Chronic Pain and Compassionate Expectations
One of the many challenges with chronic pain is the unpredictable nature of what your capacity might be from day to day. Whether your pain, fatigue, or level of disability are consistent, or dynamic, this will affect your life. Some days or periods of time you might be able to focus easily, be active, and get your work done with an acceptable level of effort; other days those tasks might feel impossible.
In some cases, you will be able to trace a method to the madness and in others it might feel distressingly random. This can commonly lead to such emotions and sensations as anxiety, low mood, stress, frustration, and a lot of negative self-talk. Recognizing and managing expectations in a compassionate framing can be a useful tool for navigating these disruptive periods.
Step 1) Identify and Name Your Days:
You can call them Active Days vs Pain Days, Easy Days vs Hard Days, Fun Days vs Cursed Days, or just A Days and B Days if you want a neutral title. Or, make-up one of your own!
For this example, I will use A Days (Active Days), and R Days (Reduced Capacity Days)
Think about the practical, mental, emotional, and physical needs you might have on any given day and how an A Day vs an R Day might affect them. Some examples might be: nutrition and hygiene, social connection, movement, work tasks or deadlines, housework.
This might look like:
A Days: Easy to get out of bed, mind feels sharp, pain feels bearable, lifting things ok, able to walk or jog, feel generally positive, able to cook, do housework.
R Days: Hard to get up, moving slowly, brain fog and trouble focusing, no lifting, joints burning, no energy to plan or cook meals, depressed.
Step 2) Make A Strategy
Now that you have a better idea of what you’re working with, it’s time to explore the options you might have on each day. For example
On A Days I Can: Do the grocery shopping, write an essay, do a light workout, visit with a friend, tidy the house.
On R Days I Can: Use the frozen meals in the freezer, do my assigned reading, do some gentle and careful stretching, call or text with a friend, leave the house tidying for an A Day.
Step 3: Bring in some Self Compassion
Along with the understandable emotions of grief, frustration, or even shame that might arise on an R Day, the part of this that can be tricky is accepting the differences between these lists without judging ourselves for them. The fact is, self-blame and shame do not tend to really motivity us and often add an extra and unnecessary layer of stress and tension to our bodies and lives.
Which is why it’s important to also include this step:
On an A Day I Will Be Kind To Myself By: Not overdoing it, challenging myself a little, taking extra note of what feels good or neutral in my body, speaking to myself with gentleness.
On an R Day I Will Be Kind to Myself By: Telling myself “you got this”, holding my boundaries around what my capacity is, practicing acceptance, speaking to myself with gentleness.
Did you noticed I put in “speaking to myself with gentleness” on both days? Well, in the words of Dr. Kristin Neff,
... if we think about it, when you go into battle, who do you want by your side? Do you want an ally saying, “I got your back, I care about you, I’m here for you,” or do you want an enemy that says, “You’re crap, you’re no good. It’s not good enough, try harder?” Who’s going to help you in that moment of battle, an inner ally or inner enemy? Clearly, an inner ally, a friend to ourselves that’s going to help us cope with life’s difficulties.
Extra Benefits to this Practice:
Questioning yourself less.
Using your time and energy more effectively.
Being able to clearly communicate expectations and needs with your loved ones. (As an ill teenager, it was far easier to tell my mother, “It’s an R Day”, and know she had an instant understanding of what that meant, than to have to explain and repeat symptoms every time I was struggling.)