It is natural at times to feel "in a bad mood" when you are in pain. You may even find yourself angry or resentful of a healthy partner or family member who doesn’t understand your situation. Let them know that it is the pain, and not them, that had you feeling this way.

Sometimes people around you, even those who love you most, can feel helpless seeing you feeling badly. They may react in a way that makes you feel even worse, by ignoring your pain or trying to cheer you up when what you want is an understanding ear. Let those close to you know how you are feeling. Try not to blame them for your pain or their reactions to your pain.

Try to use "I" words when telling other how you feel. Explain if you would like them to respond to you differently. Offer a solution or an alternative that would help the situation; you might say, "I feel hurt when you tell me I look fine after I tell you this has been a rough day for me. I would feel better if you just listened to me for a few minutes, or if you asked if anything could help to make it better."

Don’t expect your significant others to "mind-read" what you are experiencing, or to anticipate your needs. See if you can find a short-hand way of communicating your needs without having your pain experience be the focus of your relationship.

Consider keeping a pain-mood diary. You may find patterns of pain, when it is better or worse, or how interactions with others may influence your perception of pain. What thoughts do you have and what do you tell yourself when you are in pain? Telling yourself "coping" thoughts such as "I can get through this experience" rather than "negative" thoughts such as "this is unbearable" is an example.

There is a difference between your private experience of pain and pain behavior. Your reaction to pain may be influenced by your culture, gender, and place in your family. Were you brought up to "keep a stiff upper lip", or were you always given "free rein" to express intense feelings? There are no rights or wrongs, but consider the impact of your pain behavior on yourself and those around you.

Does it enhance or inhibit relationships that are important to you? Is there reason for you or others to modify and/or try to understand reactions that are different from your own?

At some point, while dealing with chronic pain, you may find that health professionals, family, or friends may not "believe" your pain, especially if there are no specific physical findings. Keep in mind that being a witness to pain which is not understood and does not appear to be controllable, creates feelings of helplessness for everyone involved. One way for others to deal with these feelings is to blame you. In some situations, you may never be able to "prove" to others that your pain is real; how do you go about living your life as best you can in the meantime?

There are times when it is tempting to want to benefit from the pain you are experiencing. Try not to confuse others by using your pain to avoid emotionally difficult situations, or as a way of gaining power or attention from others. See if there are more direct ways of getting your needs met.

Your self-esteem can suffer. Your role at home or at work may change as a result of coping with chronic pain. It becomes more challenging to find alternative sources of pleasure and mastery in order to continue to feel good about yourself.

If you find yourself feeling blue for long stretches of time, and the usual supports you count on don’t seem to be enough, you may want to consider professional assistance. Social workers, part of your health care team, are especially trained to help you identify the emotional and social impact of chronic pain on your life and on those who are close to you. Joining a support group, peer counseling, or, in some situations, individual or family therapy with a trained mental health professional.

December 1993 Coping with Chronic Pain by Roberta Horton, ACSW, Director, Department of Patient Care and Quality Management from HealthConnection, Vol. 2, No. 2

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