Chronic Pain: A Sore Subject

“Pain is an opinion,” a New York Times¹ article reported, stirring defensiveness and outrage with its headline alone. In over 20 years of working with chronic pain, I have found that there are many misunderstandings about it, whether you are a provider, a patient, or a family member of someone suffering with pain. These misunderstandings can fuel defensiveness and anger, leading to resentment and broken relationships that, in turn, can increase pain.

If readers kept reading that Times article, they would have seen that the statement "pain is an opinion" does not dismiss pain, but simply acknowledges that pain is a subjective experience (as all of our experiences are), despite how desperately we would like to make it objective, factual, and measurable. It is part of our experience that continually interacts with our environment: past, present, and future. This hardly invalidates it, but realizes it as an intricate part of the human experience. This leads us to Myth #1.

Myth #1: Objectively measuring pain would help me.

Our logical brain really wants there to be a direct visual line from injury to pain. Scans, like X-ray or MRI, and chemical mapping such as serotonin or oxytocin, help us understand pain and guide us toward better interventions; however, finding ways to objectively measure pain may not change our experience at all. All too often there isn’t a single direct cause-effect relationship. More commonly there is a multitude of factors within the rich context of our lives in which we hurt.

We defend this myth to obtain some sense of control over our experience. Noting that pain is complex or multifaceted may seem like it implies that there is no one fix. There usually isn’t, and this is scary. But rather than despair, realize that no single fix also means there are many paths toward healing.

Alterative: Trust that the sensation is real and no further evidence is needed. Ask, how can I support my healing experience on all levels? Open to how you can shift your relationship to pain so that it is not the enemy.

Myth #2: Others need to understand the considerable pain I am in.

This myth maintains that in order for our situation to improve, we need others to know how bad it really is. Can others know, and do they really need to?

We defend this myth because it feels really good when someone does understand our personal experience. Perhaps we won't feel so alone or believe we may receive better care if we could get them to understand. Support is key for going through difficult things, but repeating thoughts like, “They just don't understand,” takes up space in our brains that could be used for our own self-care.

Alternative: Validate your own experience with unconditional kindness.

Pain is like a finger trap: you can move most freely when you stop struggling.

Source: Victor Moussa/Shutterstock

Myth #3: I need my pain to go away before I can live my life the way I want to. The only other alternative is to push through.

In a nutshell, one paradox of pain is that the dogged pursuit of escaping pain leads to more suffering (try a finger trap to see how struggle further traps you). It doesn't mean that sometimes when things hurt you shouldn’t avoid them, but avoiding all pain is not possible.

We defend this myth because fear drives us to avoid pain lest it control us. We worry if we don’t control it, it may last forever. However, what we resist, persists, as the saying goes. The temptation to flip to the other extreme is “pushing through,” but neither of these approaches helps for long. It's a tricky mindset to navigate, yet can be likened to arguing with gravity: If I cannot move forward until gravity stops slowing me down, I will end up waiting forever. If I think of gravity as the enemy to push through, I become exhausted.

Alternative: Meet Life on Life's terms. The pain is here now, I will neither pull it toward me or push it away. Ask, how can I work with it as is?

Myth #4: If I am still hurting, I must be doing something wrong.

This myth assumes there is a formula that if applied just so—if I could just do the right things, get the right procedure, learn the right ways to move or think—I would have less pain. While this seems logical, sometimes pain perfectionism can develop and obsessive thought patterns take over. When pain doesn’t decrease as a result, we feel frustrated, wrong, or even punished. As long as we use pain as a measure of our success, it is still sitting in the place of command as a dictator who may never be pleased.

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Calling this out as a myth does not mean that finding a rhythm and taking steps to live more healthy won't help; it just means that focusing too much on the perfect formula can backfire if we set our expectations of relief hinging on the formula. Instead of asking, "So will this fix it?" or thinking, "I have already tried all of that," we patiently persist in doing what we know is good for us: being with (or, withing) and caring for ourselves no matter what.

Alternative: Stick with a healthy routine that is simple and flexible, letting go of pain as a measuring stick.

Myth #5: Pain is a personal problem.

Pain is attributed to many things over the centuries, including curses in pre-science eras. Treatment was to remove the curse by resolving the conflict between neighbors. While this ancient belief seems like the real myth here, maybe it is something worth looking at.

Authentic relationships can help pain.

Source: Harli Marten/Unsplash

Without blaming anyone or entertaining magical thinking, consider how making peace with our neighbor could prevent a lot of violence and trauma. Maybe we could all benefit from more authentic connections, conflict resolution, and healing in our relationships. The increased support and understanding for the human experience might reduce collective suffering. It can hardly hurt to surrender our resentments, release our expectations of how others should treat us, and create a peaceful place within ourselves.

Alternative: Pain is personal and collective. Healing our relationships within ourselves and with others may directly impact our experience and reduce suffering for all.