Cognitive-Behavioral Therapy for Pain Management
“Pain is inevitable, suffering is optional” -Haruki Murakami
There’s no doubt that being in pain sucks. Whether you experience it occasionally or daily, pain is a total drag. While it can range in severity, the way it can zap our attention and energy is universal. How much we allow it to do so is something we may have control over.
This is how:
When I was in junior high during a routine scoliosis check, I was flagged for having a slight curve in my spine. Little did I know that this would be the beginning of a lifetime of surgeries, stretches, and stenosis. As I got older, the curve became so bad there was no other recourse—surgery with spinal fusion it was! I was even guaranteed that I would “grow” a few inches although this wasn’t all that appealing as I was already considered tall at 5’9”—towering over the boys I was trying to impress in my class.
The surgery was painful but successful, titanium rods lined my spine and were fused beautifully so while cracking my back was no longer possible, my curve decreased immensely. In the course of the surgery, they had to break a few ribs too for “cosmetic” reasons as to compensate, my body had become deformed and unnaturally jetted out too far on one side. Giving the appearance that half of me was sticking out while the the other half was covered in a comfortable layer of fat (a nice visual, I know). To boot, I also have pectus excavatum which sounds more like a Harry Potter spell than an actual infliction. Let’s just cut to the chase, my body, more specifically, my bones and by proxy, my nerves and muscles, aren’t going to be winning any gold medals anytime soon—and I’m okay with that.
Pain has become familiar to me and something I experience daily. Typically, when you have this type of surgery (or in my care, surgeries), stenosis can settle in so although you may be in the prime of your life—your back is that of someone much, much older. X- rays show stenosis and arthritis, and if my date-of-birth wasn’t clipped on to every radiographic film, you would assume it was someone in their 80’s. While certain exercises and physical therapy do help, the narrowing of my spine, the still present curve and compensation there for, and bone spurs cannot and will not be ignored. Over the counter anti-inflammatory mediations are the first line of defense, as well as lidocaine patches but let’s be honest, this is something a few ibuprofen and a good pilates class cannot cure.
It’s been approximately 20 years since my first surgery (I had a second surgery after the metal rods bent in a car accident). The world has changed quite a bit and me along with it. I recently started following a few social media accounts that discuss scoliosis and individual’s struggle with it. The other day I saw a video of a young girl, expressing how she hates her scoliosis so much that it makes her want to die. Through a vein of strength, she proclaims that she hates wearing large shirts but has to hide her brace. My heart broke when I saw her pain and heard her words. If only the people who needed to hear this could hear this, I thought. If only her in 20 years could see this…could hear this. If only I could tell her that her life is worth living and she is not defined by her scoliosis.
Perhaps just another platitude, being defined by one's diagnosis is not unusual, and being defined by one’s pain can be all-consuming. Whether it’s knowingly temporary or a lifelong ailment, how and what we think about our experience is just as important as the diagnosis itself. This isn’t to say that you can “out-think” pain but you can change your mind about what it means to you, on a more intimate level. Rather than pain being something a la, “This is Spinal Tap” that is as loud as an 11—how about we start dialing it back to something quieter, less pervasive, and more manageable—more a murmur less a hairband.
When confronted with pain, of course the first plan of action is to:
1. Follow your Physician's Recommendation
Treatment ranges greatly from physical therapy to medication and any combination in-between.
2. Mindfulness and cognitive techniques are a treatment
These you can apply with any combination of previously mentioned prescriptions. Automatic thoughts and/or cognitive distortions that this is “all bad” or you will always feel like this will not only make the pain appear more intense but also make you overall miserable. All-or- nothing thinking is something we’re all guilty of to some extent but challenging these thoughts can set you free and examining them with some distance can help you reframe your experience.
3. Acknowledging your Pain and Not Letting it Define You
By acknowledging the pain and allowing it to be there but not letting it define you or set the tone for every experience, we can take control back. When given the choice to focus on the pain or focus on the good around it or the good that possibly came from it, let’s allow pain to take the backseat of the car rather than let it be the driver—in fact, why don’t we secure it in the trunk.
Carl Rogers said it best, “The curious paradox is that when I accept myself just as I am, then I can change.” When we take in who we are, flaws and all, that’s when the real work can begin. Through mindfulness, breathing techniques, positive reframing, meditation, relaxation techniques—we can, over time, change our relationship and experience with pain.
“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” —Viktor Frankl
Roubicek & Thacker Counseling is Fresno’s premier provider of individual, couples, family, and group therapy. We offer in-person and online remote therapy sessions. Contact us today to change the way you feel.