It has become increasingly apparent to me that chronic pain is a family issue. Your deepest human interactions happen at home and members trigger each other. These powerful reactions have severe consequences. Partners and parents often end up acting in ways that they would not tolerate in their children. How else could you explain these behaviors in people who are otherwise responsible members of society?
It is clear from data produced from the ACE (Adverse Childhood Experiences) study that we, as a culture are not parenting very well. The list of ACE’s is the following:
- Substance abuse
- Parental separation/ divorce
- Criminal behavior
- Mental illness
- Battered mother
The higher the ACE score, the greater the chances of the children experiencing depression addiction, extreme obesity, anxiety, suicide, partner violence, etc. The list is long. (1)
What is striking is that only 30% of children had an ACE score of zero. Over 35% had an ACE score of 3 or higher. It is ironic and unfortunate that the people you care for the most are also the ignition for strong unpleasant reactions. Why is this the case?
We are programmed from birth by our environment. It matters little what you “teach” your child. It is how you behave. So each of us have patterns of behavior that are imbedded in our nervous systems that are a result of witnessing the actions of our parents. Whether you adopt or reject the patterns, the patterns are still running your life. The behaviors play out the most strongly in our new families regardless of the makeup. They originate in the unconscious part of your brain and are not solvable – especially when you are not aware of their magnitude or existence. Hoffman process
So as you begin to engage in the DOC principles with some success, it is difficult to move forward when you are continually being triggered at home. We do know that pain and anger are linked pathways. Additionally, these reactions are so powerful, none of us want to give them up, even though we know better. The family unit may be the most critical aspect of keeping you stuck in the Abyss of pain. The crab bucket It may also be the most influential in pulling you out of it. A promising sequence involving the whole family is beginning to emerge. Here is how I finish a typical office visit after I have done my evaluation and explained the relevant issues.
Beginning the family healing
I hand them a copy of my book and show them this website, www.backincontrol.com. I ask all members of the household to go “all in”, whether or not they have pain. Everyone has anxiety, which is the pain. After I have suggested that they begin the expressive writing combined with active meditation, I jump to the final step of Stage 1 – Do not share your pain.
Here are the guidelines:
- When you walk out the door of this office you are never to discuss your pain with anyone – especially your family. BTW, no complaining about anything – period.
- On the way home you are to spend the time reminiscing about era of your relationship when you had the most fun. Remember your dreams, friends, adventures, conversations and shared suffering in detail.
- When you walk through the door of your house that same energy will be brought into the home and nurtured – without exception and indefinitely. If you must argue – take it outside. My nurse pointed out to me that you cannot have a bar fight in a bar. Why do you want your home to be a no-holds-barred fighting arena?
- They must make a commitment to honor this part on not engaging with each other when they are upset and I ask them both to verbally affirm it.
- I show them the link to “Protect Your Family from Your Pain.” Each of them has permission to withdraw from any unpleasant interaction – without reprisal. Each party also has permission to ask the other to person stop discussing his or her pain.
It has been eye-opening for me to see how much time people spend talking about their pain or what is wrong with their lives. It is not that interesting. It is incredibly frustrating for family and friends to constantly hear about it. There is nothing they can do to help. It is also interesting how responsible family members feel to help the other person solve the pain and also how the person in pain can hold the family’s feet to the fire to help. It is a deadly cycle. Your pain is yours and yours alone. It’s your responsibility to own and solve it.
I’ve had patients blurt out, “Well what can I talk about?” Almost anything is more interesting than pain. The alternatives are infinite. You have to first unhook from your pain before you can re-experience these wonders.
Not sharing the pain
I have been heading towards this conversation for a while and have taken it up several notches over this last year. It has been encouraging and change can occur quickly. I had a woman who had been in pain for over 30 years, in addition to some other significant neurological problems. She had a strong right to complain and be upset. The problem was that her husband was simply worn out. The tension in the room was high and uncomfortable. When I introduced the rule of not talking about pain, he immediately had a smile emerge and both of them relaxed a bit. I said, “I want you both to fully engage but separately. Imagine a 10-foot steel-reinforced concrete wall between the two of you regarding the topic of pain.” I then went on to explain the above-mentioned rules.
I was shocked when they returned a month later. They were animated and laughing. Her pain was down by about 60% and both of their moods were dramatically improved. They had re-discovered how to have a good time. Remember that although pain pathways are permanent, so are play pathways. You just have to re-connect with them. It is a powerful way to move forward. Interestingly, some of her neurological symptoms had improved. They could hardly contain their excitement about the possibilities. The only negative of the day was that I was so interested in what had transpired that I got hopelessly behind in clinic.
It has also struck me that one of the core concepts of healing is feeling safe, which is hard to do in this world amongst fellow workers, classmates, bosses, and most importantly from yourself. We endure an endless barrage of negative self-talk. However, you do have a choice about what you want to create at home. I think that by constructing a “safe house” that you are more able to do the same in other areas of life.
I have decided that the focus of my next book will be on both protecting the family from chronic pain and using that same energy to connect to the body’s capacity to heal. I am looking forward to seeing where this might go.
Happy Mother’s Day!!
- Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 2006;256:174–86.