Understanding Chronic Pain

Chronic Pain and the role of others – a source of support or a course for communication breakdown?

Often we hear from patients with chronic pain who will talk about how much of an impact their pain has on those around them this can be for various practical and emotional reasons. But also when we consider how stress and emotions can play in increasing pain, we realise that the role of other people figures quite prominently here too.

A source of support
Having the understanding and unwavering support of those around us when we are going through a difficult time can make a huge difference in terms of how we cope at with adversity. And chronic pain is no different, as you adapt to the changes both physically and emotionally caused by the chronic pain, having others there with you can be invaluable. Sometimes we can be fortunate enough to have this fall into place, but other times it might take some effort to help put this into place.

Causes of friction
Whilst in an ideal world we would all hope to have support around us to say the right things and the right times and to know when to leave us to be alone, interacting with others can often be an added source of stress, frustration and lots of other unhelpful feelings which increase our pain. Sometimes others can say or do things that might make it seem like they don’t understand or even believe that you’re in pain. This can be for a number of different reasons:

A lot of people don’t know what chronic pain is – sadly chronic pain isn’t a condition that figures too highly in society; even though 1 in 10 are likely to suffer with it how often have you heard it mentioned on the radio? Seen a character on TV with it? So for people who don’t have chronic pain, they may not understand what it actually means. You might want to think of ways to explain chronic pain to them, perhaps showing them this website could help
They may want to be helpful – quite often when we see someone in pain or discomfort our aim is to try and say something to make them feel better. Whilst this might be best intentioned, such as giving someone a compliment (e.g. “But you look so well”) this can not always have the desired effect (e.g. “But I feel awful!”)
Accepting you’re in pain may be hard for those around you too – Adjusting to having chronic pain can involve many different feelings of frustration and sadness, and the same can be true for those who love and care about someone with chronic pain.
Sometimes talking about chronic pain can be difficult especially when you’re in pain, feeling upset or frustrated so you might not be able to get your message across as well as you’d hoped, or the other person may just pick up on the emotion and not what you’re say actually trying to say
Often people with chronic pain may try to carry on in the same ways as they’ve always done even if it causes them more pain, but often this can lead others to incorrectly think that perhaps the pain isn’t so bad.

Getting the right messages...

Chronic pain patients will sometimes say they wish their pain was more visible so that people around them could realise how badly it affects them. There tends to be less understanding and appreciation of chronic pain compared to other chronic illnesses, and this can be a source of frustration and conflict within relationships. This can mean there is often the need to try and explain chronic pain to others in order to educate them as to what you are doing and why. However, many people with chronic pain find that it can be difficult to communicate this information to other people. Sometimes this can be about the situation people are in or that it can be a very emotive topic to talk about for everyone.

There are some broad strategies that can help in getting the message across to people:

If you know you’re going to have to say something important to someone, such as explaining to a loved one about your chronic pain, it might be worth considering how and when you do this. It can also be really useful to rehearse what it is you want to say so you can be sure the message comes across as you would like it to. Also, try and wait until you are in the ‘right frame of mind’ and not too upset or frustrated.
Asking others for help can be a new thing for someone with chronic pain to have to do, especially if you were used to being the one who helped others. But asking for help and explaining why can help in adjusting to and managing the pain.
A useful approach is to be assertive, particularly when making or responding to requests. This involves putting your point of view over – but acknowledging that other people may see things differently. Clearly and consistently stick to what you want to say and don’t getting dragged into arguing or complying with another person’s viewpoint.
It’s OK to say No! Sometimes we can feel a lot if pressure to say ‘yes’ especially if we feel it may upset the other person, but this often means taking on too much and risking having a flare-up of the pain.

While the strategies listed above will help in talking to other people about pain it is important to be realistic and recognise there may be some situations where these might not work. Whilst for some people it may just take a little while to get the message across about chronic pain, sadly there may be some people who will still not understand. Remember, this is not a reflection on you but you can at least feel you have done all you can to try and get your message across.

Tim Siggs
Trainee Clinical Psychologist

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