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The Pain Companion

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  • January 23, 2016 04:40:55 PM
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Insights, wisdom, and practical tips for living better while living with chronic pain

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Losing and Finding Ourselves Again in Pain

(This article also appears on The Mighty) Chronic pain, whether from illness, disability or surgery, can distance us from others and, seemingly, from life itself. We are immersed within, and surrounded by, the experience of pain.Everything other than pain recedes, and feels like it is being experienced from afar because there is always this aura of pain that separates us from others, and from life.It’s not that we’re not in life, obviously we are still alive, but the...

(This article also appears on The Mighty)
Chronic pain, whether from illness, disability or surgery, can distance us from others and, seemingly, from life itself. We are immersed within, and surrounded by, the experience of pain.

Everything other than pain recedes, and feels like it is being experienced from afar because there is always this aura of pain that separates us from others, and from life.

It’s not that we’re not in life, obviously we are still alive, but the quality of life is so different – as if we are looking out at life or up at life from a deeply submerged place.

Living Submerged

Other people exist on another plane. They have access to their bodies and their energy and their abilities while we are living underneath something. It can feel like living in a tank, and we must hear and see everything filtered through a thick glass and cloudy water.

When we live there for some time, it can begin to feel as if we are distanced not only from others and the ongoing stream of normal life, but from ourselves as well.

It is almost as if the field of pain has inserted itself between us and Us.

It’s an eerie and unsettling feeling, kind of like when you have the flu or are terribly jet-lagged and you don’t feel like yourself – there is a sense of fogginess and existing apart from normal life and there isn’t that much of You available.

The Cauldron of the Self

Living with chronic pain kind of feels like that all the time, and many times over. You fear you may have lost yourself in the pain. Or become someone else.

And there is a fear that you may never resurface, may never emerge from pain. And if and when you do, you won’t know that person anymore.

All of this is can be incredibly frightening and depressing and sad, but there is also a strange gift here too.

Living submerged in pain can be like living in a cauldron or a furnace of the Self. It burns away everything that doesn’t matter. It strips the self of everything petty and leaves only the essential Self that continues to shine.

You fear you will lose yourself, and in a way, you do lose yourself, or I should say, you lose the self that used to relate to the world in certain ways.But you don’t lose the inner Self.

Once you get past the fears and find a way to live with what is happening, to accept without giving up or acquiescing, allowing what’s already here to be here as it is, the old you slides away, but you are not left with nothing.

What’s left is the essential Self, what I like to call the You of you.

Polishing the Mirror

None of this happens automatically as far as I can tell. We have a choice. We can become bitter and hardened, or we can choose to allow ourselves to be opened and enriched.

It’s like what the Sufis call “polishing the mirror.” The challenges and hardships of life, if we meet them with awareness and allow them to show us what is essential and what is not, polish the mirror of the heart and allow the dross to drop away and we are left with a clearer knowing of the Self.

And that Self is tender and vulnerable because of what it has been through, yes, but it’s also incredibly strong.

You might call it your soul or spirit. It’s the eternal aspect of you that remains alive and clear and untouched. And, while pain is a very difficult mentor and not one I would ever recommend to anyone, still, it teaches.

It brings us to our knees at times, but it also brings us to ourselves. And that, in its way, is a tremendous awakening and a tremendous gift.


7 Ways to Love Yourself Through Chronic Pain

(This article first appeared on the Soul Analyse website) Living in any kind of pain, emotional or physical, can make life seem joyless. Not only are we suffering from our symptoms, but it seems like pain takes over everything. We go to sleep in it, wake up in it, eat in it, love in it, parent in it. Even though we try to put a good face on things, at some point, we’re probably going to HATE our pain.When pain is chronic, when it won’t leave no matter what we do, we often...

(This article first appeared on the Soul Analyse website)
Living in any kind of pain, emotional or physical, can make life seem joyless. Not only are we suffering from our symptoms, but it seems like pain takes over everything. We go to sleep in it, wake up in it, eat in it, love in it, parent in it. Even though we try to put a good face on things, at some point, we’re probably going to HATE our pain.

When pain is chronic, when it won’t leave no matter what we do, we often blame ourselves. What is wrong with me, we ask, that I can’t heal? Maybe I haven’t done enough, haven’t tried hard enough, must have made a mistake somewhere along the way to have ended up in this pain. This is all wrong, life is wrong, and maybe I am wrong.

While disliking pain is understandable, it’s important that we don’t transfer that dislike, anger, and even hatred onto ourselves. It’s not conducive to healing and can serve to keep us stuck in both physical and emotional pain.

So how do we move on from there?

I found that the most helpful thing I could do for my well-being and to support my overall healing was to find ways to move away from the anger, resentment, blame, and fear of living with pain. I realized that I wasn’t going to be able to heal my physical pain when I was in so much emotional pain. I made a conscious effort to renew my sense of joy and pleasure in life and not wait for pain to leave before I did that. In fact, I felt it was imperative not to wait so that I wouldn’t slide into depression, hopelessness, and despair. I chose to renew my sense of self worth and self trust through loving myself more, even in the midst of pain.

Below are are listed the approaches that worked for me. I call them "steps" to delineate them from each other and to give you a kind of game plan for getting back in touch with yourself if that is needed, but they do not have to happen in any particular order. Some will be easier than others, but I have found all of them to be necessary ingredients in coming back to a state of grace within myself while still living with pain.


Step One: Don't Let Pain Define You

Separate your feelings about yourself from your feelings about your pain. Remember that you are still here. You are still you. You are experiencing pain, but pain is not the totality of who you are. There is always more to you than your pain. Love that.

Step Two: Extend Kindness to Yourself

Find ways to be more compassionate, soft, and kind to yourself. We are such an accomplishment-oriented society, that we often transfer the Type-A approach we have for our work lives to our approach to physical healing. But I have found that the body does not always respond well to pushing it to heal. You can be kinder to yourself by:
  • ask for help when you need it
  • rest often
  • reduce or throw away your to-do list
  • allow your body and emotions the time they need to heal and trust yourself in that
  1. acknowledge what you’re going through and give yourself a break from trying to keep up with everyone else​​

Step Three: Know That Healing is Your Current Job

Remember that healing is not a straight line. It goes up and down and spirals around. Some days you will feel better. Some days you will feel worse. This has nothing to do with your worth as a person, it is simply part of the healing journey. Don’t blame yourself on your bad days. Be gentle and know that this is a day to pull back in as many ways as you can. Say no when you need to. Instead of hating that you can’t be productive, love yourself by pampering and taking care of yourself. Know that there is no more important job for you right now than to heal.

Step Four: Extend Kindness to Your Pain

Consider not only being more loving and kind to yourself, but being kinder and more loving to the painful parts of you too. Remember, pain is a signal from your body. It really isn’t the enemy. I have found that the more I fight it, resist it, or hate it, the more stubborn it is. If I can find ways to be softer with pain, understanding that it is a sign that my body is trying to heal, then I can relax a little more about having it in my life. The less I fight it and hate it, the sooner it begins to move, to release, to ease. So, as strange as this sounds, find ways to be more loving with your pain. Speak to it softly. Ask it what it needs. Treat it like a wounded animal that needs love and tenderness.

Step Five: Enjoy What is Here Now

Remember that there are still joys and pleasures that can be had, even in pain. Yes, pain may still be there, but you don’t need to starve yourself of the things you enjoy. You deserve to feel good about yourself and to love the people, things, events, smells, and sounds that you have always loved. Maybe they must be experienced in smaller doses. Maybe pain has to come along for the ride, but love yourself enough to indulge where and when you can in simple pleasures. It’s not just more enjoyable, it’s crucial to keeping depression and hopelessness at bay

Step Six: Give Yourself Credit

Congratulate yourself warmly and wholeheartedly for each new day you meet, for still being here, for carrying on, for sticking with yourself and for loving yourself through this challenging path. Do this on a daily basis. An hourly basis, if need be. Remind yourself that you are always moving toward greater healing, and sometimes the most healing path lies in not-doing. 

Step Seven: Take Yourself off the Hook

Pain is not a test or a punishment. You have not failed or made a mistake. Being in pain has no bearing on your self worth. Let go of self-recrimination. Everyone meets pain on the path of life, whether it is emotional or physical. No one has a completely pain free existence. Love yourself enough to know that you are not alone on this journey through pain.

​Finding ways to love yourself through pain not only makes the path a little easier and less stressful, it can help lift physical symptoms. When you come through the other side you will have gained something valuable: wisdom, compassion, insights, kindness, and greater trust in life and appreciation for who you are and the journey you have made.


Honoring Your Feelings, Honoring Yourself in Pain

For many of us, living with chronic pain is like losing our place in the world. It feels like our friends, our coworkers, and sometimes even our families have moved on without us. They are proceeding with their lives while we are left behind, exiled from our own life, our dreams, and our own identities, all because of pain.These are very difficult feelings to talk about. Many of us have no one to turn to. No one who can understand. We feel guilty sometimes just for feeling the way we...

For many of us, living with chronic pain is like losing our place in the world. It feels like our friends, our coworkers, and sometimes even our families have moved on without us. They are proceeding with their lives while we are left behind, exiled from our own life, our dreams, and our own identities, all because of pain.

These are very difficult feelings to talk about. Many of us have no one to turn to. No one who can understand. We feel guilty sometimes just for feeling the way we do. 

As a result, we live with our pain in silence. Because pain takes up most of our energy and attention, we often put our inner lives, our emotional selves, on hold, but that can lead to a sense of hopelessness and depression.

Here are 4 ways I've learned to be with myself in the pain, to honor my feelings, and to begin to find who I am again in the world.

1. Acknowledge Your Feelings

For me, the first thing I needed to do was acknowledge the depth of the emotional distress.  Too often, we put our attention on the medical and physical aspects of pain, leaving our inner selves out of the equation. Instead, it’s important on a regular basis to check in with ourselves and tune into our feelings.

It’s not easy. We’re afraid that if we allow ourselves to know what we’re feeling, we will feel even worse. What’s true, however, is that denying our feelings doesn’t take care of them, it only pushes them underground. We must acknowledge them on an emotional level. Only then can these feelings begin to release.

2. Understand These Feelings Are Normal

You are not alone in your feelings. Most people who live with chronic pain feel some combination of: being misunderstood, loneliness & isolation, guilt, sadness, grief, shame, overwhelm, panic, terror, remorse, anger, anxiety and depression. That’s a lot. Sometimes we can run through the gamut all in one day!

Knowing that you are not alone in your feelings, and that these feelings are a normal response to the tremendous toll that living with pain takes, can bring an immense sense of relief. That acknowledgment alone can move you into a more balanced, healing state.

3. Express Yourself

We’re usually taught not to talk about our pain, not to show it, not to be a burden on others or to “dwell on it”. While we certainly don’t want to wallow in pain, physical or emotional, it is unhealthy to simply never talk about or express it. Unfortunately, we are given few invitations to do so.

I have found writing about how pain has affected my life to be very helpful. Finding someone who is willing to be a compassionate and open-hearted ear to tell your story to is also helpful, but you need to establish one important guideline: Listen only, don’t try to give advice.

You can also use drawing, painting, simple movement and dance, singing or toning, or communing with nature and animals to be incredibly supportive ways and places to express your emotional life without having to explain yourself to anyone else. 

4. Let Go of Feelings That Are Not Healing

It’s also important to know that feelings that are not acknowledged, understood or expressed today can turn into something toxic over time. Sadness becomes victimization, fear turns into panic or terror, anger becomes bitterness and resentment.

It’s important not to hang onto strong negative emotions, even when you think they’re justified. Emotions that become embedded because we refuse to let them go are not helping us heal. In fact, they can be contributing to the longevity of our overall pain, both emotional and physical.

​When we allow ourselves to express how we feel about being in pain through creative arts, talking to someone-understanding, communing with Nature or our God, we feel heard, we feel seen, and we are validated. When that happens, those feelings no longer have to remain hidden or stuck, undermining our energy and resourcefulness. They can flow, move, and complete themselves allowing us to be more available to life, to others, to greater possibilities for overall healing, and to ourselves.
(This post was adapted from my article in Patients Rising)


Finding the Missing Link for Healing Chronic Pain

In the Western allopathic medical world, physical pain is treated almost entirely from a material standpoint.Our doctor usually asks us where and how it hurts, and we are encouraged to describe the pain only as it is manifesting in the body. It is a rare Western-trained doctor who asks us how we feel about our pain emotionally, what was going for us just before the onset of pain, or a myriad of other inquiries into our emotional, psychological, and spiritual states of being.One of the...

In the Western allopathic medical world, physical pain is treated almost entirely from a material standpoint.

Our doctor usually asks us where and how it hurts, and we are encouraged to describe the pain only as it is manifesting in the body. It is a rare Western-trained doctor who asks us how we feel about our pain emotionally, what was going for us just before the onset of pain, or a myriad of other inquiries into our emotional, psychological, and spiritual states of being.

One of the reasons that we usually don’t treat physical pain with anything more than physical remedies is that, most obviously, it is experienced in and through the body. Physical pain is so overwhelming that it appears to point only to itself. This seems logical. Yet, while we do live in a physical body, we also consist of a mind and emotions, and many believe we have a spirit or soul as well.


Although much has been written in recent years about body/mind/spirit integration, particularly in connection with the rising popularity of traditional Asian medicine, the Western medical approach is only beginning to explore the concept that true healing may need to include and address the whole person. 

Instead, we have been conditioned by our culture to approach our medical needs as isolated situations, things that happen only in and to our bodies. We are told we need to treat it, fix it, even cut parts of it out. But we are not taught to listen to the body or to our emotions and feeling states as they relate to the body, and certainly not to listen to or honor our pain. 

In a society driven by schedules and fairly rigid work and educational structures, it’s probably a natural consequence that we would develop a medical system that almost exclusively addresses the physiological aspects of pain and ignores the rest of who we are in that pain.

Yet what if, by doing that, we, as a culture, are sidestepping a significant element within the process of healing? 

Is it possible that something beyond our physical body is trying to get our attention? If so, to what end? How would addressing our spiritual natures, our belief systems, and our emotional lives at the same time that we're attending to our physical bodies change our relationship to pain? How might it affect our ability to heal? What kind of renewal might we see in our medical system?

I believe these are the kinds of questions we need to begin asking ourselves if we are going to move beyond what has become a pain epidemic in our modern world. For our current medical system, this may seem unrealistic or unnecessary. But for those of us living with unremitting pain, it may be a missing link.

This post was adapted from The Pain Companion: Everyday Wisdom for Living With and Moving Beyond Chronic Pain (Sarah Anne Shockley, New World Library, 2018)


How to Create a Pain Diary That's Easy to Keep and Actually Useful

A pain diary is a daily record  you keep for yourself detailing the nature and levels of the physical or emotional pain you are experiencing.Why would you want to keep a record of your pain? Chronicling pain sounds like one of the least appealing things you could do.Yes, I know, but there are a number of reasons why it can be very helpful for people with chronic pain to do so. Read on.Why Keep A Pain Diary?How To Set Up Your Pain DiaryKeep It Clear And SimpleRemind Me Why...

A pain diary is a daily record  you keep for yourself detailing the nature and levels of the physical or emotional pain you are experiencing.Why would you want to keep a record of your pain? Chronicling pain sounds like one of the least appealing things you could do.

Yes, I know, but there are a number of reasons why it can be very helpful for people with chronic pain to do so. Read on.

Why Keep A Pain Diary?
How To Set Up Your Pain Diary
Keep It Clear And Simple
Remind Me Why I’m Doing This

Why Keep a Pain Diary?

Here are some valuable reasons for making the effort (sometimes painful, I know) to monitor and record your pain experience:
  • To provide credibility about the nature and level of your specific pain(s) that you can show to medical practitioners and therapists, particularly if they have difficulty understanding the intensity or duration of your pain.
  • To provide important details for your physician about how your medication is working or not working, and any side effects.
  • A pain diary can be helpful to share with caregivers so they can better understand your needs.
  • Tracking your pain levels helps you see when your pain tends to be most intense so that you can plan rest, appointments, and work accordingly (at least as much as is possible).
  • A pain diary helps you more clearly see which activities affect your pain levels for good or ill.
  • Sometimes these records are useful for insurance or legal purposes.
OK, you say, I can see some of the uses for a pain diary, but how do I go about creating one that’s easy to keep, easy to refer to, and actually useful?

How To Set Up Your Pain Diary

Here are some simple guidelines that have worked for me. Modify as needed, of course.
  • Plan to keep the diary for at least one week, but longer is highly recommended if you’re up for it (since it provides more information over a longer time span).
  • Use a small notebook that’s easy on your hands and a
  • felt tip pen or other writing utensil that’s easy to use and writes clearly.
  • At the top of each page write the date.
  • Make notes on pain at least four times a day, if at all possible (upon waking, mid-day, afternoon, evening) and note specific times.
  • At each check-in time, note your overall pain level, and any specific pains and their levels, noting changes in pain quality or intensity.  Use descriptive words (see list below for ideas.) If things are pretty much the same, just write “Same.”
  • In addition to the above, in the first notes of the day, jot down how much sleep you think you got and the quality of sleep: Did you sleep fitfully, or not at all, or only doze now and then, or get up in the night?

Keep It Clear and Simple

If you only have energy for the minimum of four check-ins a day, do that.

For a more complete diary, and if you want to track the efficacy (and side effects) of medication and/or the effects of physical therapy protocols, then I suggest adding the following into your daily notes as well:
  • Medications taken and at what times.
  • Any exercise and physical therapy you do, the time you did them, and duration.
  • Note periods of rest.

Keep it simple so that doing this does not become a burden. These are notes, rather than an old-fashioned Dear Diary description of everything you do and feel. (I recommend a separate Pain Journal if you wish to go more deeply into what you’re feeling and experiencing.)
  • Use phrases instead of full sentences.
  • Use highly descriptive words (see suggested list below).
  • Use the 1 – 10 scale consistently, and in a way that makes sense to you so that you can easily communicate it to others.

Sounds like a lot, but you can use shorthand. For example, if you have a regular routine of physical therapy exercises you do, just write PT and the time. No need for further details.

The following lists of descriptive words are offered to make it easier for you to express yourself and help you find the words you need. The lists are not meant to be exhaustive, but I hope they show that descriptive words communicate much more clearly to others than just the words pain or hurt do by themselves.

Physical Pain:
sharp, dull, twinge, sting, shooting pain, tender, irritated, raw, spasm, pulling, cramping, needle-like, achy, stabbing, throbbing, burning, numb, tingly, tight, sore, queasy, flu-like, dizzy, fatigued, exhausted, listless, light, deep, intense, excruciating, brain fog, easing, releasing, letting up.

Emotional Pain:
low, depressed, angry, despondent, frustrated, hopeless, hopeful, numb, scared, terrified, anxious, confused, stuck, sad, lonely, isolated, ashamed, resentful, sinking, uplifted, tense, relaxed, relieved.

If you are keeping a Pain Diary of physical pain, it’s up to you whether or not you want to add your emotional state into your notes and how comfortable you feel sharing that with others.

Remind Me Why I'm Doing This

Why not just explain all this verbally the next time you see your doctor?

Mostly because our brain in pain doesn’t work well: we often can’t remember details, the right words don’t come easily, we’re exhausted, we can’t think straight, and we used up all our available energy just getting to the appointment.

If the Pain Diary sounds challenging to set up, feel free to download my Pain Diary PDF. You can print it out and write on it or use it as a basis for your own and modify as needed.

I hope this is helpful. Please feel free to share this post and the template with others.
(This article also appeared in The Mighty.)


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