Acceptance..it’s a funny thing and definitely the hardest thing I did when I was diagnosed with CRPS. When I say acceptance I don’t mean accept that your condition is permanent and you just have to live with it, I mean accepting it and trying to move on and see the silver lining. I know this may sounds impossible to many spoonies and chronic pain sufferer’s out there and at first it was for me too. For more information about the mechanisms behind pain and chronic pain in general check out my other blog posts.
I was 18 and meant to be fit, healthy and I didn’t even look sick but I was in terrible pain. I am sure if you have ever been in pain especially for a long time the question of “Why is this happening to me?” pops into your head!! Once I started to understand how the symptoms were being caused and that doing certain things wouldn’t actually make it worse, I slowly saw improvements. To read more about my story check out the About me page. I just thought this was me but there is actually a lot of research into this and how acceptance of your pain can actually lead to lower levels of pain, anxiety, depression, disability and more. (McCracken 2008) The importance of education in reducing chronic pain is also reflected in Rothbaum et 1982 stating that patients may need complete explanations or reasons for their pain so that they can move ahead toward understanding and acceptance.
There are generally two responses to chronic pain you either let the pain negatively affect you or you seek meaning and to fight and turn it into something positive and this is echoed in Ferguson et (2004). I’m going to be honest here originally I negatively let it affect me, I honestly hated my leg and thought it was useless. I certainly couldn’t see myself running or being active again at all or being where I am toddy. However, it got to a point maybe it was circumstance or just being told that I couldn’t do it another time for various things from my degree to learning to drive but it was like a light bulb, I decided to fight. There is actually a term for this its called acceptance with resilience. Now I wouldn’t be without my CRPS diagnosis it is who I am and I don’t let it affect me, it has taken over 4 years but still. Furthermore it has been proven that accepting your pain in general will have a positive effect to the pain experience including a reduction in pain as well as having positive effect on other aspects of life including social, and work life. (Boer et al 2014)
This got me thinking so here is some more the research and science to my chronic pain experience and the effect “acceptance with resilience”.
The official definition is an exaggerated negative mental set regarding actual or anticipated pain experiences. (Sullivan et al 2001) These feelings are linked to increased amounts of pain, suffering, pain medication and disability. Furthermore catastrophizing is directly linked to fear avoidance and increasing all negative aspects of the pain experience. Also it has been proven that if the patient is unable to make sense of their symptoms and do not get an adequate explanation that actually make sense to them, they are more likely to catastrophize and increase their level of pain. (Wilgen et al 2008)
Some qualities of catastrphization are:
- Why me?
- Looking for any drugs, medication or treatment to make it better
- Isolation, separating themselves from society
- Anxiety and depression or at least negative attitude towards their situation
Pain does NOT mean DAMAGE
This is properly one of the most important things I learnt when I was being explained about my pain. Just cause I am in pain and doing a certain thing like walking hurts it doesn’t necessarily mean that I am actually making my pain worse at all!! Not surprisingly (Jensen et al.1994) found that thinking this in most cases leads to increase amount of physical and psychosocial disability. When you break a bone or pull a muscle your pain isn’t actually coming from the where you damaged it. It is a result of the brain evaluating the situation it has in front of it including the threat of danger, previous experiences, social norms, beliefs and may more. (Moseley 2015) Normally the brain will get the right balance but not always especially if you have had it a while it can often jump the gun and try to protect you before you’ve done any more damage to it.
Pain and avoidance
Avoidance, this was definitely a part of how I felt when I first got CRPS, I remember often thinking this is not my leg!! I was avoiding it, for me I avoided the pain didn’t want to think about it or deal with it. Notice the word it, I didn’t considered it a part of me. Unfortunately it does lead to catastrifisation and increased pain. Its not surprising the biggest reason for distress is attempting to control the condition when it’s out of your control. (Burger, 1988) However by actually avoiding your pain it means you don’t open yourself up to opportunities to actually challenge the negative experience and possibly surprise yourself to what you can actually do. Furthermore by avoiding the pain it can actually increase the amount of pain your in as well as the disability associated with it. (Bunzli et al 2015) It is also proven that if you don’t know why it is getting worse or understand what may trigger off the pain making it more unpredictable it can increase the pain you experience. (meulders et al 2011)
I’m not saying to anyone struggling with pain or new diagnosis that you have to see the sliver lining and everything will be alright. I am not exaggerating when I say this was the biggest fight of my life my biggest challenge and I don’t expect anyone to change their mindset quickly. I am however saying that your mindset can make a huge difference to the pain you experience and your pain itself. If I can come out the other side and get back to what I love there is no reason you can’t.
Ferguson AD, Richie BS, & Gomez MJ (2004). Psychological factors after traumatic amputation in landmine survivors: the bridge between physical healing and full recovery. Disability and rehabilitation,
van Wilgen C.P., van Ittersum M.W, Kaptein,A.A, van Wijhe, M. (2008), Illness perceptions in patients with fibromyalgia and their relationship to quality of life and catastrophizing. Arthritis & Rheumatism,
Bunzli S, Smith A, Schütze R, O’Sullivan,P. (2015) Beliefs underlying pain-related fear and how they evolve: a qualitative investigation in people with chronic back pain and high pain-related fear. British Medical Journal
Meulders, A., Vandebroek, N., Vervliet, B., & Vlaeyen, J. W. S. (2013). Generalization Gradients in Cued and Contextual Pain-Related Fear: An Experimental Study in Healthy Participants. Frontiers in Human Neuroscience,