of the changes our bodies go through because of illness (and/or medications we have to take). Having a perception of body-self unity and positive thoughts about our illness can improve self-esteem (we’ll get to how to do this in a minute). Second, acceptance of disability is related to self-esteem in people who have disabilities (chronic illness is a disability). Acceptance doesn’t just include accepting the diagnosis, but acceptance all that comes with it (pain, lifestyle changes, loss, etc.). The better we are at accepting… the more we are able to do? (Well, yes, but that would actually be another post, so back to the main topic)…

It continues (June 2018).

People tend to use different coping strategies when dealing with illness. Though none of these strategies should be categorized as “positive” or “negative” I prefer to think of them as “toward moves” (helping me live a good life) or “away moves” (taking me away from the good life). Away moves would include things like catastrophizing, which has been linked to pain-related disability (yes, it makes your pain worse), higher levels of depression, and overall lower health and well-being. Other away moves include avoidance strategies, like using drugs or alcohol to cope, denial of illness, or staying in bed all day everyday. If you do these things, understand that no one is judging. These are probably natural coping strategies for you as they are for many, many people. However, if we want to improve self-esteem (and thereby improve quality of life with our illness) we want to look at toward moves.

I can even see the change in these pictures, can you? (June 2019)

These toward moves coping strategies include hope (goal-directed energy plus planning to meet goals), humour (reframing distress), psychological appraisals (meaning of the stressor, ability to cope, and emotion-focused coping, such as seeking support), and approach behaviours such as seeking social support and positively reframing the situation (yes, the research supports mindset). These are all associated with better well-being, better mental health, and better illness outcomes. This all comes from the cognitive adaptation to chronic illness theory, which in addition to self-esteem, looks at making meaning of illness, and regaining mastery.

Just last year (June 2020).

I think it’s important to assess which coping strategies you are using, and make changes if needed. If our self-esteem improves, and therefore our disability decreases, then our quality of life is also better. Sounds good to me! To finish my beginning story, I did a lot of personal development work, that led me to starting this blog, and along the way my self-esteem and self-worth drastically improved again, and my levels of disability have shrunk and shrunk and shrunk. My illness may not be cured, but my quality of life is so much better. This experience is also known as posttraumatic growth, which happens when positive change results from adversity, giving the individual better mental health.

I continue to use “toward moves” coping strategies to this day (June 2021).

New season of the podcast (totally revamped show!) coming June 28. Check out the trailer here.

Keep making the most of it!

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Mental Strength & Resilience for Spoonies

My mom actually suggested I do a post on mental strength and I thought about it for a bit because I find that it is very similar to resilience, which I’m fairly certain I’ve posted about before. However, I did some research and found that while there are similarities there are differences as well and to be honest, both are pretty essential when you’re a chronic illness warrior and can increase positive mental health. I’m going to give you an overview of each concept and how they tie together and some ways that can help you increase them (many of which I have personal experience with) so that we can all grow stronger together in our own separate battles.

It’s not easy to find strength in illness.

First, let’s define resilience. Resilience is our ability to respond positively and to adapt to negative, traumatic, and stressful events, in a way that is constructive. Now let’s define mental strength. Mental strength is our ability to effectively handle stressors and challenges in our lives the best we can despite the situation we find ourselves in. As you can see there are similarities, what I think the biggest difference in is that resilience occurs in the face of significantly impactful events such as trauma, whereas mental strength helps us with less significant (yet still impactful) stressors. We often hear of mental strength in regards to athletes and their ability to practice the same thing over and over. People who are mentally strong like adversity because it’s a challenge not a threat.

Kids are the most resilient of us all – me as a baby circa. 1986/87

The great thing is that both resilience and mental strength can be learned! According to the American Psychological Association (APA), the thoughts, and behaviours involved in resilience can be learned. They state that what makes up resilience includes:

  • your ability to make “realistic plans” and accomplish them
  • self-confidence and self-esteem
  • problem-solving and communication skills
  • emotion regulation

How does this apply to chronic illness? I see it as (1) making realistic plans is including limitations you do have because of your illness but not letting your illness limit you; (2) you can still have self-confidence and self-esteem with a chronic illness; (3) problem-solving and communication actually become more important when you have a chronic illness; and (4) emotion regulation is essential for everyone.

Everyone can build resilience and mental strength.

What are some ways we can build resilience? Let’s break each of these down further:

  • making realistic plans & accomplishing them: includes gaining skills (like going back to school or just learning something new in general); and taking action toward the goals you make for yourself while keeping a positive and hopeful outlook on your ability to accomplish them!
  • self-confidence and self-esteem: accepting change because nothing stays the same, including your illness; engaging in activities that help you learn more about yourself (try something new, be creative, get as active as you can, etc.); view yourself in a positive way (stop the negative self-talk and write down things you like about yourself); and of course, self-care!!!!
  • problem-solving and communication: setting goals for yourself; and making connections with friends, family and colleagues because support is important.
  • emotion regulation: controlled exposure (I would suggest with the help of a therapist); taking a realistic view of crisis situations (I like the phrase, “if that happened, then what would I do?”); and activities such as journaling, meditation and other spiritual practices can help with emotion regulation (I’ll probably do a longer post on emotion regulation at some other time).

So if that’s how we build resilience, what can we do to build mental strength? Turner (2017) states that the elements of mental strength include having a sense of control and purpose of your life and emotions; making a commitment by setting goals for yourself; challenging yourself when necessary; and having that self-confidence. Very similar to what we just talked about for resilience. I’ve got to say that I possess all of these, and I’m not sharing that to make anyone feel like they aren’t enough because they are currently not mentally strong. I’ve had times when I haven’t been strong, it takes a lot of work to get here. My point in sharing is that you can come from a place of anxiety and stress over your health condition and get to a point where you can deal with most things that come your way (I say most because no one can deal with everything perfectly). It just took me a few years of hard work to get here. Here are some ways you can develop your mental strength:

  • gratitude – write down 5 things every day that you are thankful for. I also recommend taking the free Science of Well-being course offered by Yale University. Here’s the link!
  • practice mindfulness – in whatever way you like. I prefer meditation and body scans, and throw in the occasional mindful walk.
  • act “as if” – this is an interesting concept developed by psychologist Alfred Adler. He stated we should act as if things are the way you want them to be (essentially you get to reauthor your life). This one is a bit more complicated and may also deserve its own post.
Image from the Science of Well-Being course.

Before I wrap up this very long post, I want to share research by Pickering & Holliday (2010). They stated that “mental strength contributes to resilience processes and resilient behaviour.” So basically develop your mental strength and you’ll develop your resilience. I mean as we’ve seen there is a lot of overlap between the two so it totally makes sense!

Also, from the Science of Well-Being and I thought it’s great to end on.

Let me know what you think of mental strength and resilience! Comment on the post or shoot me a DM on Instagram (@janeversuspain). I would love to hear from my readers! For now, keep making the most of it!