Seven years ago I did so much cycling that my legs blew up. My body completely gave out and my brain decided that from now on everything was going to hurt all the time so that I would stop running myself into the ground. Since then I’ve had every type of scan ever invented and been to every kind of doctor under the sun. No one has ever found anything physically wrong with me.
Chronic pain is when your brain continuously fires out pain signals despite nothing in your body being damaged. When your nervous system goes haywire, normally sensible reactions like fear and self-preservation become very distressing false alarms. Whilst the problem is superficially a physical one, the real challenges faced by someone with chronic pain are mental. Pain is scary; chronic pain can be unrelentingly terrifying.
Despite this, chronic pain has made me happier. On the face of it I’m now pretty much normal, although I don’t drink much and am almost always in bed by 1am. I rollerblade everywhere and run 5K in a respectable time. But at every given moment, my entire body is in pain. The first years of this were, by and large, horrific. There are a lot of very bad ways to approach chronic pain, and I’ve tried them all. It beats the hell out of you. It breaks you down completely. But then you get to build yourself up again from scratch.
Mental state is the biggest modulator of physical pain. Things hurt more when you’re stressed or sad, and the increased pain makes you both stressed and sad. The way out of this vicious circle is a wholesale change to how you perceive fear, suffering and setbacks. Of course you have to look after your body, especially the parts that are causing you trouble. But first and foremost you have to look after your mind.
You become more honest with yourself about your emotions and motivations. Pain can really, really get you down. You are never really comfortable, always distracted, and can’t do the stuff you used to enjoy doing. However, it is still incredibly difficult to admit to yourself that pain might be running you over. You invent explanations and stories in which you are an invulnerable superman who barely notices the weight of the world on his back. But misleading yourself like this results in so much contortion and denial that with time these pictures fade, and your introspection necessarily becomes as raw and truthful as you can deal with.
Chronic pain is like mental illness. It is a squeamish, taboo class of affliction that few people know how to deal with, so you and others dance around the issue and you don’t have to admit to any fragility. But once you come round to the idea that you are breakable and that this is OK, a new world of self-understanding opens up.
You have an increased will to change things as a result of what you learn about yourself. You put yourself in more good situations and take yourself out of more bad ones, with less regard for norms or strange looks. “I’ve got that thing with my legs, remember?” You are kinder to yourself and give yourself more permission to do weird stuff if that’s what feels right. You do some truly uncommon things for reasons you don’t feel much like talking about. At an ex-girlfriend’s parents’ wedding anniversary, you quietly leave the party for an hour to go and have a bath in the dark. So what? A bit later you realise that other people probably do this too, and that that’s probably worth bearing in mind.
You become calmer. At first your only real emotion is rage. Rage at yourself, rage at the doctors, rage at everyone else who has no idea what you’re going through. Before long you learn that this doesn’t help. But it’s what comes naturally, so you stick with it out of habit. You start reading; the books tell you that you must accept and welcome your pain as a friend. Bullshit, you’re a fighter, you’re going to keep fighting. Then after a much longer period, you have nothing left. You realise that all this fury and fighting and tensing up against the pain is the majority of what is making everything so bad. You quietly dig those books back out from under your bed and start again.
So you try acceptance. You cultivate stoicism, although you aren’t quite sure what it means. You try realising that there is not a whole lot anyone can do to make things physically better, and that this does not mean your life is over. You try believing that if you’re going to have a bad day then that’s what’s going to happen and the best you can do is to use it to learn and practice. And as you’re trying these things, you notice that whilst your body doesn’t feel particularly different, you still feel a whole lot better.
You stop being so afraid of things, because fear is what screws you up. The raw pain experience often isn’t that bad; the scary part is knowing that you will still be hurting tomorrow, will probably be hurting in a year and may well be hurting forever. You don’t have much control over your pain, but you do have control over how you interpret and react to it. Fear plays a pivotal role in the lifecycle of any bad experience, real or imaginary, and if you look closely at events and possibilities before being afraid of them then you will kick many of them to the kerb before they even begin. You create fewer bad experiences.
Prosaically, chronic pain has forced me into the same good habits that everyone else is after. I make sure I sleep and eat well. I don’t work too hard. I don’t drink much. I prioritise balance. For most people, an imbalanced life means burnout in a few years time, but with chronic pain this can happen almost immediately.
I take pride in what I have achieved. Doctors can’t do much. Drugs are ineffective. The only thing that makes any difference to the quality of my experience and happiness is me. This isn’t some self-help hand-clappery. I try and accept help along the way, but educating and rebuilding yourself works, and there is medically no alternative.
I’m not battling pain, so I haven’t beaten it as such, but I haven’t let it beat me either. I am in many ways stronger, whether I like it or not. I am in all likelihood more understanding of some of the crap that other people go through, although that might just be maturity or my imagination.
And I am happier.
This post was also republished on Lifehacker.Discussion on Hacker News