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Escaping the Abyss of Chronic Pain

Breaking free from 15 years of chronic pain.

I spend a lot of time describing other’s successes, and people remind me that my story is one of them. I did my best to describe my descent into The Abyss, but words can’t tell the depth of suffering I was experiencing. In 2002, I was actively suicidal, and one evening, I began to put my plan into action. I am not entirely sure why I didn’t follow through.

Now I am doing well, but I am also thriving at a level that I never dreamed possible. It is not that I don’t get stressed and have a recurrence of symptoms. I "fail" frequently. But I have the awareness and tools to keep moving forward. I am eternally grateful that I made it through and have been able to pass on lessons learned. Fifteen years is a long time in this hole, but I am well aware that many people have been there much longer. This lesson intends to explain how I emerged and discuss some of the harsh lessons learned while pursuing dead-end approaches.

Reaching Rock Bottom

Image by Holger Langmaier from Pixabay
Source: Image by Holger Langmaier from Pixabay

My lowest point was a distinct moment one evening in April of 2002. I heard a lecture the night before by author and concentration camp survivor Elie Weisel1. I felt like I was in that camp, although I realized I could not possibly comprehend the degree of that level of suffering. He had pointed out that when people in the camp would mentally give up, they would be gone within a few days. He decided to live regardless of the consequences.

I felt a shift. I decided that I was tired of trying to fix my pain, and I would move on, regardless of how much pain I was in. The mental pain was the worst part of the ordeal. I was obsessed with finding a way out of all of my misery and spent a reasonable amount of time reading books, trying new treatments, discussing problems with anyone who would listen, and actively engaging in counseling. I was a self-described epiphany addict. I was looking for the one answer to my pain.

Pulling Out of the Station

I had no idea that shifting attention to the future instead of solving the past was a significant part of the solution.

About a month later, I had a flash of insight into what it meant to be in a victim role and realized that there was no answer to that either. I made another distinct decision that I was done with that role. I felt another shift and surge of energy unexperienced for years. By not wasting efforts on solving an unsolvable problem, I was free to move forward powerfully. I put strategies into action that began to have an effect. There was no plan or insights into what they should be or why they might work. Most of them were dead ends, but I pursued the ones that seemed to help.

A foundational resource was engaging in the exercises described in a book I read years earlier, Feeling Good by David Burns.2 One of his first admonitions was engaging in the tools he suggested instead of just reading his book. One of the basic exercises was writing in a three-column format. First, write down a disruptive thought and categorize it into one of 10 categories of cognitive distortions. Then write a more rational review in the third column.

I was alone with plenty of time, and I began to write and write. I instinctively tore up the writings. It was initially disconcerting to observe the types of cognitive distortions that were torturing me. But, within six weeks, I noticed an appreciable drop in my anxiety, and I finally had a ray of hope.

Effects From Lack of Sleep

Around this time, I read the book, The Promise of Sleep, by William Dement, founder of modern sleep medicine.3 He pointed out that less than 5% of physicians were addressing sleep with their patients.

Lack of sleep has a significant effect on creating symptoms – it is inflammatory4 and compromises coping capacity. It seemed like a solvable problem, and it was easy to follow my patients’ progress. I took a surgical approach to it and saw patients weekly until they could consistently sleep. I would not hesitate to use medications for a short period to get started. I did not expect that pain would improve, and I was surprised when a significant number of people reported less pain and improvement in mood. Although adequate sleep did not solve everyone’s pain, the other interventions were of limited value until I heard people's reports.

In the meantime, I was not able to sleep despite being on some strong medications. For some reason, years of feeling a burning sensation in my feet was getting worse. It became intolerable at night. Watching patients have success with improved sleep yet unable to experience it myself was incredibly frustrating.

Accepting Your Anger

Although my anxiety had significantly diminished, I was still having more than made me comfortable. I was diligent in writing and had begun to learn mindfulness. Sleep was still problematic. Yet, I figured out that being a victim was an issue, and the shift I described earlier was significant. But I still did not connect the link between being a victim and anger. I was certainly not an angry person.

I had developed a persona of being calm under any amount of pressure. I was so good at it that I didn’t feel anger. However, it was clear to everyone else that I was not that relaxed, and I was a master of disguising it – to myself. About a month later, I exploded in a manner I can’t describe in words. I was shocked. My situation was complicated, and I was forced to acknowledge deep anger (rage) and being a perpetual victim.

The details of how I processed anger are not necessary because I didn’t do it well. But one day, I gave up, admitted I was angry, and couldn’t solve it. I felt another much more significant shift. Within six weeks, my anxiety dropped, and my physical symptoms almost completely disappeared. But I still couldn’t connect the dots and understand why I was the one experiencing such pain.

It took another five years to make sense of aspects of this ordeal. What had I done wrong? I did have a difficult childhood. But at age 15, I left it behind and moved on. I worked hard, coped with my past, underwent counseling, took leadership roles, committed to caring for my patients, and intended not to repeat history.

I still feel that the whole experience was unnecessary. But it never is, and many people go through similar journeys. I have also learned at a deeper level that holding on to the past is a huge problem that will guarantee a life of misery. It is clear that acknowledging my anger was the key that started a process that eventually solved my pain. From some of my patients’ experiences, I now know that it is also a shortcut to deep healing. I took the long road.

Practice, Practice, Practice

I have learned that there is no magic in solving chronic mental and physical pain. Once you understand the nature of the problem and its principles, it is a learned skill set. It requires mastering the basics with practice and constantly adding on more advanced techniques. Eventually, most of it becomes automatic.

My wife reminds me (almost daily) that I am free of pain only if I continue to engage with concepts that I teach patients. If I quit (which I do), I have a recurrence of symptoms within a couple of weeks. My scalp itches, ears ring, feet burn, I can’t sleep, and rashes show up on the backs of both of my wrists.

I have severe arthritis in both of knees and hips that is my current challenge. Although I am not thrilled with daily pain, it is not nearly as disruptive as during the period of suffering that added a layer of anxiety. The most significant factor affecting my arthritis pain is consistently getting adequate sleep. Sleep continues to be my challenge.

Strategies I Use Daily

The list I use daily looks long, but I do not spend much time on them. Most of them are slight modifications of routine. I view them from three perspectives:

  • Input: What am I holding onto and what I am uploading into my nervous system
  • State of my nervous system: Calm or hypervigilant
  • Output: My physiological profile (threat vs. safety)

What Is Input?

  • A few minutes of daily expressive writing – still the necessary core exercise
  • Remaining aware of my reactions to others and other’s reactions to me which is humbling
  • Processing anger
    • Using calming techniques
    • Understanding the deadly nature of perfectionism
    • Staying aware of going into the victim role
    • Remembering that forgiveness is a learned skill instead of a philosophy
  • Active meditation/mindfulness
  • Minimizing watching the news or violent TV
  • Not discussing my pain, being critical, or complaining.
  • Using calming techniques
  • Understanding the deadly nature of perfectionism
  • Staying aware of going into the victim role
  • Remembering that forgiveness is a learned skill instead of a philosophy

Paying Attention to My Nervous System

  • Consistent sleep
  • Regular exercise
  • Anti-inflammatory diet
  • Nurturing a sense of play
  • Visualizing a different outcome before an expected unpleasant situation happens
  • Reading Anthony DeMello’s The Way to Love
  • Giving back and having a sense of purpose.

Modifying My Output

  • Breathing exercises
  • Continually letting go
  • Humming
  • Enjoyable music
  • Consciously relaxing muscle groups

Although each of these works on a different aspect of the pain cascade, there is a lot of overlap. The essence of the problem is that your body is in a sustained state of threat physiology, and the solution lies in finding and creating safety.

My Life Today

Many people, including me, fall into one trap: believing that the goal is to become completely pain-free. Life keeps coming at all of us, and there will always be good and bad days. But I have a set of strategies to calm down my nervous system and optimize my body’s physiology. What is so different is that I choose what direction I want to go by allowing myself to feel both positive and negative sensations.

Hanscom/ Mendonca
Source: Hanscom/ Mendonca

The metaphor and awareness tool that has emerged is “The Ring of Fire.” It focuses on the last rest stop of The DOC Journey and is the “signature tool.” By breaking free from the grip of chronic pain, I can create a life that I want – from reactive to Creative.

I feel fortunate to have made it through this ordeal, and one of the benefits of severe suffering is a deep appreciation of what I have today. The most privilege I experience is learning how to pass insights to others and witness them heal themselves.

For immediate help in the U.S., 24/7: National Suicide Prevention Lifeline, 1-800-273-TALK. Outside of the U.S., visit the International Resources page for suicide hotlines in your country. To find a therapist near you, see the Psychology Today Therapy Directory.

References

1. Weisel, Elie. Night. Hill and Wang. New York, NY, 1958.

2. Burns, David. Feeling Good. Harper Collins, New York, NY, 1980.

3. Dement, William. The Promise of Sleep. Delacourte Press, 1999.

4. Krysta K, et al. Sleep and inflammatory markers in different psychiatric disorders. J Neural Transm (2017); 124:S179-S186. doi 10.1007/s00702-015-1492-3

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