When people are living with persistent chronic pain, they very naturally become focused on reducing that pain. In my work with people in chronic pain, I generally encourage people to change this focus. Specifically, I suggest that people focus on being able to do more (which, in pain management jargon, is referred to as increasing function) and improving their quality of life.
If you are interested in learning more about the rationale behind this suggestion, you may enjoy listening to this webinar on Functional Measures for Assessing and Managing People with Chronic Pain with Dr. Jane Ballantyne (1hr).
I invite people to consider that chronic pain is largely a function issue. Every human body has a maximum amount of activity that they can engage in before they end up in an incredible amount of pain. For some human bodies, that amount of activity can be as much as doing a marathon or an Ironman triathlon. For other human bodies, that amount of activity might be simply washing the breakfast dishes or taking a shower.
For people who end up in incredible amounts of pain after something like washing dishes, we want to coach them to slowly increase the amount of activity they are able to perform before their pain flares up.
For many people, an important part of the healing process is reducing expectations around how much they will be able to do. To clarify what I mean, I ask the people in my programs: what are the things you give up in an effort to get more done?
Here is a list of the most popular answers:
- Eating well
- Spending time with family and friends
It’s a short list, but I would argue that everything on that list is essential to being a healthy human being.
The research supporting links between sleep and our overall well-being continues to get stronger, and there are incredible links between a lack of sleep and pain. We are only ever going to feel as well as we eat, and caring for ourselves is an essential foundation of being able to meet the demands of life, long-term. We are social creatures. We need human connection, but many of us forgo opportunities to spend time with others in exchange for getting more done.
While many of us are already doing more than is sustainable, we also feel like we like we still have way too much to do, like we are just constantly trying to keep up. We want to take care of ourselves, eat well, rest well, and see our loved ones, but we also want to get sh*t done. How do we do both? How do we find balance?
I have gotten a lot better at finding balance over the years, and for me, the answers have largely come in the form of practicing yoga, mindfulness, and meditation. (Though a husband who has a very low tolerance for “all business Sarah”, as he calls it, has also played a role.) If I were to summarize the way that my yoga practice has helped me to decrease my expectations around function, I’d say:
- Practicing yoga has chipped away at an ingrained belief that we are what we do, that my productivity is my worth. Yoga has a way of teaching us that we are who we are; we are kind, compassionate, wise, and generous beings who are inherently worthy of love and belonging.
- The tools of yoga have deepened my body awareness and allowed me to become much more aware of how I am being impacted by the choices I make. I notice that crappy food makes me feel crappy. I notice that upsetting movies really upset me. I notice the moments where I can choose to feel more ease. I notice that I am happier when life is slower.
I continue to work on being at peace with my sense that there is too much to do. Quite likely, I will feel this way for the rest of my life. I can choose to respond with urgency and try to get more and more done, or I can choose to respond with playful laughter and focus on enjoying whatever thing I am actually doing right now.
Whenever I die, there will be things left undone. I can resist that or I can accept it. The challenge of my practice is to continue to choose the path of acceptance because it brings me infinitely more joy.