TLC Therapeutic Services

Grief and Chronic Pain

  1. Accept the reality of the loss.    What is Acceptance of chronic pain? Acceptance can be defined as a way of addressing an unchangeable situation or a life experience. It is not the same as defeat, helplessness, quitting, or resigning to a life of unhappiness, struggle, or misery. According to dictionary.com, acceptance is defined as, “the mental attitude that something is believable and true .” Accepting that you have pain (or that your pain is true and believable) is different than giving up all hope.  Denying that your pain is not chronic may serve to delay the grieving process, and thus move on to adapting to this new life experience. Though we should always maintain hope that there is a treatment that may decrease our pain, relying only on this type of thinking blocks acceptance and grieving. 
  2. Experience the pain of the loss.  Anger, Depression, Anxiety, Loneliness,  Stigma      Anger is a necessary stage of the healing process. Feelings of anger may seem endless, but it is important to feel them. The more you truly feel anger, the more it will begin to subside and the more you will heal.  Your anger has no limits and it may extend to your doctors, family, friends and loved ones.  Example: “This isn’t fair! I didn’t do anything to deserve this!” or “Just give me something that will make me feel better!”* Feelings of emptiness and grief appear at a very deep level.  This depressive stage feels as though it will last forever.  It is important to understand that this depression is not a sign of mental illness.  It is the appropriate response to a loss or a life-altering situation. {Still, depression can and should be alleviated with professional help - research regarding brain chemistry shows that whether you are born pre-disposed to depression and have it before this stressor, or it is a reaction to a stressor, changes in your brain are the same). Having a chronic pain or illness may also bring up feelings of anxiety; anxiety about what the future holds, anxiety about not being able to live up to expectations, anxiety about social situations, anxiety about medical bills, etc. Example: “I’m going to be in pain forever so why even bother?” or “I’m going to be in debt forever.  How am I ever going to pay off these medical bills?”  These feelings of pain can be so strong that it is very helpful to work with a therapist and/or a support group. 
  3. Adjust to a Life with Chronic Pain. Having a chronic condition often means giving up a lot.  This is a time to work on coping skills to help us manage our condition and to improve self-esteem This is a time to work on relationships, to develop respect and understanding. To work on love and belonging, find and build resources, find treatments that work, incorporate into daily life, build confidence. Adjust expectations of self. Work on automatic thoughts that may lead to negative thoughts and difficulty coping. This is a good time to see a therapist or a CBT group. Identify the origin oft these thoughts (they have been with you since you were a small child, and apply to ALL areas of your life, how are they affecting you with chronic pain?). Work on re-structuring negative thoughts to adaptive thoughts. Eliminate thoughts of “Never”, “should”, “always”. “I am worthless/burden”   This task corresponds with Maslow’s ESTEEM and LOVE/BELONGING. 
  4. Withdraw Negative Emotional Energy and Re-invest it in Moving Forward   This is a time where we begin to work on goal-setting. We look at ourselves and define who we are. This also corresponds to Maslow’s Hierarchy of Self-Actualization.  Self-Actualization is not easily attainable by anybody, (even those in upper-socio economic brackets, WITHOUT illness,) but is especially difficult for  those who still have issues with Safety (Employment, Finance, and Health,etc). Chronic Pain Sufferers notably, will always have health issues (SAFETY), so it HUGE and difficult emotionally to be invalidated by doctors, psychologists and others that we should “adjust, get back to living, get a job, find meaning” within months of our realization of this being a part of our lives in some intensity forever.  Since Health is a constant battle and will always surface from time to time it will often bring up the painful emotions we experience (2nd Task).  That being said, with time, chronic pain patients CAN find meaning. One method is  through goal-setting . Of course there are other ways to navigate finding meaning, and that is something you can work through with an approach tailored to you as an individual. 

IT IS IMPORTANT TO NOTE THAT THESE FOUR STAGES ARE EXPERIENCED ALL AT THE SAME TIME; it is a common misconception that one accomplish stage 1, go to stage 2 and 3, and 4. We constantly vary on all levels.

Our work together will largely focus on processing the grief of chronic pain.  We have lost so much, and ignoring the losses make adjustment and learning to live with pain extremely difficult. My experience as a grief counselor for 5 years has led me to adapt Worden's Four Tasks of Mourning to the model above. 
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