If you’re happy and you know it, you’re not in pain? Not really. Not exactly. Not entirely.
It certainly seems like a belief one would have. Pain does seem to hold a certain rather unpleasant, well, pain quality to it that diminishes ones desire for positive emotions.
People living with chronic pain often experience depression and negative emotions, which can magnifying the severity and ongoing nature of pain. But we also experience positive emotions in the midst of chronic pain. Because our experience is chronic. And it is just a fact that because it is chronic our emotions are a constant flux. Positive emotions, feelings such as happiness, excitement and calmness, can actually lower our perception of pain intensity. They can even break the cycle of pain and negative emotions and reduce our perceived suffering at some level.
It should come to no surprise we are capable of a full range of emotions. Yes, we experience our fair share of negative emotions. Yes, we struggle with that. Because, yes, pain sucks. It is perfectly normal in the coping process to struggle with negative thoughts. A difficult process for all of us. Because, pain.
The misery
The notion that pain begets a constant state of misery though is peculiar to me. Not only do we try to do all sorts of things to actively distract ourselves from pain and boost our mood but it is simply impossible to stay in one state of emotion for all time.
To be surprised we are not bombarded with negative emotions all the time? That this is a shocker? That is some sort of stigma right there. Because we know that dampening that negativity, actively doing things to counter those moods, helps us. We know that our moods help with our pain. We know we are fully capable of laughter, joy, happiness and humour when we are in pain. Within limits. We have moods. Because we are fully functioning human beings. There are days we cope better than others.
Managing emotional states
“pain and negative emotions can be conceptualized as overlapping phenomena that are ‘embodied and embedded’” (Study)
When we manage our emotional states our perceived suffering can be reduced. However, pain is a constant flux and so can our emotional response to pain. Therefore our perceived suffering likewise can be volatile. When we actively do thing like meditation or self-care that calm down our negative emotional states our perceived suffering can be reduced.
Negative “emotional states modulate the affective component of the pain experience.” (Study) Specifically, negative emotional states amplify the unpleasantness of pain. When we manage our pain our emotional suffering due to pain can be reduced. This is because the fluctuation of pain itself amplifies our emotional responses. Pain management becomes important in so many way because of this fact. We become at high risk for depression and/or anxiety when our pain isn’t managed.
It is and can be a tangled web that we can often not be entirely aware of. And sometimes we are keenly aware of the connection between pain level, emotional states and suffering.
When my depression wasn’t treated I struggled massively with during high unmanaged pain with negative thoughts. Even with therapy to manage those negative thoughts… because the pain makes them so Real and Tangible. Like the perfect storm. And my depression did need medication, which worked quite well for me combined with therapy. But I still have negative thoughts and certainly with the high pain. The lingering depression is something I work through. It isn’t the tidal wave it once was. However, high pain makes it darker, emptier, and deeper. Depression and high levels of emotional distress can greatly complicate our chronic pain treatment. (Study)
“a nationwide Swedish study of over 20 000 patients with chronic pain referred to specialist rehabilitation clinics, showed that 39 % of patients had clinical levels of depressive and anxiety symptoms [21]. Alongside emotional distress, these patients reported lower activity engagement, more pain, lower function and reduced quality of life, as compared to patients with chronic pain and no -or lower-distress levels. In sum, chronic pain and emotional distress are intrinsically related and the co-occurrence aggravates the burden.” (Study)
We are going to struggle with negative thoughts and emotions. With the intensity of pain, the emotional reaction to that pain, and the resulting suffering it causes.
Freedom to express emotion
Conceptually we are aware positive emotional states are going to help us cope and manage our pain. We know it will help us with the pain tolerance, with depression and anxiety and with suffering.
Things that benefit us in helping promote and regulate positive emotions are:
- Meditation
- Self-care
- Distraction
- Hobbies
- CBT
- Emotion awareness and Expression therapy
- Dialectical Behavior Therapy (DBT)
- Pain Reprocessing Therapy (PRT)
- Pain management
For me, regulating my emotions is best done with distraction techniques. I engage in various hobbies from low concentration when pain is higher to higher concentration when pain is lower. When distraction is not possible self-care becomes more vital and managing my depression quite important.
I’m aware of the fact that positive emotions are not something to be forced of inflicted on myself. Gently encouraged perhaps. Doing things that bring me small joys during the day maybe. Small accomplishments. I’m aware the flux of less positive emotions that flow with pain and fatigue are temporary and knowing this helps me get through them. Feeling that they are this sort of every flowing river that will just flow through me, passing moment to moment helps me get through the more aggressive currents.
Certainly, I know I have the capacity for joy, laughter, and happiness within chronic pain. I know chronic pain itself ebbs and flows.
Chronically Nikki 