Remember that old slogan, “What would you do for a Klondike bar?” Well, I’ll up the stakes – what would you do to get your pain treated? A woman in Michigan was willing to shoot herself to get doctors to address her shoulder pain. (Now, I know the crux of this story really centers on access to healthcare and the poor economy, neither of which will I address here.) What I find truly striking is the way this story speaks to the issue of pain’s potential impact on people’s mood and behavior. Regardless of good sense, finances, or circumstances – pain can impair your logic, the resulting depressed mood can harm your perspective, and combined you can make rash or poor choices out of desperation. This story shows loud and clear how much suffering chronic pain patients endure – this woman had not yet even met criteria for chronic pain, having suffered only one month so far. One month! So, as you try to communicate to friends, family, and providers how you suffer, day in and out, for years at a time, you can point to this story – one month in pain was enough for a woman to grow distressed enough to shoot herself. (Obvious disclaimer – I am not encouraging shooting oneself as a means to address your need for treatment – this is a terrible and dangerous idea and should not be repeated.)
The other moral of this story (apart from saying that chronic pain can really hurt that bad) is that communicating your emotional distress (in appropriate ways) is an important skill to learn. This communication is very unique to the person and to the people in his/her life, and so your methods may vary. However, the key is finding methods that work. For instance, some pain patients attempt a passive, or passive-aggressive, approach – behaving or speaking in ways that they hope spouses recognize their pain, or growing angry and vengeful if the “right” response to pain flare-ups is not given. Such approaches usually fail, because the message gets muddled in translation. (The woman in the story could be said to have taken a passive approach – though she took strong action, she only hoped that the treatment of her gunshot would lead to incidental treatment of her shoulder pain/injury – this in fact did not happen and she is still suffering from her original injury. Passive or passive-aggressive approaches may get you attention, but it may not be what you hoped for.)
I encourage direct or indirect communication that has a clear message and asserts your needs in that moment. For a direct, assertive communication example, consider this: “Hey sis, my back pain is flaring up today and has me really down. Would you mind if we cancelled dinner and I just stayed home on the couch? Actually, could you grab some take-out and come sit with me awhile?” This message communicates three important pieces of information: 1) what is your pain level (very bad), 2) how it is affecting your mood/behavior/needs (can’t leave the house), and 3) what the people in your support network can do or not do to make things more tolerable (visit me and bring food).
And such communication can be indirect also – consider a man saying to his wife “Dear, I’ll be in the back room watching tv.” This statement says nothing directly about pain – but, let’s say that this couple had previously agreed that the husband got angry and frustrated when talking about his pain. Let’s also say that they needed an indirect way for him to communicate his distress without talking about it – so they agreed upon a phrase and behavior (watching tv in the back room) to let the wife know that her husband’s pain was flaring. They also have learned that the husband’s pain flare-ups are best handled by allowing him time alone, and that he would emerge from the tv room when his mood or pain would be less likely to lead to a fight between them. Of course, somewhere in this story you see that direct discussion has to occur, but it may only need to be said once, and henceforth the communication can be indirect but still have a clear message with all three components noted above. In this example, the phrase means pain is very bad today, thus my mood is angry and I am likely to snap at people, so please let me isolate for a few hours and use tv as a distraction.
These are just a few oversimplified examples of communication styles. I encourage you to find your own healthy way to share with people in your life, to let them know how your pain affects you. Be sure to include those three components: 1) pain level, 2) how it impacts your mood/behavior, and 3) what people can do to help. Use this news story as a jumping off point to explain how bad the pain feels, and how you sometimes may act bizarrely because of the pain. But also let this story be a cautionary tale – better to find an effective communication method (through trial and error) than to wait until things become intolerable and you are left without a way to ask for help.