“I am asking you to not give ANY advice to any member of your family for the next month; especially your children.” This is the foundation of the family dynamics in dealing with chronic pain.
Chronic pain takes a terrible toll on families. People in pain often have forgotten what it’s like to have fun. They tend to become socially isolated and withdrawn, even within their own home. Much of the conversation centers around pain and medical care. It becomes tedious and frustrating because there is little that can be done to solve the problem. Additionally, it’s common for patients to lash out with their family being the closest target. A term used to describe the anger associated being trapped by pain is “rage”. (1)
But now the whole family is also trapped. The scenarios become apparent quickly within the first couple of visits. So, I ask them a simple question, “Do you like your family?” The answer is always, “Of course!” The essence of the problem is that anger has become so normalized within the household that they can’t see effects of their pain on those around them. The core of human relationships is being aware of other’s needs from their perspective. The essence of abuse is lack of awareness and anger obliterates it.
Then I ask, “If your family is so important to you, why would you allow yourself to get so upset with them? Would you yell at a stranger the way you talk to your family?” Of course not. “Then why would you treat your family who you care about better than someone you have no connection to?” Protect your family from your pain
After a brief conversation, I assign some homework. I want them to individually ask each member what it’s like for them when they are exposed to your anger. Then I ask them to consider, “How do you look when you’re angry?” Why would you want them to see you in that state?” Anger isn’t attractive and you’re no exception.
How do you want your family to feel when they hear your footsteps approaching the front door? Are they excited or are they dreading it? Are they on hold until they see what mood you’re in? What do you want them to feel? Do you enjoy playing with your family? How often to you do it? Can you really play if you aren’t in a good mood? Is your family a haven of safety and joy?
Who’s the adult?
I was taken aback a few years ago while talking to a large muscular patient. It was slightly intimidating just being in the room with him. He was a high-level businessman who had suffered from chronic neck pain for years. I asked him if he ever got upset? He initially said he didn’t and then admitted he did occasionally. That turned out to be a daily occurrence and happened multiple times a day. I asked him, “Who’s the target of your anger?” He replied, “My daughter.” I asked him how old she was, and he said, “Ten.”
I was startled because the focus of anger tends to be the partner. I asked him who was the adult in this scenario, and how do you think she might feel being the focus of his rage. He hadn’t considered that angle, but he couldn’t let go of how much she was upsetting him.
The second part of the homework is that I want him or her to practice awareness beginning when they walk out my office door. The assignment is that they are not to give any advice to their partner or children until the next visit. None, unless specifically asked. I also ask them to consider some of following. “How often do you give unasked-for-advice? Do you realize that you’re actually telling them that they aren’t good enough the way they are? Are you overtly critical? Do you enjoy or appreciate being criticized? How would you react? How do you expect them to react?”
It appears that the family is one of the greatest factors in propagating pain and anxiety. One of the most perverse parts of the human condition is that the species that survived did so because they learned to cooperate with other humans. The need for human connection is deep and the deeper the better – except that the triggers that set you off are stronger. So potentially the most safe and secure place in your home is often the most dangerous.
You don’t feel safe because your body has betrayed you and you’re being constantly assaulted by pain. Then it plays out in your home and no one feels safe. Is this what you had in mind when you got together with your partner and were excited about building a future together? What happened? What can you do? You have choices and the first step is becoming aware of the depth of the problem. Healing begins at home
Even if you think your family environment isn’t a problem, I would challenge you to still ask your family the above-mentioned questions. These issues are universal, and you’ll be surprised and sobered at the answers. The good news is that with becoming more aware, the family environment can quickly improve. We’ve been excited by speed and depth of the changes. The whole family feels hope.
This is an essay sent to me by one of my patients on Mother’s Day
- Sarno, John. Healing Back Pain: The Mind-Body Connection. Warner Books, NY, NY, 1991.
Here are a couple of books that I have frequented recommended regarding parenting and improving your relationship with your partner. They have both had a significant and humbling impact on my interactions with my family. Looking back on my experience with pain, it is incredibly frustrating to see how my endless quest to find a cure for my pain interfered with my relationships both in and out of the home.
- Gordon, Thomas. Parent Effectiveness Training. Three Rivers Press, NY, NY, 1970, 1975, 2000.
- Burns, David. Feeling Good Together. Broadway Books, NY, NY, 2008.