Clients with chronic pain describe similar experiences of a struggle to focus. They are constantly vacillating between two not-so-great options:

1) experience their bodies and all the pain and suffering within them or

2) attempt to balance in the space somewhere outside the body, beyond pain’s grasp.

I present these two options like there is choice in the matter. Often there is not a choice at all. Every day is a new attempt to try and survive the experience of pain. Chronic pain does not have a rest day. It does not decide to vacation and give us a break. Chronic pain, even when intermittent, exists all the time.

I am a person and therapist without this affliction, but I support a loved one who carries Pain around like a suit made of lead. I am still not sure how to even begin addressing this topic because it is so beyond my own personal lived experience. I broke my arm when I was 5 years old which was the first experience of physical pain I remember. When I conceive chronic pain, I imagine what it felt like to see my right arm snapped in a zig-zag line against the dark-green linoleum floor. I try to remember the sound of the fall from the countertop I was climbing to the floor and the panic rushing through my little body as my brain connected the visual of my arm to a raging fire of a pain. I imagine what it would feel like to experience that moment of my arm breaking every second of every minute of every day. Even then, I know this image does not math correctly. My arm healed. My brain helped my nervous system let go of the experience which allowed memory to not trigger me into a panic when I revisit the image of the linoleum floor I fell on. I moved on. Chronic pain does not move on, it moves in. It is there every morning when the brain comes online to wake up. It is there every step taken into the hallway and out the door. It is there sitting or standing, watching tv or reading, working or not.

Pain is complicated and nuanced medically, socially, and psychologically. An invisible disability, my clients with chronic pain report doctors and loved ones not believing them, accusations of being dramatic, or condemnation for drug-seeking. Some grapple with what it means to need a mobility aid like a cane or a wheelchair. How do and will people treat them as a result of looking enfeebled, something our culture does not embrace well? Some deal with suicidal ideation because the pressure to conform to the agile, able-bodied world is overwhelming. Chronic pain does not live in a vacuum, but in the complexity of other physical and mental health experiences. This creates a conundrum in how to triage what to focus on first. Do we treat the pain, the mental illness, the relational distress caused by caregiver fatigue, the suicidal ideation, the lack of supportive medical care, the society with extraordinarily limited disability benefits? Does it matter when any one of these things stops us in our tracks?

For our friends and loved ones, chronic pain is a torturous reminder of the depths their minds can be pushed to when managing what can feel like a traitorous body. There is a space between lived reality and dissociation that is an elusive sweet spot for those with chronic pain. I think of this space as a scale with “Holy [insert swear word of choice]! I can’t live in this much pain!” on one end and “I’m no longer inside my body and need to sleep this off!” on the other end. The space between these two statements requires a mindfulness journey saturated in digesting and integrating trauma, learning skills for coping and distraction, robust medical intervention and care, facilitation of relational and community support, and, most importantly, learning a new-to-the-user experience of self. While therapy cannot facilitate every aspect of these healing journeys, it can certainly provide space to continue exploring one’s personal journey with chronic pain. Some days we find the elusive mistress who exists between giving up and starting again. Some days we do not. Regardless, therapy can facilitate the conversation about chronic pain we need for ourselves and for our relationships. If you have questions about how this process can help you, please reach out to me! I would love to set up a consultation to discuss this more.