The idea of accepting chronic pain can be an emotive topic for people. It was for me. I was having none of that!
I think people can take different meaning from the word ‘acceptance’ in relation to chronic pain.
When it was first suggested to me that I had to learn to manage chronic pain, I was far from ready to accept that.
I saw ‘acceptance’ of the persistent pain as defeat. It was devastating to me.
It was also where I turned a corner.
Don’t get me wrong – I had no intention of turning that corner. I hadn’t even seen it coming, let alone prepared for it. I was metaphorically flung round that corner on the day I first visited my pain management consultant.
I didn’t suddenly accept the chronic pain that day. But the facts were staring me in the face. I wasn’t going to be cured. I had to manage the pain.
That was it.
Up until then, I’d been fixated on trying to sort the cause of the pain, after my injury. Trying so many different treatments and procedures.
And when none of them were able to successfully eliminate the pain, I then focused on trying to control it.
I still do try to control it, but more in the sense of managing it. I no longer expect to be free of it.
But I’ve managed over the years to find the right combination of treatments to stabilize it. I know what makes it worse, I know how much I can do, and how much to rest.
I’ve come to accept that it’s just part of me now. And I’ve stopped being angry with it, because I don’t want to be angry with a part of myself any more.
What acceptance means to me now is just a way of coping with chronic pain.
For me, it means no longer using my energy searching for a cure. No longer trying to trick myself that I have no limits. No longer fighting against.
My sense of acceptance is working with the pain.
What acceptance meant to me changed over time, at different stages in my pain journey. It seemed complex, not easily defined, and had different aspects to it.
Acceptance also means different things to different people.
Different aspects of acceptance of chronic pain
I don’t believe there’s one single answer to the question, ‘how do you accept pain?’ This is because acceptance means different things to different people.
With this in mind, I’d like to talk about some different aspects of acceptance. Perhaps one or some of them will resonate with you.
Researchers in 2003 interviewed people with chronic pain to find out what acceptance meant to them, how they understood learning to live with pain. Here is a summary some of the different accounts of acceptance of chronic pain that they discovered.
- Controlling pain, rather than being controlled by it
- Living day to day (the acceptance of uncertainty)
- Acknowledging limitations and adapting life goals
- Shifting focus away from pain to life’s pleasures (empowerment)
- Confronting the loss of a pain-free self
- Living in spite of the pain
- Choosing your battles (no longer resisting pain)
- Finding spiritual strength
The researchers point out that these different accounts of what it means to accept pain share several common features.
They explain that the first common factor in the meaning of acceptance to people with chronic pain, involved the shift of focus away from pain and its effects on their life. Acceptance involved focusing on other aspects of life, and not being defined by the pain.
“To accept chronic pain has…the goal of reducing the potential of chronic pain to overpower life.”
(Risdon et al., 2003)
The second common feature of acceptance is acknowledging that a cure is unlikely, and that pain may be a feature of the rest of a person’s life, and that the pain itself might not change.
“Perhaps a primary feature of acceptance of chronic pain is that change in life is required.”
(Risdon et al., 2003)
The third common thread that the researchers found, was that acceptance wasn’t a sign of weakness, inferiority, or the end of a meaningful life.
They point out that for the people with chronic pain who were interviewed, acceptance didn’t revolve around the feeling or the experience of the pain itself. Rather, acceptance revolved around the effects of pain on people’s social roles, and how they measured their self-worth and value in society.
What does acceptance of chronic pain look like to you? What chances would need to happen in so that you could achieve that?
Strategies to help with acceptance of chronic pain
I believe that different things can help different people at different times.
Two acceptance-based psychological strategies that you may find useful, are mindfulness and acceptance and commitment therapy (ACT).
Mindfulness involves consciously directing your mind to the present moment, and just noticing sensations, thoughts or feelings without judgement.
ACT involves identifying your values and trying to find your direction in life based on those values. It also It’s also directed towards learning to sit with and experience uncomfortable feelings and sensations, rather than trying to avoid them.
In 2011, researchers compiled the results of all the relevant studies on both of these strategies.
They found that the two acceptance-based strategies had a medium effect on pain intensity for people with chronic pain. It had a similar level of effect on quality of life, depression, anxiety, and physical wellbeing with chronic pain.
“The results suggest that at present mindfulness-based stress reduction program and acceptance and commitment therapy are not superior to cognitive behavioral therapy but can be good alternatives.”
(Veehof et al., 2011)
It makes sense that people can find ACT helpful for chronic pain, as it seems like a lot of what acceptance means to people revolve around changes in how they see themselves as a person, and their role in society. Identifying your values can help and finding ways to orientate towards them can be useful in the circumstances. I intend to write in more detail about strategies like mindfulness and ACT in future blogs.
Conclusion
What it means to have acceptance of chronic pain seems to differ according to different people, and I believe that what it means to a person can change over time.
It can mean not being defined by pain, changing focus away from pain to other aspects of life, acceptance that pain could be lasting, and accepting the way pain can change how you view yourself. People seem to view acceptance of pain in terms of taking control of the pain, without fighting it.
Acceptance-based strategies like mindfulness or ACT can be useful to people with chronic pain. Your personal path to acceptance will depend on what acceptance actually means to you.
References
Risdon, A., Eccleston, C., Crombez, G., & McCracken, L. (2003). How can we learn to live with pain? A Q-methodological analysis of the diverse understandings of acceptance of chronic pain. Social Science & Medicine, Volume 56, Issue 2, Pages 375-386.
Veehof, M. M., Oskam, M., Schreurs, K. M. G., & Bohlmeijer, E. T. (2011). Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. PAIN®, Volume 152, Issue 3, Pages 533-542.