Welcome to the current newsletter issue of
Advances in Medicine (AIM)- Take AIM against pain.
Feel free to send me an e-mail with your own thoughts
and experiences. Email: timsams@mypainreliefdoc.com.
* * *
I have spent five days a week, month after month, for 25 years
working with people in pain (PIPs) to decrease their pain and
improve their ability to function. You can imagine that some
patterns and trends have emerged. But, there are also some themes
that stand out above all others. While I don't want these
newsletters to sound preachy or critical, over the next year I
will address these key themes.
Today, I saw a woman in her 50s, Mandy,* whose life had
deteriorated to the point where she was nearly housebound, not
because of pain, but because of fear - of everything. She stopped
driving because she was afraid that if she got into an accident,
she would be charged with DUI since she takes opioids. She
stopped being in crowds because she was afraid she would get
bumped into. She stopped socializing with extended family because
"they all criticize me for taking pain medication." She stopped
getting mammograms because she was afraid of the results. She
stopped answering her phone because she was afraid of solicitors
and collection agents. She stopped exercising because she was
afraid of injuring herself. She spent all day in the living room
watching television and feeling "safe" in her suffering.
Courage is one of the most important aspects of mental health. It
is certainly one of the most important aspects of managing
chronic pain. They say that insanity is doing the same thing over
and over again and expecting a different result. If you want to
have less pain and be able to function better, you will need to
do less of the familiar (easy) and more of the unfamiliar (hard
and scary). How effectively you do this is determined by how
effectively you have challenged your fears over the course of
your life. The more often you have avoided performing healthy,
scary behaviors, the easier it gets to avoid your fears. And the
more you retreat from fear, the more you convince yourself that
the next time you will also retreat, and the next, and the next.
You learn that you can't trust yourself to challenge future
scary, difficult things. And that is terrifying when you need to
summon courage for something important.
Each time you confront a fear only to slink away, your world
condenses a little bit. Each time you confront a fear head-on and
survive it, your world expands a little bit. Expansion and
contraction over the course of a life brings you to where you are
today, to where Mandy is today. She had spent a lifetime usually
avoiding challenging her fears, which resulted in generalized
anxiety and avoidance of the most basic activities, both pain-
related and not.
You can't expect or even hope to have less pain and better
function by rehashing the behaviors that are familiar to you. It
is axiomatic that new, potentially pain-relieving behaviors will
make you anxious and uncomfortable. Revel in that. When you try a
new pain cream that rocks your world with a warming sensation,
you know it's working. The same is true of a new pain-relief
strategy. You know there is gold in the hard-to-get-to hills on
the other side of the mountain.
Mandy will begin challenging her fears this week by answering the
phone when it rings and driving herself to her doctor
appointments. I truly believe she will complete this homework and
walk a little straighter the next time I see her. She really
wants to change and does not believe she is too old. These may
seem like baby steps. They're not.
Every time you discover something that frightens you, but that
seems intrinsically healthy, give yourself permission to
challenge it, to fail, or to be embarrassed. It matters less that
you succeed and more that you tried - and didn't die. Whether
it's exercise, pain class, setting limits with your spouse,
finally ending your legal case, confronting your doctor, or
detoxing from opioids, you can break out of the cocoon of the
failed familiar, and soar over unexplored landscape.
As always, your feedback is welcome as are suggestions for future
newsletter topics.
Good light,
Dr. Tim
My Pain Relief Doc
http://www.mypainreliefdoc.com
Copyright 2006. Dr. Tim Sams and My Pain Relief Doc.
All rights reserved. http://www.mypainreliefdoc.com
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You may freely distribute a copy of this newsletter or
use it on your web site or RSS feed, as long as you
include the entire article, along with the web links
and copyright information. Thanks, Dr. Tim
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*Not her real name