Chapter Eleven deals with actions and gives you an opportunity to create your own action plan for each of the four points to continually bring them back into balance. Last, we have provided a focused, long-term care plan to help you proactively stay in the recovery process.
To illustrate these concepts, throughout the book we present the stories of two families’ experiences with chronic pain, addiction, and recovery. You will meet Jim and Mary, married for over twenty years, and their two children, Mandi and Ross, who have all been struggling with Jim’s chronic pain since he injured his back at work. You will also meet Amy and Chris, a couple who enjoyed a happy relationship for four years before Amy’s diagnosis of fibromyalgia and escalating use of painkillers changed everything. We hope their stories will help to personalize the information you are learning in this book. Although your situation may be different from theirs, you will probably find that you relate to them a great deal, because the stress and difficult emotions chronic pain generates within families are similar no matter what the type of pain or the circumstances of the family.
How to Use This Book
This book is designed for you to write in, highlight, take notes on, and refer back to. It may be helpful for you to share portions of your work with a counselor, therapist, family member, close friend, sponsor, and/or other professional health care provider. Although each chapter is written to stand on its own, we suggest you start at the beginning and do not skip any chapters. Pace yourself and take breaks when you need to. If you find yourself stuck or having difficulty with an exercise, do not stop working; rather, move on to the next exercise and come back later to the one you are having difficulty with. Don’t be afraid to ask for help along the way.
Now your journey of pain recovery begins, and it is time to go to work.
KEEPING A JOURNAL
We recommend that you keep a separate journal or notebook as you work toward balance. Writing can be a powerful healing tool, especially when entering any process of recovery. Taking some time each day to write about your journey can help you identify thought patterns, express feelings, maintain gratitude, and monitor progress. Documenting your experiences will allow you to reflect on successes and will help you stay encouraged and hopeful.
Jim was forty-six when he had the accident at work. He and Mary had been married for twenty-two years at that point and had deep, abiding love for one another and their two kids, Mandi, age twenty-two, and Ross, age sixteen. Jim worked as a psychologist in private practice, doing consulting for a large hospital. The accident happened when Jim was in front of the hospital. A disgruntled family member got into an altercation with an employee, and Jim tried to intercede. He was thrown to the floor, fracturing his back and rupturing two discs, they would come to learn. “Why hadn’t he just minded his own darn business?” Mary would find herself asking late at night when she was unable to sleep. She would become enraged that their life had been irrevocably damaged that day, all because her gallant husband felt the need to be a hero.
Amy and Chris had been together for four years. Things had started off idyllically—they clicked immediately and had similar goals of success, romance, and eventually marriage and kids. Now, after her diagnosis of fibromyalgia, there was only a shell of their relationship. They didn’t go out, have fun, or even relate to one another. They couldn’t talk without fighting, it seemed. Amy felt that deep in Chris’s heart, he didn’t believe she really hurt like she did. He just didn’t get it. Neither did her mom, her boss, or most of her friends. Chris felt powerless to help her and frustrated that she didn’t seem to want to help herself. In the last nine months—since the prescriptions took hold— she was downright stoned a good part of the time. He’d be damned if he’d put up with a drug addict in his life.
These two families are confronting chronic pain, and in this book their stories will help us to illustrate the challenges of living with this widespread but underrecognized phenomenon. It is estimated that more than 70 million Americans are afflicted with chronic pain. Each person’s journey is different, but some common themes run through them all. As with Jim and Amy, when a person develops chronic pain, everyone that person lives with or has a close relationship with is likely to suffer.
A range of difficult and stressful emotions often accompany the pain problem, such as fear, helplessness, frustration, anxiety, depression, grief, and anger. Lifestyle changes and prolonged stress brought on by Jim’s condition are taking a heavy physical, mental, emotional, and spiritual toll on Mary, Mandi, and Ross, and causing communication to break down. Chris’s attitudes toward Amy’s pain and her dependence on prescription painkillers have caused a rift between them and threatened their relationship. But there are many things families can do to better cope with the unbalancing effects of chronic pain. A good starting point is to learn as much as you can about chronic pain and your family member’s specific condition.
A Pain Primer
Pain is an intriguing phenomenon, the source of consternation, irritation, and suffering for millions since the beginning of time. It alerts us that something is wrong—that there is damage or threat of damage to our tissues. Pain is usually produced at the site of an injury and is processed in our complex, computerlike nervous system, causing a vast array of physical and emotional responses. The simplest response is to withdraw from the source of pain and then to protect the area that hurts.
Pain occurs in the body as a result of the interaction of nerve cells, the spinal cord, and the brain (together known as the nervous system). Interactions of a multitude of chemicals, including endorphins, prostaglandins, and neurotransmitters, with electrical impulses coming from the nerve cells create the pain experience, and also pain relief. The brain is exquisitely complex. The part of the brain that processes pain impulses, mainly the thalamus, interacts with other areas of the brain that govern memory, emotions, alertness, movement, blood pressure, hormone levels, and hundreds of other functions. The net effect, in a split second—a composite result of many inputs and outputs—is the experience of pain. Needless to say, this system is efficient beyond that of the most sophisticated computer; however, in the case of chronic pain, the system has gone awry.
There are two types of pain, acute and chronic. In acute pain, the computer functions properly, as it was meant to. With chronic pain, on the other hand, it is as if the computer has been affected by a nasty virus, turning previously healthy and necessary mechanisms into overactive and inefficient impulses that disrupt normal function. Acute pain is time-limited—usually gone within a few hours to days. It may last weeks to a few months, but it eventually goes away. Acute pain can be associated with fractured bones, sore teeth, bruises, cuts, surgeries and their aftermath, infections, and a variety of other injuries and conditions. It exists when there has been damage, and as the damage heals, the pain subsides and eventually resolves, and life returns to the way it was before. Acute pain is part of the body’s “response-to-injury” system, which causes us to try to put an end to the offending, pain-causing
