We live in an interesting time within the field of pain management. We literally have two competing ways of understanding the nature of pain – what it is and how it works and what to do about it.
Recent data in the Lancet show that as societies become increasingly industrialized around the world, rates of low back pain, migraine, depression, obesity and type 2 diabetes increase (among other conditions). It's an interesting commentary on the social determinants of health.
In the last post, we discussed the nature of perfectionism and the problems associated with it. Specifically, we reviewed how perfectionism is problematic and how perfectionism leads to poor coping with chronic pain. In this post, let’s review some basic ways to begin to overcome perfectionism.
While clinical lore is that perfectionists are more prone to the development of chronic pain, it may just be that perfectionists are more likely to seek care for their chronic pain. Reason? Perfectionists with chronic pain are more prone to behavioral exacerbations of pain as well as anxiety and depression. Let’s see how.
Coping gets short shrift in our healthcare system. We don’t spend a lot of time or money on it. Instead, we devote the vast majority of our healthcare resources to various procedures and medications that attempt to cure conditions, or at the very least attempt to get rid of the symptoms that on-going health conditions cause. We hardly spend any time or money on what patients themselves can do to keep the conditions from disrupting their lives.
Contexts matter. The same joke might go over in very different ways, depending on whether it’s told by a comedian in front of an audience at a comedy club or told by an applicant in the middle of a job interview. An action done over and over again might be considered in one context an admirable example of perseverance in the face of adversity, whereas in another context it might be considered an exercise in futility.
The Institute for Chronic Pain has a new content page on our website entitled: Why Healthcare Providers Deliver Ineffective Care. As is our custom, we announce such additions to the website on our blog and provide a little introduction to it. The content on this new page of the website is particularly important to me because providing content like it is one of the reasons why I founded the Institute. It’s not too far of a stretch to say that it’s why we do what we do. By way of introduction, then, I’d like to explain.
The stigma of chronic pain is personally hurtful. It is a negative judgment of you that others make. Specifically, stigma occurs when others judge you simply for being who you are – someone with chronic pain. You are looked down upon because of it. As such, stigma is more than hurtful. It’s shaming.
People with chronic pain know that they tend to have a pain flare when they are under stress. They are, however, sometimes sensitive to acknowledge it aloud for fear that others might think that their pain is all in the head. Nonetheless, the fact that stress makes pain worse is entirely normal and common. It is a natural product of how we are made.
All or nothing thinking is one of the most common, problematic ways of coping with pain. It’s right up there with catastrophizing, fear-avoidance, and refusing to accept the chronicity of pain. All of these problems prevent people from coping with pain well and being able to live a full life despite having chronic pain. Since we have reviewed the other problematic ways of coping with pain in previous posts, let’s discuss all or nothing thinking today.