Anxiety is part of our lives. But those of us who suffer from chronic pain know how much anxiety can increase muscle spasms and inflammation throughout our body. Just the thought of doing basic chores, getting out of bed, socializing, leaving the house can be too much to imagine. All exacerbating our pain.
Last week I discussed the fears I had when my daughter and I visited Disneyland for her birthday celebration. An already stressful and taxing day walking the park and standing in lines turned overwhelming when I couldn’t park at the entrance. Instead I’d have to take a tram from a garage miles away. Just the thought of coping with this new challenge threatened to shut me down.
As we searched for a parking spot, I was in my head anticipating the catastrophe to come. The anxiety and negative thoughts swirling through my mind-
“This will add at least another half hour at the end of a brutal day.”
“I can’t possibly handle this unexpected problem at a time when I’ll be in pain and in desperate need of a bath and bed.”
“Everything I expected and planned for is ruined. The day is over before it’s begun.”
Catastrophizing is a common reaction to anxiety and worries. The idea we can’t overcome, deal with, or survive an event. A horrible name since it implies histrionics or embellishment. Neither are true. Studies have documented how chemicals released with chronic anxiety, stress and medical conditions change the physiology of the brain.
How we feel and see this impediment has a huge impact on our pain. The two are inextricably linked. Thoughts are the stream of consciousness that enter our minds. Behaviors are the physiological actions we take in response. By looking at our thoughts, analyzing their reality and changing them to a positive the resulting behavior is changed to a positive as well.
Catastropizing was introduced as a type of thinking where persistent negative thoughts regarding chronic pain and the emotional and physiological response they invoke interferes with all aspects of life. From accomplishing basic chores to impacting our jobs and relationships. But this type of negative thinking doesn’t just affect those of us in pain, everyone has their moments. We can all benefit from stopping this dangerous cycle that only leads to more despair and hurt.
It was developed by Albert Ellis, a physician in 1962, and refined in later years by psychologist, Michael Sullivan to include the 3 “I”s of pain.
Infinite. The belief the agony will never end.
Insurmountable. Nothing we do will have any effect.
Incurable. There’s no hope of finding any intervention that can help.
These issues keep us in a never-ending loop. And the fear it could get even worse no matter what we do keeps us immobilized. Feeling hopeless and powerless is exhausting, frightening and all consuming. Often to the point it’s our only focus.
Pain affects us both physically and emotionally. Our thoughts play a big part in how we see and think about our pain. Which thoughts we choose to hear and perpetuate or shut down is a key component to coping better.
For those who’ve lived with chronic pain, easy answers and quick fixes sound great, but we all eventually learn that investigating every claim that supposedly offers a cure just sets us up for failure and more heartache. There is a point in all our lives where we must pivot from,
“How do I live with this condition?”
Accepting that it exists does not mean crawling into bed and giving up. We continue to do whatever we can to manage it in ways that allow us to function and enjoy our lives e.g. exercise, weight loss, diet, medications, meditation, and distraction Releasing the emotional stigma attached to chronic pain and stopping the negative thoughts that denigrate and lessen who we are as individuals, partners, parents, friends, workers… can lighten the load we feel. It all starts with how we see ourselves and the words we form in our heads.
Negative thoughts are so much more damaging than positive ones. It seems like one nasty comment can ruin our day, but several compliments go by barely noticed. And when they come from within it’s even more devastating. That’s why it’s so important to reword your feelings into positive thoughts.
“I exercised five minutes today. It hurt, but not like I thought it would. I can do this again tomorrow.”
“I didn’t want to meet for dinner but getting out, laughing, sharing and seeing my friends made me feel better. I have to remember this when I want to say no next time.”
“I still hurt, but I’m proud of how much I’ve grown and how far I’ve come.”
Start with baby steps
Anticipating pain can be debilitating. The possibility becomes so large and distorted in our mind the thought of any action seems impossible. Start with baby steps. If the idea of walking in the park is too much to envision, walk from your bedroom to the kitchen. Then acknowledge, “I hurt, but I made it back and forth.”
Then do it again. Eventually, “I can do this,” will overwhelm the negative until those thoughts fade away altogether.
Let it go
Imagine putting all your fears and worries on a balloon.
Then let it float away.
Or pop it.
Write it them on the computer. Then delete it.
Write them on a piece of paper then flush it down a toilet. As it circles the bowl feel them swirling away.
Following these steps that day at Disneyland,
- I immediately recognized my thoughts were negative and the cause of my anxiety.
- I asked if my fears were real. Some were. The extra time and energy required to get to and from the garage would add to my pain levels. But the joy of spending the day with my daughter in a magical setting was worth it.
- I decided to take baby steps and deal with any and all issues as they appeared. Refusing to tackle them all at once.
- Then I chose to change my thinking. It wasn’t insurmountable. I could deal with this new reality by making appropriate plans to lessen its impact, like leave the park earlier, take more breaks to rest, and arranging to have wheelchair assistance extended to the parking garage.
By accepting what I could change, focusing on the present and letting go of the fears of what might happen, that day proved to be as wonderful as I had hoped.
This works when we haven’t jumped off the deep end and can still see the truth of a situation. But when the anxiety becomes overwhelming, to the point they can’t be managed this way, other techniques might be required to first calm and de-escalate the roller coaster pinging around our brain. Only then can we see our thoughts for what they are and choose to change them.
Next week I’ll discuss other methods that can help when we feel out of control.