Coping With Chronic Pain

Chronic pain is like another person living in your house, and that other person is not a cheerful, active, motherly type who scurries around getting you tea and washing your underwear. Pain is more like a grumpy, scolding old man who never wants to talk about anything but his own problems, whining for you to clip his toenails and shouting for you to empty his bed pan. It takes a lot of emotional energy just to meet his needs without having your own tantrum, let alone get a good night’s sleep, be kind to your spouse or accomplish some of your other goals in life.

This is the last in a series of blogs about chronic pain, and having had a hip replacement this fall, I was reminded about the practical nature of struggling well with constant discomfort. In this piece I want to offer some strategies that have been helpful to me, and I hope you will share your own tips. Everybody is unique, and every situation is, too, so it pays to have a lot of ideas in your toolbox when you are hurting.

1.  Know yourself. No one else can ever experience what you experience or cope the same way you do. Not even doctors or therapists know your inner world, so it is imperative that you know yourself.

  • Learn to use a pain scale. This is for you and also for your doctors.  You can use a standard scale like this one, but I prefer to make my own. For example, I know that my pain is about a 6 when I can’t sleep through it. It’s an 8 when I start screeching and gasping. But those things may not be an accurate measure of your pain at all. Use the same scale every time for consistency. A pain scale can help you plan your activity level, gauge your need for medication or note changes in your condition.
  • Separate your poor coping from your healthy coping. We all develop coping mechanisms over time when dealing with chronic pain. You may not even be aware of yours, so take some time to observe and catalog them. What is healthy coping for some (distractions like computer games, for example) may be addictions or unhealthy escapes for others. I like my clients to develop a list of ten things that, at least sometimes, help them cope in a positive manner.
  • Consider your unique circumstances. Pain isn’t your only struggle in life. If you have an unhappy marriage, a sick child, a stressful job, a mountain of debt, etc. your inner resources are stretched thinner than the next person’s. It’s too easy to compare yourself to someone who manages “better” than you do, who does more or talks less about it. Give yourself some grace. What is normal and what is possible for you will never be exactly the same as anyone else, because no one else is you, living your life.

2.  Be the best you can be.

  • Pain shapes you. It’s easy to see this as a negative, but it doesn’t have to be.  Pain can help you become a more compassionate, more patient, more spiritual person. Being your best is a conscious decision, discovering what you can do at your best and what you need to avoid to be your best. It’s deciding what to share with whom and where you can give back using your unique gifts. Again, it’s not about comparing but about living the life you’ve been given in the best possible way. Decide to do it well.
  • Your pain can make you stronger or weaker. You can be an agent rather than a victim in your own life. The pain doesn’t control you; the pain doesn’t make your decisions; you do. Pain itself isn’t weakness. How you handle it can be weakness or strength. Keep reading.

3.  Emphasize emotional well-being.

  • Sometimes it’s a trade-off with physical well-being. People will ask you to do things, even expect you to do things, that are going to make you hurt later. Make good decisions based on your own experience.  After breaking my foot doing something I knew I shouldn’t be doing, I have more freedom to say no to some things. Don’t wait till you break a bone to start saying no! If you want to pick some activities that are good for your emotional well-being (like a trip to the mall you know will exhaust you), plan for the aftermath and limit the activity with time-constraints or mobility aids or accountability with others.
  • Loving well depends on your heart, not your body. The most important thing in God’s Kingdom is not activity or knowledge or competence. It is love. And love doesn’t depend on your physical ability. Your emotional well-being and your mark on the world are both enhanced by the ways you give and share love. Get creative. Share your words, your prayers, your art, your encouragement, your joy, your life-lessons, your affection.
  • Self-care. Your emotional well-being is no one’s responsibility but yours. Others can help, and you can ask for what you need, but you are the only one who can provide rest, treatment, stimulation, distraction, etc. at the right time in the way that you really need it. Sometimes people feel that self-care is selfish. It’s not. No one feels loved by you when you are stressed, resentful, complaining or frustrated. Self-care helps you love the people around you well. Make a list of things you need to be doing regularly (see below) and practice those things.

4.  What can I do, practically?

  • Find opportunities for worship. Pain IS an opportunity for worship. Jesus suffered terrible pain for me – I can just begin to understand some of that through my own pain.
  • Pray. Make your pain a subject of prayer. Less pain, more energy, but also God’s work through pain. Pick one person who is willing to pray for you that you can share with. Pray for the pain of others.  Keep a list or journal.
  • Keep doing. Make plans. Volunteer. Get out there every day you can – even when you don’t want to.
  • Watch your attitude. Be honest with some, especially those who will pray, but don’t let complaint become your defining characteristic. If it’s always coming out of your mouth, then it’s also living in your heart. That’s not good for you or your relationships.
  • Take your medicationMedication adherence is poor in people with chronic conditions. There are many possible bad outcomes from not taking the medications you’ve been given in the way you are supposed to, including over-medication, inconsistent pain control and mistaken assumptions on the part of your medical providers. Be honest with your physician about how you are taking your medications so she can adjust them in ways that are helpful.
  • Explore. Don’t give up. Try new medications when recommended, look at alternative therapies like massage, ice/heat, PT, acupuncture, etc. Different things help different people.
  • Exercise. The rest of your body still needs it, and some types of pain will benefit, too. Try swimming, walking, stretching, yoga, biking, Tai Chi. I have an arm-cycle at home that I use when swimming isn’t an option.
  • Find a group. Any kind of group. You need community!
  • Discover your heroes. Read a biography or memoir dealing with something similar to your condition. Join (or start) a support group. Find someone locally or online who is just ahead of you on the road.
  • Find creative ways to express your pain. Art therapy, journaling, writing a biography or blog…
  • Look out for depression. Depression and pain are comorbid. There are multiple reasons for that. If you are not sure whether you might be depressed, take a test or ask people who know you well. If you are experiencing both, be sure you are treating both. 
  • Try counseling. Find a counselor who knows about chronic pain (but not one who is a know-it-all). You need at least one place where you can talk honestly about your struggles and learn a few new coping strategies.

Your pain isn’t really a grumpy old man living in your house; it’s a part of the life God gave you. God knew everything about you before you were born, and He chose to allow you to walk this road. Everybody has their own kind of pain, but you have this. It is shaping you one way or another, and God’s purpose is always to create beauty. You don’t have a choice about whether you struggle. You only have a choice about whether you do it alone or in company with the One who knows and loves you best. Now for a little while … you have been distressed by various trials, so that the proof of your faith, being more precious than gold which is perishable, even though tested by fire, may be found to result in praise and glory and honor at the revelation of Jesus Christ. (I Peter 1:6-7)

Suffering, a Book Review

Dr. Paul Tripp, pastor, counselor, conference speaker and author of at least 21 books, kept up his hectic schedule because he was disciplined about diet, exercise and health. So it was a bolt from the blue when a mysterious illness put him in the hospital with spasms so intense he screamed in pain and fear for thirty-six hours straight. That wasn’t the end of his suffering, either, but you will have to read his latest book to find out more.

A New Book

You may know Tripp for his parenting videos aimed at the heart or his books on human relationships, such as How People Change. Or perhaps you get his weekly devotional in your email inbox. If so, then you are familiar with his casual style, mixing Scriptural truths with clarifying anecdotes in a way that generally hits a bulls-eye but occasionally seems too formulaic. Well, Dr. Tripp has been prolific of late, publishing three new volumes in 2018 despite his major health issues. Because of those health issues I wanted to include a review of his latest book, Suffering: Gospel Hope When Life Doesn’t Make Sense in this blog series on pain. 

I’ve read virtually every book on suffering and theodicy in the popular, conservative, Christian market (and a few that aren’t), so I didn’t expect to be surprised by Tripp’s entry in the genre. But I was surprised by two things: the transparency of his story and the fact that he brought one excellent new idea to the theology of suffering.

Self-Disclosure

Paul Tripp often includes his family problems as illustrations in his work, so it wouldn’t be fair to say he has concealed his mistakes. But he has seemed to maintain a certain distance. I had the privilege of lunching with him at a small, post-conference gathering, and I have to say, he did not leave me with warm fuzzies there, either. (Now that I’ve read about his recent illness, I wonder what he might have been going through at the time.) His descriptions in Suffering are not vastly different from his self-disclosure in other works, but I was able to empathize with his struggles in a deeper way. Tripp speaks of his new-found dependence, saying, “Honestly, I didn’t suffer just physical pain, but also the even more profound pain of the death of my delusion of invincibility and the pride of productivity.”

His descriptions of physical pain are heart-rending, too. Now he knows; now we are connected. I want to say, “Welcome to the fellowship of His sufferings,” (Phil. 3:10), because I think there is a promise in that verse. When you enter into suffering, you enter into a hidden room where Christ has lived and died; you enter into His fellowship in a new way, and the Gospel becomes so much dearer.

Suffering as a Canvas

That said, I’m not sure feeling closer to Paul Tripp is enough reason to spend $17 on another book about suffering. What I will really take away with me is the idea that our lives are shaped not just by what we suffer but by what we bring to our suffering (p. 27). If we bring doubt or fear or pride or resentment or self-hatred into our suffering, then we will suffer that way. Our suffering is like a canvas upon which each one of us paints his own picture. For some, the experience is colored with envy or depression, while for others, suffering is a place of focus and reflection. I would add that each bout and each type of suffering is going to be a little different, too. God is at work in different ways in all our lives at all times, and if we will seek Him within our suffering we will find out what has been hiding in our hearts all along. That is a good thing.

The first two-thirds of the book exposes some of the common problems that we bring into our experience of suffering, while the last third enumerates some of the sources of comfort God offers for our suffering. These later chapters offer practical steps, applicable Scripture and the power of telling yourself the truths you have trouble believing. I found them a good reminder in a time of my own suffering. There are questions at the back of each chapter, so the book could easily be used for a group study.

Conclusion

In all, I would say that the profundity of this book can be summed up in just one sentence: you never just suffer the thing that you’re suffering, but you always also suffer the way that you’re suffering that thing (p. 27). Other books which try to put all suffering into one basket miss the deep truth that everything God makes is unique – unique in its flaws and unique in its gifts – and those unique qualities (good and bad) are often revealed by suffering. Realizing that will help me as I reflect upon my own experiences of suffering. It might help you, too.


Entering Pain

I once had a very wise doctor who taught me an important lesson about pain. At the time, he was removing an inch-long metal screw from my hip under local anesthetic. He seemed to be using an ordinary, Home Depot Phillips head screwdriver which rather amused us both. But the novelty of the situation soon gave way to the piercing pain of metal turning against bone. When I began to fidget and moan, the doctor asked me to do him a special favor. He said that he was conducting a research project into the nature of pain and wanted me to carefully describe what I was feeling. I struggled to describe the location and varying pitch of the sensations, whether it throbbed or stung, felt cold or ached or surged. Sooner than expected he tied the last stitch, and I took my shiny souvenir home in a jar.

The funny thing was, he never did compile the results of his meticulous survey. The man had used a benevolent, psychological trick to get me to stop resisting the pain of minor surgery. But in the process I discovered a truth which has been important to me. Instead of panicking and running from the pain, he got me to look at it, even to move toward it. I don’t know that I felt any less agony, but I felt it differently. The pain was less like a monster attacking from the outside than it was a peculiar part of my own being which could be touched and explored. I found the same kind of meditation very useful in other situations, including the natural delivery of two children.

Pain, like other difficult circumstances in life, can be fled or it can be explored.  One can fight and flail against the inevitable, or one can accept and even find peace inside the dreaded cavern. In her beautiful book, The Scent of Water, Elizabeth Goudge describes depression as a dark cave. But she points out that many scholars believe the stable where Christ was born was a cave, and also the tomb where He was buried. If depression is a cave and pain is a cavern, they are inhabited by One who is well acquainted with the layout. 

Christ dwells wherever we do, at the bottom of the ocean, the end of the world or the darkest pit. He offers us His companionship and strength. When we stop running from all our pain — emotional, spiritual and physical — and explore it to the edges, we can find many truths inside it. It is Christ in you who paints the ceiling with glowing crystals. It is Christ’s arm which keeps your foot from slipping in the dark. It is the presence of Christ which turns cold desperation into peculiar fellowship. And it is Christ’s love which places daily treasures for you to mine. God can sculpt the stalagmites of your grief into monuments of His glory. It is a trick of the mind to stop fighting the pain; it is a truth of the heart to find God inside it.

Not only the comfortable, good and happy walk with Christ. In fact, they mostly ignore Him. The next time you feel the walls of pain closing in on your soul, try taking a good look around in there. You might be surprised at what you find. Or Who you find.


This is the third in a series of blogs about chronic pain of all kinds. Go back to the first one here.


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