Managing Chronic Pain

By Lauren Caccamo, LSW

Chronic pain, whether it be in your back, your joints, your neck, maybe even your whole body, is uncomfortable to say the least. The constant nagging of that ache, pull, or sharpness can tug at your mind hundreds of times throughout the day and can make it difficult to live an intentional, focused life. Over 20% of Americans live with chronic pain and we now know the profound effects it can have on an individual’s mental health, as it is highly associated with depression and anxiety disorders.

Often times, people come to therapy seeking guidance on how to manage their chronic pain and the mental health difficulties that come along with it. Acceptance and Commitment Therapy, or ACT, is one of the approaches widely used by psychotherapists to help clients manage pain. Unlike conventional treatments that try to control or cure pain, ACT helps individuals learn to live with their pain. In this form of therapy, it’s not about changing thoughts, feelings, or sensations, that often times with chronic pain we have little or no control over; it’s about seeing those thoughts, feelings, or sensations in a different light. In order to better learn to live with the discomfort, we need to take back the power from pain and focus in on what we want to prioritize in our lives. ACT teaches we can do this through the practice of mindfulness and living a “value driven life.”

How To Deal With Chronic Pain?

Mindfulness is one of the essential tools for living with chronic pain according to ACT. By definition, mindfulness is about bringing awareness and acknowledgement to the present moment in a nonjudgmental manner; it’s about observing our surroundings and being with whatever presents itself in the here and now. When thinking about mindfulness in relation to chronic pain, try exercising your mindfulness muscle with these three steps. First practice bringing awareness to the sensations in the body. This may be saying out loud, “Ah, yes I can feel the radiating discomfort in my lower back” or thinking “there’s that familiar pounding of my migraine coming on”. You have noticed it. Next, acknowledge these bodily sensations that exist without judgment. This is one of the toughest parts, but when you feel that pain do not judge it, do not get angry at it, do not immediately label it as negative, just observe it. This can be a statement as simple as, “Yes the discomfort in my neck is here with me now.” Finally continue to move forward with life in the present moment. You acknowledged the discomfort and you are going to continue to interact with what is in your present moment, including your life, your environment, and the people around you. At this point you’re probably thinking, “Yeah, if only it was as easy as those three steps.” And you’re right, it can be incredibly difficult to get caught up in chronic pain, especially if it’s the first thing you experience in the morning or is what is keeping you up at night. You may be constantly ruminating over the pain or even get stuck in a rut of not wanting to do anything. This is where the skills of noticing, acknowledging, and continuing on become crucial. Do not dwell, do not judge, just observe and continue to be open to each present moment. If this sounds difficult, remember, mindfulness is a practice that takes work and commitment. Work and commitment that is often tied deeper to the things we value most, which can help motivate us through the toughest of times. Mindfulness is a muscle we strengthen over time, similar to our muscles we build, say, in the gym. It doesn’t happen overnight, so remember to allow yourself patience. 

Another essential piece of ACT is understanding our personal values and striving towards living a life informed by those values, or living a ‘value driven life’. Although our lives can easily get side tracked by pain, we hope to be able to refocus with our values. Values are basic and fundamental beliefs that motivate how we behave. What do you value? Is it your family? Or friends? Is it curiosity? Knowledge? Your career? Growth? What are those pieces of life that spark passion for you? We all have them, and although different for each of us, they are incredibly important and inform how we interact with the world around us. Acceptance and Commitment Therapy believes that if we are living in alignment with our values, we as humans will experience a more fulfilling life. Often times, chronic pain makes it incredibly difficult to pursue what is most important to us, but the question is, can we still have that pain be present in our lives AND attempt to live out those values that are so important to us? The idea is that we can observe the pain, acknowledge that it is uncomfortable without judgement, yet still pursue those experiences we love in the present moment because they are so important to us. And by pursuing those things, our lives will feel fuller, even if the pain is still present. In order to work towards living a value driven life, identify what values are important to you. Once you have identified your values, you can then have them serve as motivation in some of the toughest of battles with chronic pain.

Sometimes life hurts, sometimes it hurts like hell, but no matter what comes your way you can continue to practice approaching life in a mindful manner and prioritizing your values and those things you love. By doing this you will experience more fulfillment in life than you would if you didn’t. By doing this you won’t let pain take over your life. By doing this, you will take your power back from chronic pain.

Check out these mindfulness exercises to start to build your “mindfulness muscle” today! 

If you are interested in better understanding you values, check out this values inventory provided by some of the creators of ACT.