For many people, social isolation and distancing are something new. For someone suffering chronic pain, they may already feel isolated.
Social isolation and social distancing: these are terms that did not exist in our vocabulary until a few weeks ago. Most of the planet is now social distancing and many are socially isolating. Avoiding contact is one of the simple ways we can all contribute to flattening the curve; another new term.
It struck me during a recent session when the person told me that isolation was not new to them. This is how they had felt for the past year and a half whilst suffering on-going pain. This caused me to reflect on the number of suffering people who I have worked with who have expressed feelings of isolation. Pain is lonely.
Only I can feel my pain
Pain cannot be seen. Pain is a perception that only the person can perceive. It can dominate the inner world as an experience, together with the thoughts and feelings about the pain. In this way, pain is isolating. No matter the care and love we receive, and of course these are important for recovery, no-one else can ever know what it is like. We can try to describe the qualities, change our movements, shout out, gesture and grimace, yet it is always ours.
The ownership of our pain has one distinct advantage. It is mine to change. If this were not the case, we could not become empowered to transform our suffering. Whilst in most cases this is challenging, it is possible. This begins, in my view, with understanding your pain and its purpose in your life: what is the need to meet? What is the message? The founder of modern pain science, Professor Pat Wall, was the first to classify pain as such: ‘Pain is better classified as an awareness of a need-state than as a sensation’. Again, I emphasise the necessity of understanding pain.
The recent Understand Pain (UP social enterprise I co-founded in 2015) project that I have been running has highlighted the importance of the individual understanding their pain as the first step. This is practical knowledge, used to inform better decisions to work towards a picture of success. Participants have regularly commented on how the conversations we have had about their pain have been most helpful. Deeper enquiry revealed how they felt more confident to move, taking the important step of re-connecting with their bodies in a healthy way.
In chronic pain, a common pattern is to withdraw, gradually doing less and less — a disconnection with what matters: people, purpose and the planet (being out in the world). We have an implicit fear of loss and less, hence feeding the existing protect state. Many sufferers limit their socialisation, are unable to work as they wish or at all, play sport or be involved in activities that bring them joy. As time passes, this becomes a downward spiral.
We all hold a world view. This is based upon our belief system, which has been shaped by our experiences and learning to date — conscious and subconscious. We are all subject to this social conditioning. Some of our beliefs and consequent actions deliver results. Others, our limiting beliefs, do not. These are the ones that hold us back. However, we can identify such beliefs and use practices to let them go whilst mainly focusing on our strengths.
The world view results in a set of rules that we live by. These rules help to keep us safe. In chronic pain, we can feel safe by doing less and less, especially if we think that we are damaging ourselves each time we feel pain. This is not the case — pain and injury are poorly related. Pain is not bound to the tissue state, instead a part of the way we protect ourselves.
We are designed to connect. Living in communities has been one of the primary reasons for our success as a species. Whilst some people enjoy periods of solitude and choose to spend time alone, when isolation is enforced, it has significant effects upon our health.
Loneliness is a perception. The way I interpret my own situation is the key factor. If I perceive that I am lonely, research suggests I will be more inflamed. This makes sense on the basis that if I am bitten by the lion and alone, my healing mechanisms are ready. The problem lies in the fact that persistent inflammation has many undesirable effects, including pain.
When we feel that we are connected, we are in more of an anti-viral mode
When we feel that we are connected, we are in more of an anti-viral mode. This also adds up, because as we know only too well at the moment, proximity creates the opportunity for viruses to spread. At the moment we need our anti-viral mechanisms to be optimised, yet feeling lonely turns these down. It’s a double whammy, emphasising the importance of trying to keep connected, or making sure people who live alone feel part of the community or family.
This will be one reason why it feels unnatural to keep distance. Our default is to connect. Touch and contact is an important part of this connection. This is how we care for others, show compassion, develop a sense of self, communicate and bond. It will be fascinating to see how we readjust when proximity is permitted once more when this time passes.
One of the important parts of the Pain Coach Programme focuses on how people can re-connect with what really matters. This includes people. Not just any people, but those that encourage us and make us feel good. Mike Pegg refers to them as pot fillers (visit the page for exercises).
Pot fillers build our confidence and belief. They focus on our strengths and help us to use them to achieve results. This could be at work, at home or in sport. Some we will know, but others who we listen to and read can also be inspiring and fill our pot. Connecting or re-connecting with such individuals is an important part of being well. Being well and practicing the skills of wellness is a vital part of overcoming pain. Through such practices we create the conditions to move on to a better life.
Now and onwards
It looks like we will continue to isolate and keep our distance for some weeks yet. There are many challenges to overcome that require a togetherness across the globe, in communities, in teams and families. We are seeing plenty of examples of positive and compassionate contributions at all levels: read here, here and here. Thanks to Mike Pegg for posting.
The response to Covid-19 has highlighted the roles that society truly values. Who is really contributing at the moment? In no particular order: nurses, doctors, allied health professionals, drivers, volunteers, supermarket workers, emergency services, carers, cleaners. All of these people are pursuing a purpose. They are serving something greater than themselves and society is applauding and appreciating their work. This brings people together, and togetherness is an antidote to loneliness.
People are isolated and lonely for different reasons. Some are feeling the effects of the Covid-19 strategy, but see a light at the end of the tunnel. This will pass. However, people suffering chronic pain may not be able to see such a light. Yes, the social isolation will lift, but will their pain get better? The modern messages about chronic pain say yes. You can feel better and improve your life.
Our role is to show people how.