Picture taken from Ernesto Sanchez’s guest post, “The Journey of 1000 Moons”
Here’s a puzzling situation I often encounter: A patient experiencing severe chronic pain on my spine intake questionnaire rates him or herself as a zero on a 10-point scale with regards to anxiety, depression, and anger. They may have even undergone multiple failed spine surgeries. Yet upon further, almost intrusive, questioning by me, they adamantly will stick to their story, “I am just fine except for the pain.” My next question is, “What about your pain?”
Your Hand Over the Heat
If you were to put your hand close to a red-hot burner on a stove, what would happen to your level of anxiety?
- It would quickly escalate.
- You would withdraw your hand.
- You would protect yourself.
- Anxiety would be alleviated.
What would happen to your anxiety if you were forced to leave your hand over the burner?
- It would go through the roof.
- You would feel trapped and extremely angry.
I Don’t Believe You are OK
Anxiety is a Programming Problem not a Psychological Problem
The changes to the central nervous system during chronic pain present a programming problem rather than a psychological Problem.
- Anxiety gains strength with time and repetition.
- Anger is a powerful force that covers up the feeling of anxiety
- Anger spins anxiety inducing neurological circuits more quickly.
- We deal with anxiety by exerting some form of control.
- If you are successful in controlling the situation or yourself, then your anxiety is alleviated.
- Without control, you become frustrated or angry. Anger = loss control
With chronic pain, you have, metaphorically, lost your ability to “withdraw your hand from the red hot burner.” How can you rate yourself as a zero on anxiety and irritability? If you had no other stress in your life, chronic pain alone would be enough to destroy the quality of your life.
There are several other stress factors to consider with chronic pain.
- People in chronic pain don’t see an end to their suffering. They lose hope in returning to a pain-free life.
- Chronic pain patients are truly victims of pain. When you are truly a victim, it is more difficult to let go and not have anger run your life.
- When chronic pain patients suppress anxiety and anger, these negative feelings become much stronger–see White Bears and ANTS.
Being Pain-Free is a Basic Need
We all deserve to live free of constant pain. Being pain free is a basic need. We cannot accomplish higher goals and flourish as human beings without first securing the comfort of being in our bodies. I talk about this in “Maslow’s Omission.”
Also, see me talk about this in the Video: “Your Hand Over the Stove.”
“The Link Between Pain and Anxiety”. Inspiyr, January 21st, 2013