I’ve asked myself this a few times while writing this series. The thing is, there is such an emotional component to physical pain. I mean, there is a whole field of psychology committed to researching, discussing, and improving the brain-gut connection.
So, it only seems fitting that the underbelly of psychology is a perfect place to start. It can sometimes be a chicken or the egg situation, right? My stomach hurts and now I’m worrying about it versus I am worrying and now my stomach hurts. Then my favorite rollercoaster ride: I am worried about my stomach aches, so it is hurting either way. Stomach aches and other related physical aches (i.e., headaches, body aches, etc.) are not only connected to anxiety, but can be related to depression, anger, and/or stress in general.
Ya’ll know one of my first lines of defense is tapping into those five senses. However, the things I reach for when I’m not feeling well are specific to my physical experience when compared to what I might grab if I’m feeling mentally stressed.
For example, when I might normally reach for something sour or spicy to distract my tastebuds when I’m overwhelmed emotionally, I always make sure I have something minty (hard candy, gum, tea, the works) when my stomach is upset. I’m also a big fan of ginger, especially candied ginger when I’m not feeling good. I have certain pajamas, preferred blankets, and specific kinds of music and movies I like to utilize when I’m physically sick. There are even certain parts of my house I like to lounge when I’m feeling badly. If you’ve read Blog #4, you know I firmly believe that the body creates associations between our physical and mental state and the places we’re having those experiences. Even though there’s nothing I want more than to curl up in bed and stay there when I’m feeling ill (and don’t get me wrong, I do do that sometimes), I’ll try and lie on a separate couch outside of my room.
When I’m experiencing a pain flare up, it’s a similar process. I have certain places and tools I use to decompress, distract myself, and eventually move through the experience. One big thing I have learned from chronic pain is that it is not just a physical experience but creeps into your emotional state as well. The resulting intrusive thoughts and anxiety can be debilitating.
Waking up in pain is not a great way to start your day, almost worse is waking up feeling okay but tip toeing around your actual life waiting for the other shoe to drop. Even if you have a relatively pain-free day, at least part of you is in some way affected by the fear:
· Will it last?
· If it doesn’t, will the pain be the same?
· Will the normal tools work?
· Did I pack everything I might need?
· Should I tell someone if I’m hurting?
· If I do, will they believe me?
· When’s the next appointment with the doctor to make sure everything is managed appropriately?
All day, every day. Nighttime is both a blessing and a curse, knowing that sleep might be the one, safe space where you know aside from normal tossing and turning you will be relatively free of pain, your body and your brain in recovery mode. But there are still those lingering worries about what it is going
to be like tomorrow. You develop a distrust of your mind/body. If something new happens:
· Is this just another version of what I’ve already experienced?
· Is this something new?
· Is this a side effect?
· Should I make another doctor’s appointment?
· Will they believe me?
· Is this getting annoying for those around me?
How might this distrust affect your average person’s everyday life? Well for those that know me, they know that I have a bunch of ear piercings and a couple tattoos. I have had ideas of new piercings or new tattoos and prior to my pain, my biggest decision was of what and where? But because I don’t really trust my body anymore, I can’t be certain it has what it takes to fight off infections and keep me safe. Fear not readers, there is always a way to figure out how to achieve your goals (generally speaking, of course)! Not going anywhere near a Tattoo/Piercing Shop anytime soon? No problem. I have a few websites I order temporary tattoos from where I can be creative with pictures and placements without worry. My family even jumped on the bandwagon and got me some really cool ear cuffs (just my existing lobe piercing necessary) so I could get creative and feel more edgy rather than on edge.
For me, this distrust has also provided me with personal insight into all of my kiddos’ lives who physically experience their emotional stress. For example, one of the primary criteria for Panic Disorder is “persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attacks, “going crazy”).”
How stressful to first have even experienced something so emotionally and often times physically taxing in the first place, but then to constantly be thinking about the fear of if and when it will happen again. Living with chronic intrusive ideation or experiencing chronic pain, not only impacts your thoughts but your own nervous system’s natural response to the world, in danger or not.
I encourage my clients to use their Fitbits, Apple Watches, or good ole fashioned fingers to track their resting and active heart rate, because sometimes the body can trick the brain into thinking they are in more danger than they are. Rapid heart rate (or feeling as though your heartbeat has increased) is a common side effect of worry and panic. Knowing your resting heart rate and having access to your active rate can be used to check those worries about your physical responses to stress and tell yourself that even though it feels like your heart is beating out of your chest, it’s really not much faster than your resting rate. You are safer than you think, but that does not diminish the physical experience or the overall toll that this whole process takes on your mind and body.
This week was a toughie pain-wise and after what seemed like non-stop brain chatter, I thought, “What if I feel this way forever?” That really got to me because I take on this pressure to “handle” both the physical and mental components of this particular experience and I was feeling down on myself for even allowing such a negative idea to make its way into my mind.
How could I be so pessimistic? I’ve worked hard to get where I am professionally, I don’t want to “let my pain win” and forego some opportunities because it’s going to be hard on my body. I can’t give up!
But I’m not giving up. There’s such pressure to get a handle on all of this. Pressure from others, but also from myself. I mean, I’m a Psychologist with over a decade of school, training, and experience learning how the brain works, how it interacts with the body, and how to effectively talk about it all in an effort to manage it successfully. I, as many of my clients have reported to me, feel a sense of failure when this mental game rears its ugly head because others may assume, or actively remind us that if those negative thoughts still exist, we must not be working hard enough. Trust me ya’ll, we’re doing the work. I remind clients every single day that even if therapy is a complete success, they’ve developed insight into their experience, and are implementing the skills they’ve learned work best for them, those negative thoughts will never fully disappear. They exist and unfortunately we have very little control of when and where they decide to pop up. Fortunately, we have lots of control on what to do once they do.
What did I do?
I let those thoughts come to the surface, because keeping them inside never works out for me. I cried a little. I went for a run. I made a dairy-free personal pizza (Thanks Daily Harvest!). I acknowledged the realizations I had above. I made a promise to myself that even if the feeling had passed or I just didn’t want to remain/put myself back in this space later, I would tell my husband about all the feelings and then decided it was important to put them down here. Maybe just as an exercise in getting it off my chest, but hopefully more in an effort to remind you that you aren’t alone in these thoughts and it’s okay to be sad. Today requires enough energy, no use in giving tomorrow or next year or 10 years from now much of it, because honestly, I, like all of you, have no idea what’s going to happen so it wouldn’t be the best use of my time to judge myself for the negative thoughts I have about myself in the future.
In signing off today, I don’t want to place any additional pressure on you to sit in a “bad” day or do whatever it takes to have a “good” day. I’m just going to quote The Odd Life of Timothy Green:
Have the day you have!