The Potential Pitfalls of Your Pain Narrative or Story

Ever since the dawn of time, we have relied on stories to make sense of our environment, community, and life events. Stories help us process and deal with our fears, concerns and with what happens to us. Stories shed light and aid our understanding, guiding us in what action we should take, or whether we should merely lay these things to rest.

When we consult with a physician, a history is taken before examination, which is the way it should be. With simpler, more recent onset problems, the history is usually shorter and simple. Complications can occur with chronic conditions that are longstanding and that impact many areas of our lives. These have a complex and lengthy narrative.

We see this in chronic pain, where we tend to cluster our many questions, symptoms, and problems in order to inform our physicians when the opportunity presents. However, there is usually so much to cover and present-day physician consults are so brief, that we understandably tend to focus on the most pressing and frustrating problems, hoping for clarity and reassurance during these short sessions.

But what we do not see is that the usually bleak, sometimes overwhelming negative history then becomes the overarching narrative we also tell our family and friends, whenever they express concern regarding our condition. This is then repeated as their narrative when others ask them how we are doing.

With time, the repetition and reach of the story may result in our social circle having a more unrealistically negative picture of our condition, and they may treat us accordingly, expressing it through over-concern, coddling and other unhelpful behaviors.

But even that is not the end of it.

Through repetition and focus, the dominant themes become a staple or mantra for our own negative internal dialogue, and here the problem becomes obvious. Endless reflection and rumination trap us in the most negative cycles of our experience, to the point where, rather than character becoming destiny, as the old saying cautions, narrative may become destiny.

So how do we get around it?

Firstly, we need to become aware of this potential problem. Then we need to attempt, when speaking to friends, family and even physicians, to try and include some even mildly positive points as well as some things that may have improved even slightly, or by including newly gained coping skills, so that the detail does not become an overly negative spiral. No-one is expecting you to tell a story that you cannot relate to, but it is vital to inform family and friends that not everything is entirely bleak and sad.

There are often small gains that can be expanded through focus and we do see this in clinical practice.

You can easily temper certain aspects of your challenges by reframing things. For example, instead of saying that “pain always wakes me up at night,” you can say “for now, the pain seems to be waking me frequently.” Rather than “nothing works,” perhaps state that you have yet to find a reliable treatment approach. Not only will this make others worry less and you feel better, but it may crack open further possibility and recovery potential. A very least it will make you feel less trapped in the pain cycle.

First comes awareness, followed by initial effort and the accumulation of small advantages, and then time spent in this healthier mode may well secure significant change and shifts for the better.

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