Living with chronic pain

Sally (not her real name) walked slowly into my office and chose an upright, less comfortable chair. She took quite a while to find a comfortable posture and then looked at me with eyes that knows suffering. After the normal introductions I asked Sally how I can be of help. She started to speak and then, eyes brimming with tears, she continued to tell me about her struggle with her debilitating, excruciating and seemingly never ending chronic pain. It all started 18 months ago with a cycling accident and subsequent soft tissue injury to her back. The pain however never subsided and is in fact getting worse. Sally stopped cycling, spends a lot of time in her bed and had to resign from a job that she loved. “I am not even half the person I used to be” she said and “I am surprised my husband has not left me”

For most of us, our past experience of injury or surgery is that the pain fades away once we have recovered from the illness or the wound has healed. For people like Sally, who suffers from chronic pain, the pain just continues or just appeared out of the blue and is ongoing. In Australia three out of ten Australians have experienced chronic pain and twenty percent of us live with someone with chronic pain.

It is normal for people with chronic pain to experience a deep sense of loss of the old pain free self. Not knowing what sort of a day it will be makes it very difficult to plan ahead and hard to look forward to a holiday because of the knowledge that the pain will follow you there. It goes without saying that no one ever chooses to have chronic pain. One of the most challenging for us is to accept physical limitations and a body that is not functioning as it is supposed to.

Most people want their pain to be fixed. Many individuals try to fight the pain and believe that with enough tenacity they can break through the pain barrier. Unfortunately this mostly leads to aggravated pain and being worn out. Pain saps energy and all the willpower in the world will not make it go away. Ignoring pain only works in the short term. Chronic pain is tenacious in its ability to make itself known and will eventually be too much of a presence to ignore.

Chronic pain not only robs people of their sense of a wholesome self but often severely restricts their physical functioning and significantly impacts on their lifestyle. Remember Sally ?, her beloved bicycle lived in the shed and her memories of early morning rides with friends felt like a dream.

Living with chronic pain, really living, means that sufferers come to terms with the idea that despite the best efforts of the medical profession it is unlikely that their pain will go away in the foreseeable future. Accepting your pain does not mean that you are giving into it. It means that you adopt a stance of “it is what it is”. Instead of focusing on how badly you want the pain to stop, you accept the pain as is and find ways to continue living.

You need to find people who will take your condition seriously. Talk honestly about how you are feeling and obtain support for your actions to continue living. It may be a family member, your GP or someone at the many specialised pain management clinics (PMC’s) around Australia.

Psychologists are becoming increasingly more involved in helping people with chronic pain to live fulfilling lives. You will discover how to use Mindfulness to pay attention to your pain with inquisitiveness rather than judgement. Cognitive Behaviour Therapy techniques will help you to develop a positive mindset and a Solutions Focused approach will help you to action your plans. Over time you will be able to increase the amount and quality of things you can do. This may be different from the things you did before but your life can be full of meaning and enjoyment again.

Sally discovered that as a person she is infinitely more than her pain. Being curious rather than judgemental about her pain helped her to discover that her pain varies in intensity throughout the day and with good planning and resources many tasks can be accomplished.

You don’t have to be pain free to really live!

Joe is a Clinical Psychologist at Alpha Psychology.  He has extensive experience in helping people to manage chronic pain.

Is communication REALLY that simple?

How often do we flippantly speak of the importance of communication as if it is something simple and easy? We say it in reference to couples who are about to embark on marriage, we say it when a friendship is on shaky ground, we say it in the context of our workplace and management skills, and we say it in just about every social interaction that isn’t going as we had hoped.

Communication is not simple! Communication is a complex, multifaceted, multilayered, verbal and nonverbal, conscious and unconscious phenomenon. I think many of us take it for granted and I think most of us communicate in a way that we are not even conscious of. The unconscious part of us, the integral, instinctive, reactive and underdeveloped elements of our formation come together during our communications and can negatively impact on our relationships which can then impact on other areas of our life.

Transactional Analysis
The reason I raise this point so bluntly is simply that we need to know more about ourselves and about our reactions and responses to others. Transactional analysis has been around since the late 1950’s, coined by psychiatrist Dr Eric Berne. For anyone who is interested in social psychology, or the study of human interactions, you will be fascinated by the following educational uTube videos. Enjoy and happy pondering!

 

“You’re just going to have to let them go…”

By Hester Ng, Provisional Psychologist

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What is grief? It seems pretty obvious. “Something that happens when you lose something or someone that matters to you…”

Ok, so what does grief look like? The answer is less obvious… but still it’s easy to pull up some ideas. Crying. Losing sleep. Sleeping too much. Not eating. Eating too much. A deep sense of loss.

How long should grief last? Now this one starts to get much harder to answer. Should the length of grief be directly related to how long you were connected to the person or thing lost? Or does it not matter? Someone might grieve the loss of their 3 month relationship for 2 years, whilst another may grieve the loss of their 30 year marriage for 2 months.

What do people grieve about? Well there are obvious answers that come to mind. Death. Marriage. Pets. But what about more ambiguous losses? Sometimes losses come and people around you have no idea that you are grieving. Or they have no understanding at all of the loss you have experienced. Things like miscarriage, chronic or terminal illness, dementia, violence and missing people.

Grief. Something that none of us can escape. It’s a universal experience that unifies us. But it’s also deeply personal and the way it plays out in each person is very unique. No two people grieving will look the same.

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Grief has been understood in a variety of ways in psychology literature and these have strongly influenced how we as a society think about what grief is supposed to look like.

There are those who say that grief is something that works through stages. Then there are those who see grief as a fluid experience – which means that it doesn’t follow any sort of structure or pattern.

The view which has gained a lot of momentum in our culture is the idea that grief is experienced in a predictable process of five stages (shock and denial, anger, bargaining, depression and acceptance). If someone fails to experience the fullness of each stage, then that means that something has gone wrong with their grieving process.

If grief worked like this, it would be much easier to manage! It takes something extremely intricate and complex and turns it into something predictable and manageable. But the biggest problem with seeing grief in this light is for people who don’t follow these stages in their grieving. We end up making people feel ashamed or labelling those who might grieve differently.

What is interesting is that there has been a real movement away from looking at grief in that way. In fact, the whole idea of telling someone to ‘let go’ of their loved one actually be unhelpful. Grieving well doesn’t necessarily been cutting ties, but it could look like maintaining some sort of relationship with the person who has passed.

So, in the case of losing a loved one – what can you do to help someone grieve well?

  1. Rather than ‘letting go’ or ‘cutting ties’, encourage the person to see their life as a story, with their loss as one of the many chapters in the story. Not something that has to delete or destroy previous chapters.
  2. Rather than getting ‘closure’, it’s about helping the individual redefine their relationship and bond with the person who has passed. One way to do this is to encourage them to keep a journal where they can write letters to their loved one.
  3. Encourage the individual to process the loss by talking and expressing themselves. This will help them to find meaning in what has happened and also recreate a new way of looking at their world as it is now without the person they have lost. Finding a counsellor or psychologist who is well trained to provide an empathetic ear could be extremely helpful.

Some questions to ponder:

  • How do you understand grief?
  • Is it more or less helpful to see it as something to experience in stages?
  • Have you ever encouraged someone to let go of a loved one? How did they respond?

Bottom line:

It’s something we will all have to experience at one time or another, but every individual’s grieving process is going to look different.

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Klass, D., Silverman, P. R., & Nickman, S. L. (Eds.). (1996). Continuing bonds: New understandings of grief. Taylor & Francis.

Kubler-Ross, E. (1969). On death and dying. New York: Macmillan.

Neimeyer, R. A. (2006). Making meaning in the midst of loss. Grief Matters: The Australian Journal of Grief and Bereavement, 9, 62.

 

Transition to University – Some Things to Consider

By Adam Wright, Psychologist.

On the 28th February this year, summer will officially end for thousands of people across Australia, as they begin the first semester of university or TAFE for 2015. This group of people will be very diverse, ranging from the fresh 18-year-old straight-out-of-a-gruelling HSC, to mature age students re-training after years in the workforce. No matter who you are or what your story is, university can be a very rewarding experience, but it can also be a very daunting and troubling experience. Having gone through university both as a student and as a student counsellor, I thought I would dedicate today’s blog to a list of things to consider about university, for those who will be taking the plunge at the end of the month.

 

1. There is a lot more freedom of education at uni

For those of you who have come out of school, you have probably become very used to a specific style of education. You go to school every day, follow a strict timetable with little variation and leave at the organised end of school every day.

But Uni is different. If you don’t go to your job or you skip school pretty soon people start asking questions and actions start being taken. At university your lecturers and tutors are teaching a class of hundreds (especially 1st year subjects). Often for courses there are comparatively fewer checks of attendance – there may be course requirements for attendance to tutorials but not lectures, and many universities offer lectures to be downloaded like podcasts and listened to at home. A uni staffer once told me how the numbers of students lying on the grass tended to increase across the semester, as people started to realise that attendance was not compulsory and the motivation to sit in a crowded theatre for 2 hours started to diminish rapidly!

This new sense of freedom can be intoxicating. Suddenly you are presented with an opportunity to learn at your own pace, to schedule your life with much greater flexibility and even to prioritise social activities ahead of study.

 

2. University has a very unique emphasis on self-driven learning.

The overall aim of school is to meet broad learning criteria in order to facilitate moving from one grade to the next. What you learn is very largely determined by the school. The role of your teacher is to help with that process, and so they take a very directive and supportive role in making sure you meet the criteria. With the HSC, schools often take a very hands-on approach with the student to make sure they are getting the highest ATAR.

However at Uni, lecturers and tutors are often not as personally involved as teachers are, and the emphasis is very much on self-directed learning.

Lecturers and tutors often do their teaching work as a supplement to their usual work, which is research-based. Lecturers teach multiple classes and tutors often have multiple classes they see once a week, not once a day. You are very much expected to do your own reading and complete your assignments yourself. Staff are available to assist you in your learning, but it is still very much your learning.

It is a legal requirement to finish schooling up to and including year 10, but there is no requirement for people to finish university. If you don’t do the work or you are failing the subject, no-one will seek you out to discuss how you can get back on track. Failing a subject and having to repeat it the next year is a very real thing for university students.

For a lot of people this sudden change can be a very alienating experience. This level of freedom and autonomy is very unusual in life, and it can be very unsettling.

 

3. There is a host of available services to make University bearable.

The good news is, universities are very aware of this, and a lot of resources are expended to make sure that overall, the university experience is rewarding and not unmanageable. Every university has a free and diverse support system, offering counselling (usually free to students), disability support, welfare support, careers counselling and more. Most university websites have a section on their website for these services, which if it isn’t in a header in the ‘current students’ section of the website, can be easily accessed by typing ‘counselling’ or something similar into the search bar/Google.

These support services exist because universities believe every student should be able to progress through their degree on the strength of their merit and hard work. That means, if you would otherwise be succeeding were it not for stress, anxiety, disability or other difficult circumstances, universities are committed to helping where they can to prevent those circumstances affecting your ability to learn and achieve your goals. You do have to access them yourself, however, to gain their full benefits.

 

4. University is what you make of it

There is so much breadth to what you can do at university, the real take-home message has to be that uni is what you make it to be. I thought to finish, I would encourage you to think about your values when it comes to uni. Some final things to consider:

What are your interests? Chances are there is a student social group for that interest!

How do you see university, is it a stepping stone to a career, a chance to further discover yourself and your interests, or something else entirely?

What aspects of your character/personality would you like to see develop? Where do you think you should be challenged in your life?

What kind of person would you like to see yourself being as you walk through the gates?

 

Adam Wright is a registered psychologist at the Resilience Centre