Chronic pain and boredom

Boredom and chronic pain: Finding meaning and purpose

When chronic pain is severe, it can cause physical limitations and reduced mobility for many people.  It can mean that many things we were used to doing before can be more difficult to physically manage. 

People with chronic pain can experience boredom when the pain physically restricts their ability to act or engage with purpose in things they find meaningful. Lack of purpose is associated with higher levels of pain.  Engaging in meaningful activities is related to better adaptation to pain. 

Many people find themselves unable to manage physical activities and tasks that they were used to doing before, including their role of employment.  This can lead to a sense of boredom, which can potentially impact our mental health.

In this post, I’ll be looking at the emotion of boredom in those with chronic pain.  As with a many other factors in life, aspects of boredom and chronic pain can influence each other in either direction. 

We’ll discuss how chronic pain can cause boredom, how aspects of boredom can affect pain, and then go on to look at some ways of dealing with boredom when you have chronic pain. 

What is the root of boredom with chronic pain? 

James Danckert, a psychology researcher with a special interest in understanding aspects of boredom, likened the purpose of boredom to the purpose of acute pain.

 “The function of pain is not to make us hurt… but to make us act.”

(University of Waterloo Faculty of Arts, 2019)

He described boredom as having the same purpose as acute pain.  If we stepped barefoot onto a fire, the purpose of acute pain is a call to act, to take our feet out of the fire.  He believes boredom is a ‘call to action’ in the same way. . 

In the case of boredom, the purpose of the boredom is to get us to act in a way that is satisfying and meaningful.

The root of boredom is not acting in a way that we find meaningful and satisfying.

When viewed from this perspective, it’s unsurprising that people with chronic pain can tend to feel bored.  It’s understandable that being in a state of boredom feels especially uncomfortable for people with chronic pain. 

Danckert points out survey data from 8–15-year-olds show that boredom increases with age in this age group.

He suggests that older children are more bored, because they have gained more knowledge but are still being constrained in many ways by their environment, so that they are not yet able to act on it.

“They’re developing new skills, but are not fully able to deploy them.”  

(University of Waterloo Faculty of Arts, 2019)

People with chronic pain can also feel constrained.  We can feel constrained by the persistent pain and the physical challenges that come with it.

The pain can affect our ability to act using the skills we have developed through life up the point of injury or pain condition.

People with chronic pain can find that the physical limitations affect their social roles.  It can impact out sense of purpose

“Patients wonder how their life can be meaningful if they experience chronic pain and they are often less able to engage with those aspects of their life that gave their life meaning because of the pain.” 

(Dezutter, Dewitte & Vanhooren, 2016)

So, boredom can arise from not being engaged in activities that we find meaningful and satisfying. Boredom could also arise from being more socially isolated with chronic pain, from not being socially engaged.  I wrote more on social isolation on my post on chronic pain and relationships

Can boredom cause physical pain?

This 2015 study  looked at how different people with chronic pain perceived their lives as having meaning.  Researchers defined ‘meaning’ as,

“The extent to which people comprehend, make sense of, or see significance in their lives, accompanied by the degree to which they perceive themselves to have a purpose, mission, or overarching aim in life.”  

(Dezutter, Luyckx & Wachholtz, 2015)

They found having meaning in life to be important to adapting to chronic pain, and for psychological well-being.

People with chronic pain who viewed themselves as having a purpose or aim in life reported lower levels of pain intensity and lower use of pain medication .

The aspect of boredom that comes from having a lack of purpose is associated with higher levels of physical pain.  It was also related to depression, which in itself can influence a person’s experience of pain.

This lab study in 2009  directly tested how pain level was affected by a variety of things.

Each person was asked questions to measure their perception of having a purpose in life, among other things.

Researchers then induced pain in the people who took part, by applying heat and cold. 

They found that,

“Resilience and a sense of purpose in life were both related to the ability to habituate to heat and cold pain in healthy women. These personal characteristics may enhance habituation to pain by providing the confidence and motivation to persist in the face of painful stimuli.” 

(Bruce et al., 2009)

So, a sense of purpose in life is associated with lower levels of pain and better adaption to pain in chronic pain, along with the ability to adapt to acute pain.

In 2020, researchers  wanted to discover how people’s experience of chronic pain was affected by spirituality.  One of the main aspects they were measuring was the level of meaning and purpose in life a person saw themselves as having.

They found that those who used spiritual/religious beliefs as a resource for having a sense of purpose and meaning, coped better with pain in that they were more likely to continue doing activates despite the pain.

“Searching for a sense of meaning and purpose for pain… could make spiritual individuals more resilient to pain and its impact.”

(Ferreira-Valente et al., 2020) 

Lack of purpose is an aspect of feeling bored, so how do we deal with boredom?

How to deal with chronic pain boredom

There are a lot of ways to tackle feelings of boredom for people with chronic pain, and different methods can help different people at different times. Here are some suggestions.

1. Think of other ways that you could interpret your situation

These researchers were studying boredom in quarantine and isolation during the covid-19 pandemic. 

They explain that boredom is not a direct consequence of a situation, but a subjective process of interpretation.

People in the study varied a lot on how they interpreted staying at home and being bored. 

“While the non-bored participants interpret the situation as a relief or as irrelevant, the bored participants interpret it as a major restriction that only some are able to cope with.” 

(Ohlmeier et al., 2022)  

So, how we think of the situation with pain could affect the boredom we experience. 

For example, we might not feel boredom as much if we view needing to rest more during a pain flare as an opportunity for relief, or just as something we need to do. 

If we interpret the pain flare as a major restriction, perhaps we’re more prone to feelings of boredom. 

2. Identify your values

What values as are important for you to live by? 

Your values could be anything from accomplishment, adaptability or approachability, to skillfulness, solidarity or solitude.

If you’re not sure where to start, looking at a values list can help you really think about what’s important to you.

Being mindful of our values can focus our attention towards a sense of meaning in our lives.

3. Use your values to direct goals

Once you’ve brought your values to your attention, and you’ve given it some thought, it can be easier to know what kind of directions you would like to go in life. 

We can align our goals according to our values to give ourselves more sense of purpose, which is associated with being better able to cope with and adapt to pain. 

It can be more effective to make specific, action-orientated goals.  We don’t always have control over outcomes, but we can decide on the steps we want to take.

A 1996 study looking at goals and chronic pain found that when people were able to adjust their personal goals, it helped improve their pain experience.

People who reappraised their goals according to their current situation with chronic pain, reported lower pain intensity and pain-related disability.

Break things down into achievable chunks to make smaller, more achievable goals.

4. Think about what you can do

A part of the journey for many with chronic pain, is grieving for what is lost.  The losses can be wide-reaching and they can really hurt emotionally.

If there are things you can’t do so easily any more, many of those could be things that were important to you. Grieving for losses in and for parts of you that feel lost is common with chronic pain.

It’s horrible. It can take up a lot of emotional bandwidth.

If you feel like you have a space here and there – you might set aside an actual time – to think about what you can do.

While you are thinking about finding purpose and meaning, and setting value driven goals, shift your focus to what you are capable of. 

Even with pain, we are capable of many things. 

We can break activities down into smaller chunks, and pace activities with rest. 

5. Use activity pacing

When finding ways to work towards your value-based goals, it really helps to pace actives throughout the hour/day/week/month as appropriate as much as possible.

With chronic pain, we can tend to have times when the pain is severe, and other times when it’s milder.  It’s common for people to want to squeeze in everything they can manage while they’re having a ‘good day’. 

The satisfaction for getting everything done is usually very short-lived, as we cycle from ‘boom’ to ‘bust’, where the pain flares again and we need to rest.

I really understand that urge to get stuff done when it’s a ‘better day’. I got stuck in the boom and bust cycle for quite some time.

But it’s been better in the long run to get to know what I can manage without causing a terrible amount of extra pain and learn how long I can do activities for.

Know how many activates you can do in a day, how long you can ‘chunk’ things in terms of time, and how often you need to rest.

Some people note things down so they can keep track. It can be satisfying to see what they’ve accomplished when they see all the smaller chunks listed together.

It can be encouraging and builds confidence in ability to do more. We might find that we can increase the amount of time spent on some activities as we go.

Though sometimes a pain flare can seem to come out of nowhere, and it can feel disheartening at times.  We can still use activity pacing strategies when the pain is severe, and adapt them so that the time spent resting is longer.

When we’re pacing, there can be less space for boredom, as we’re just resting between chunks of activity.

6. Consider a chronic pain support group

The pain group stereotype seems to be a bunch of people talking about their pain. But chronic pain support groups aren’t focused around that. 

Chronic pain groups have been shown to give people a sense of purpose and find new meaning in life with pain.

Being involved in the community of the pain support group, where people felt understood, can encourage group members to start other groups around their interests or hobbies.

Conclusion

There are many ways to think about and finding a sense of meaning and purpose in life, as we integrate a new sense of who we are with chronic pain.

Boredom is a ‘call to action’ to engage in something purposeful in a meaningful way.  By considering our values, we can adjust our goals to find new ways to engage in life so we don’t feel so bored.

A greater sense of purpose in life is related to lower pain intensity and ability to cope with and adapt to pain.

References

Dezutter J., Dewitte L., Vanhooren S. (2016). Chronic Pain and Meaning in Life: Challenge and Change. In: van Rysewyk S. (eds) Meanings of Pain. Springer, Cham.

Dezutter, J.., Luyckx, K.., & Wachholtz, A. (2015). Meaning in life in chronic pain patients over time: associations with pain experience and psychological well-being. Journal of behavioral medicine38(2), 384–396.

Ferreira-Valente, A., Damião, C., Pais-Ribeiro, J., Jensen, M., P. (2020). The Role of Spirituality in Pain, Function, and Coping in Individuals with Chronic Pain, Pain Medicine, Volume 21, Issue 3, Pages 448–457.

Finlay, K. A., Peacock, S., & Elander, J. (2018) Developing successful social support: An interpretative phenomenological analysis of mechanisms and processes in a chronic pain support group. Psychology & Health, 33:7, 846-871.

Ohlmeier, S., Klingler, C., Schellartz, I., Pfaff, H. (2022). Having a Break or Being Imprisoned: Influence of Subjective Interpretations of Quarantine and Isolation on Boredom. International Journal of Environmental Research and Public Health. 19(4):2207.

Smith, B., J., Tooley, E., M., Montague, E., Q., Robinson, A., E., Cosper, C., J., & Mullins, P. G. (2009). The Role of Resilience and Purpose in Life in Habituation to Heat and Cold Pain.  The Journal of Pain, Volume 10, Issue 5, Pages 493-500.

Schmitz, U., Saile, H., & Nilges, P. (1996).  Coping with chronic pain: flexible goal adjustment as an interactive buffer against pain-related distress.  PAIN, Volume 67, Issue 1, Pages 41-51

University Of Waterloo Faculty of Arts (2019). Psychology Prof James Danckert on boredom research [Video]. YouTube.  https://www.youtube.com/watch?v=7LOhSAC_bLA