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Thursday, June 07, 2018
FEAR, ANXIETY, AND CHRONIC PAIN: An excerpt from THE PAIN COMPANION by Sarah Anne Shockley
 

In the twenty-first century, one might wish that pain were an easily treatable nonissue. It is not. Millions of doctor and emergency room visits stem from pain, and addiction to pain medications, which is rampant in the United States, often takes root when someone in pain is attempting to manage unremitting discomfort. 

In The Pain Companion: Everyday Wisdom for Living With and Moving Beyond Chronic Pain, author Sarah Anne Shockley, who has personally lived with chronic pain since 2007, offers fellow pain sufferers a compassionate and supportive guide for living with pain that can be used alongside their ongoing medical or therapeutic healing programs. We hope you’ll enjoy this excerpt from the book.

# # #

When healthy, many of us take our bodies for granted most of the time. We’re not surprised to wake up in the morning and be in a body that works generally well. We get up and go about our day not worrying if we can put one foot in front of the other. In fact, basic body functioning is usually the least of our worries. We’re so sure of our bodies, we often pay minimal attention to them until they show signs of distress. 

However, since the body is our vehicle for being in life and for participating in life, when we can’t rely on it, it’s incredibly frightening. All of a sudden everything changes. 

When the body is not functioning properly, it brings up a huge amount of fear and anxiety. We can’t wake up in the morning and assume everything is going to be all right. In fact, things may be very, very not all right. 

Anxieties begin to multiply as the length of time in pain increases. You get the double whammy of needing to rest and relax so you can heal, but you don’t feel relaxed at all because of ongoing work and family demands. 

With prolonged time away from work comes the stress of not being able to keep up with what needs to be done. Tasks already put off for a week or two become critical, but you don’t know how you will handle them with your body still compromised. 

You may become worried about things falling apart without you, missing advancement opportunities, or the possibility that you may never go back to work at all. 

Other stresses come from dealing with medical appointments, insurance companies, child-care arrangements, medical bills, and demands from family or partners. It seems hugely unfair that, at the time when you most need to rest and heal, your anxieties are mounting.

I often woke up in the middle of the night with panic attacks from survival terrors. I didn’t know if I would be approved for ongoing disability funds, how I would live with a body that wasn’t employable, or how I was going to meet even the simplest demands of life. 

Being totally stressed-out and worried made the level of pain in my body skyrocket, so I had to find some way of working with the tension, anxiety, and fear.

Antidotes to Fear, Anxiety, and Stress

Acknowledge That Fear Is Not a Creative Force

Fear naturally arises when you are living in pain because so many unanswerable questions remain about the possibility of things getting even worse; how and if the pain will subside; and when, how, and if you will get better.

Fear is a natural reaction to the unknown, particularly if you are feeling less than fit physically, but all in all, I find it to be an unhelpful response. As I eventually realized, stressing out about my situation does not actually help it. For one thing, fear does not bring anything positive with it. It is not a creative force. 

Fear does not change anything except to add more stress to the situation. No amount of worry is going to reorganize the world or fix anything. In fact, being anxious usually makes any physical condition worse. 

Our minds worry over the future because we think that worrying is actually doing something. We think that if we’re not worried, it means we don’t care. But fear, worry, and anxiety do not actually produce positive results. They sap energy. 

Employ the Fear Protocol

The following is my Fear Protocol. It’s the method I created for myself to help reduce the terrors and anxiety of panic attacks. After you read through it and use it a couple of times, it’s easy to remember the five steps. They will become second nature. Use them anytime you feel anxious or afraid, day or night. Allaying fear is a discipline of the mind, and I find this technique to be immensely helpful.

The Fear Protocol:

Step 1: Notice What’s Really Happening
Step 2: Notice What Has Already Worked Out
Step 3: Notice What You Can Take Charge Of
Step 4: Notice What’s Going Well Right Now
Step 5: Time It and Start Again

Step 1. Notice What’s Really Happening

Tell your mind that you are leaving your worry alone for a moment. Know that it will still be there if you want to go back to it later. 

Fear is always about the future. It’s about what might happen. Notice that what you’re afraid of probably isn’t happening in this moment and may never happen. In fact, most of the things we worry about never actually occur.

Step 2. Notice What Has Already Worked Out

Consciously calm your breathing and go back in time to the last thing you were really worried about. Notice how much of your worrying helped. Did worry have a direct positive impact on the outcome? Did it work out the way it worked out regardless of the amount of time you spent in fear and anxiety? 

Also, notice that, one way or another, it did work out. Go back over the last several weeks and months and look at the things that caused you a great deal of anxiety and notice how many of them have already worked themselves out better than you feared. For now, you are still alive and carrying on. Go back to earlier in the day and notice if what you are worried about happened yet today.

Now, to whatever degree you can muster, allow yourself to trust that things will work themselves out this time, too, one way or another. Sometimes it will be in ways you want, sometimes not, and sometimes it will work out even better than you thought. 

Step 3. Notice What You Can Take Charge Of

Since fear seems to come from feeling out of control of the situation, pay attention to what you can take charge of. 

You are ultimately in charge of how you feel, for one. It is your choice to be in fear and anxiety or to find a way to trust in life. Consider how you can be proactive and take charge of the decisions you need to make today and tomorrow. Make one firm decision right now, even if it is a relatively minor one.

Step 4. Notice What’s Going Well Right Now

Consciously relax and breathe as calmly as you can. Find something to be grateful about that is happening right now in the moment and put your attention there. Find anything, even if it’s the fact that your sheets are clean, or you can hear a nice breeze outside, or the neighbors have stopped shouting.

Notice the systems already in place that are working for you. In your mind’s eye, see the people who are helpful to you and say thank you to them one by one: your doctor, your friends, your family, your coworkers. 

If you are getting any financial assistance whatsoever, acknowledge that help to yourself and say thank you inside. If you’ve noticed any improvements in your condition, say thank you. 

If the people you love are doing well, say thank you. If things could be worse than they are now, notice that they aren’t and say thank you. Say thank you for all the things that could have gone wrong and didn’t. 

Step 5. Time It and Start Again

Go back to worrying if you really need to. Take exactly five minutes to worry excessively without making yourself wrong for it. Stop immediately when the time is up. Work through the protocol from the top again until you feel better. End on a positive note.

# # #

Sarah Anne Shockley is the author of The Pain Companion. In the fall of 2007, she contracted thoracic outlet syndrome (TOS), which is a collapse of the area between the clavicles and first ribs, and has lived with debilitating nerve pain ever since. She has been a regular columnist for the Pain News Network and is a regular contributor to The Mighty, a 1.5 million–member online community for those living with chronic illness and pain. Visit her online at www.ThePainCompanion.com.

Excerpted from the book The Pain Companion. Copyright © 2018 by Sarah Anne Shockley.  


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