Pain Recovery. Robert Hunter

      List all the real and perceived benefits you have ever received from having chronic pain. Be sure to include the things you get, as well as things you were or are able to avoid. One example of each is provided for thought.

      PHYSICAL {example: I don’t have to help around the house.}

      SOCIAL {example: If I don’t show up or cancel at the last minute, everyone understands.}

      EMOTIONAL {example: If I get frustrated or angry, I can blame it on my pain.}

      FAMILIAL (include emotional, as well as specific household or practical responsibilities) {example: My family pays more attention to me when my pain is bad.}

      WORK LIFE {example: If I call in sick, I can always say it’s because of my pain.}

      FINANCIAL {example: I receive workers’ compensation payments. It’s less money than I made when I worked, but enough to live on. I can’t do the same job, so why should I take a job that pays less?}

      SEXUAL {example: My partner no longer expects me to work as hard at providing him or her with sexual pleasure.}

      It’s important to look closely at secondary gain, as the perceived benefits might not be as attractive as you believe. Most of the time secondary gain is not gain at all, but loss. Chronic pain sufferers often inadvertently buy into secondary gain without looking at primary loss.

      Most people find they are just stuck and afraid to move forward. Once you walk through this fear, you will find you gain much more by a return to normalcy in your life.

      { exercise 1.4 }

       Examining Secondary Gain _________________________

      Go over the list of examples of secondary gain you identified and take a minute to look at what is actually going on. Write about your observations.

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       Manifestations of Chronic Pain

      Chronic pain can be a troublesome annoyance or a devastating curse that interrupts life functions, relationships, employment, and most things that bring us satisfaction. It takes over our lives, consumes us, and threatens our well-being and the well-being of those who care about us—family, friends, coworkers.

      For many with chronic pain, and probably most of you who are reading this, traditional pain management (medication and physical interventions) has not helped sufficiently. You have developed a constellation of troubling symptoms.

      { exercise 1.5 }

       Pain Manifestations__________________________

      Here is a list of some of the manifestations of chronic pain. Please check off those you have experienced.

      ____ Feelings of depression, anger, worry, discouragement, and irritability.

      ____ Sleep difficulties.

      ____ Financial problems.

      ____ Problems relating to others, causing significant disturbance in relationships.

      ____ Inability to tolerate physical activities.

      ____ Withdrawal from social activities.

      ____ Inability to concentrate.

      ____ Poor memory.

      ____ Isolation from support systems, including family, friends, and coworkers.

      ____ A decrease in sexual activity or performance.

      ____ A decrease in self-esteem.

      ____ Secondary physical problems.

      ____ Problematic use of pain medications and/or alcohol or addiction.

      ____ Avoiding work and leisure activities.

      ____ Negative attitudes concerning everyday life.

      ____ Other: _____________________ ____________________________

      Write about the feelings that come up as you review this list.

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       Many Have Difficulty Telling the Difference between Physical and Emotional Pain

      If you identify with some of the features listed, your life is probably damaged significantly by chronic pain. Chances are your family has been gravely affected as well. Pain has invaded your life, and life has become drudgery. Depression can result and even lead to hopeless or suicidal feelings. The suffering that accompanies chronic pain (your emotional responses) is often much greater than the pain itself.

      Furthermore, often your responses to the pain exacerbate the pain itself. You judge it (negatively of course), resist it, get angry at it, and try to get away from it, and the pain gets worse. In fact, much worse. Resisting the pain causes the pain to get worse.

       Pain is not right or wrong, good or bad. Pain simply exists in your life. You can change your experience of pain and your attitude toward it.

      { exercise 1.6 }

       Developing a New Awareness _______________

      Let’s try an experiment. Identify a source of pain in your body right at this moment. Get mad at it—tighten the muscles in the area—worry about how much worse it is getting—throw hatred and loathing right into the pain—feel the despair because this is the way it is and will always be. Hold these negative feelings for a few moments…

      Now relax for a minute. Just take a deep, slow breath. If you are having any angry or despairing thoughts, try to set them aside for a moment. Just breathe. And breathe again. Try to loosen the muscles that you just tightened. Think about something positive—a memory, a favorite place, a song, a loved one. And relax. Keep breathing.

      Write below about any emotions, thoughts, and spiritual or physical experiences that came up for you. Did you feel the pain get worse as you tightened your body and mind? Were you able to relax, and as you did, did the pain lessen? If not, what got in the way?

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      If you are caught in the negative spiral of chronic pain, it may seem like there is no way out, but that’s not the truth. You now have some clues to your experience of pain and some potential ways out. As the simple exercise above demonstrates, when you tighten your muscles and send negative energy toward the pain, the pain gets worse.

      It’s as straightforward as that. If you successfully reduced your muscle tension, stopped judging the experience as negative, and paid attention to your responses, the pain diminished, even if only a little. Always take notice of small improvements, for those add up. If you noticed your pain increase and then decrease