Pain

Chronic Pain – Part 8: Pain & Communication

Effective communication is crucial for collaborative pain management, but communicating clearly can be extremely difficult due to the cognitive effects of pain. Three common challenges to successful communication when living with chronic pain are brain fog, the gulf in understanding, and fears of complaining too much. Brain fog Brain fog is usually experienced as a […]

Effective communication is crucial for collaborative pain management, but communicating clearly can be extremely difficult due to the cognitive effects of pain.

Three common challenges to successful communication when living with chronic pain are brain fog, the gulf in understanding, and fears of complaining too much.

Brain fog

Brain fog is usually experienced as a lack of mental clarity, an inability to focus, forgetfulness, and an overall mental malaise. 

If you’ve been inside a house when the alarm sounds, you’ve experienced the overwhelming sensual assault of the noise, and your urgency in turning it off at all costs!

Pain is the body’s alarm system, and when it peaks, it feels like an alarm goes off in your brain, overloading your senses, and making it difficult to concentrate on anything else. 

Communication relies on clear thinking to be effective. We need to be able to pick up on detail and tone, listen actively, and practise empathy. All of these are hampered when our cognitive ability is diminished by brain fog.

Patience is key for those living with chronic pain and their loved ones. Brain fog may inhibit complex conversations, but if we slow down and connect mindfully, or park important discussions for a later time, we can help ourselves and each other.

The gulf in understanding

We must accept that complete understanding of our chronic pain experience is an impossible dream, even with fellow chronic pain companions.

Everyone’s journey with pain brings a unique perspective and perception. However, there are patterns of physical and psychological issues we can all learn about and empathise with and hear each other across the gulf of understanding.

We don’t need to have identical chronologies to appreciate emotional distress, isolation, sadness, and frustration. It is in our power to listen and reflect, two practices that are increasingly rare in a world that can’t stop talking.

Fears of complaining too much.

When 857 people living with arthritis were asked by ArthritisPower ‘Do you endure pain in public because you worry that people might think you complain too much?’, a whopping 88% said yes.

The fear of over-communicating pain levels presents a challenge: say too much and we feel like a broken record; say too little, and we fail to express our needs. The cost of bottled up feelings is high: higher anxiety, lower mood and energy.

According to Dr. Jeffrey Wentzel, we can complain productively by following 5 key tips:

  1. Start a journal to express your complaints, and reflect on them.
  2. Identify the core people in your life you can be fully vulnerable with about your pain.
  3. Connect with others who have the same condition.
  4. Accept help from others.
  5. Be aware of when you need professional help and support.

When communicating your pain with loved ones, metaphors can help. The Spoon Theory metaphor, created by Christine Miserandino, is useful. People living with chronic pain begin the day with a number of ‘spoons’, representing units of physical and mental energy required for each activity or task. 

On days with higher pain levels, small tasks may require multiple spoons, or you might start the day with a smaller number of spoons. Thinking of it this way allows you to pace yourself, allocate your spoons within a certain limit, to prevent using tomorrow’s quota today.

Another useful strategy, from our contributor TOS, is to use percentages to describe your pain levels, and the support you need from your partner or loved ones. You might say ‘today I’m 40%, I need you to be 60%’. This is a helpful way to express your needs, prevent confusion and accept your limits for the day, so you can make the best of it.

References: https://www.versusarthritis.org/media/24834/red-whale-chronic-pain-communication-skills-and-self-management-may-2022.pdf

https://creakyjoints.org/research/complaining-productively-chronic-pain/ 

https://health.clevelandclinic.org/spoon-theory-chronic-illness/