Tag Archives: pain

Self esteem and pain

Ongoing pain can really undermine a person. It takes a toll in wellbeing, it eats away at your confidence, and it can undermine you feelings of self worth and self esteem. This can be especially bad if you need to hide your pain for the benefit of the comfortable people around you. Having to do everything a well person would do, but while hurting and pretending not to hurt is a course of action that may easily leave you feeling like you’re not a real person.

I’m heartily sick of seeing people who are suffering getting told off on social media for talking about their discomfort. I’m weary of people who are ‘depressed’ by other people’s difficulties and feel the right answer is to make the person who is suffering feel guilty and ashamed for talking about it, so as to shut them up. This adds more layers of suffering for a person who is already in trouble. We need to stop sacrificing people who are in distress just to maintain the ease of people who are already having a better time of it.

I wish we had the support in place that meant people who are ill could reliably afford to rest. I wish illness did not radically increase your risks of living in poverty. I wish we did not measure people so much by their economic activity. I wish there was more scope for people to heal and recover when they need to. I imagine a society in which no one was expected to push relentlessly through pain and suffering, and where we were not so quick to assume that someone struggling is lazy, or not trying hard enough.

Living with pain will eat away at your sense of self if there is no scope for that pain to even matter. If your life does not allow you to take care of yourself, if there is no one to help you, give you breaks or take care of you, suffering is inevitable. When your self esteem is constantly undermined in this way, it is that bit harder to hold boundaries, protect yourself or ask for what you need. And so you trudge on, hurting and exhausted, because trudging on seems to be the only option.

What would it take to change that? The answer isn’t about personal changes, and it should not be the responsibility of people who are suffering to find individual solutions to systemic problems. We need a kinder society where taking care of people matters, where there is economic support for whoever needs it, and medical care free at the point of delivery. We need a work culture that won’t punish you for being ill, and won’t break you with needless stress in the first place. We need the time and energy to take care of ourselves. It would be revolutionary to start treating quality of life like it matters, and not as a perk for those who enjoy the accident of being born into the most privilege.


How hard is it?

If you’re dealing with long term illness, pain or mental health difficulties, it can seem appropriate to try and figure out how hard things really are. How does your experience compare with other people’s? This will likely stem from a feeling that you are making too much fuss, and not being stoical enough. You may not feel confident that you are entitled to ask other people to take your suffering seriously.

Distress is not really a thing that can be measured in relation to other people’s distress. However, the urge to do so comes from experiences like being told you shouldn’t make a fuss because other people are worse off. By this logic, only one person in the world at any given time is allowed to make a fuss!

In any sane and compassionate scenario, what will matter is that you are suffering. If you have to prove you are suffering enough to be taken seriously, there’s something wrong with the situation. If you’ve had extensive exposure to having to prove your discomfort, you may be in the habit of doing it to yourself even when there’s no longer anyone around to suggest that it probably isn’t as bad as you are making out.

Many people have terrible double standards around taking their own discomfort really seriously while being dismissive of everyone else. It is of course the people who know perfectly well that they make a fuss about little or nothing who tend to mistrust other people’s self-reporting. People who are used to being comfortable often treat minor setbacks like a bigger deal, people who are used to being uncomfortable often learn not to let it be the most important thing.

I’ve noticed around my issues that I feel obliged to be able to explain and demonstrate things. If I am upset, I have to make sure that I can reasonably explain why I am upset and I have to feel confident that any normal person would also be upset in the circumstances. It’s never felt like enough just to not like something or be uncomfortable. I’m trying to stop doing this, and to make space for how I feel regardless of whether I can demonstrate the reasonableness of the feeling. I often catch myself accounting what I’ve done against how I’m feeling, like this is an equation to balance, and if I haven’t done enough to feel tired, I don’t feel comfortable stopping.

All bodies are unique, all situations are unique, all minds are unique. What someone else might do is not that useful a measure. How hard it is for you is the most important consideration. But, if you’ve had knocks to your confidence, or don’t get taken seriously, it can be hard to hang on to that. No one else really knows what anyone else is feeling or going through. How hard is it? Really only you can say. Feeling you are entitled to say can be challenging. Trusting that your experience and needs are what matter can be hard if you’ve been taught not to do that.

If you know it’s important to keep a sense of proportion… if you care about not asking too much of other people… if you worry about whether things aren’t as hard as you think they are… trust yourself. You are paying attention, you aren’t being self-indulgent, your experiences and opinions are valid. It’s the people who never worry about these things who tend to make a lot of fuss over very little. Try and work out whose the voices are that tell you your experiences aren’t valid – the odds are there are specific people who have downplayed your distress and treated you like you were playing up the discomfort to get your own way, or get out of something. You don’t owe those people anything at all.


Pain, Shame and Guilt

I think in many ways it’s a reflection of how seldom mental health is taken seriously that we add shame and guilt on top of people’s existing pain. No one who considered themselves kind and well meaning would tell a person with flu to just pull themselves together and try harder as though this is how you get over flu. We don’t tend to tell people whose bodies have been seriously injured that they should ‘man up’. Culturally we do have some serious and parallel issues around how we treat chronic pain and long term disability, but that’s a post for another day.

We treat psychological injuries as though they are personal failures and in doing so, add to the burden already wounded people are carrying.  Telling people the reasons you think they shouldn’t be in pain doesn’t ease pain. What it does do is help that person internalise shame and carry guilt about their own suffering. That in turn makes it harder to ask for help.

Depression isn’t an individual failing. Often the reasons for it aren’t personal, but systemic. Poverty and the stress of insecurity makes people ill. Overwork, leading to exhaustion and burnout makes people ill. Distress caused by mass extinction and climate chaos makes people ill. Being made responsible for things we have no power over also makes us ill. Here in the UK we have a culture of working people to death, blaming them for not being able to find work in a shrinking jobs market, causing poverty and then blaming people for being poor and a host of other such horrors that pile on the misery. The result is that not only do you get to suffer the consequences of stress and insecurity, but you get to feel like it’s all your fault for not being good enough in the first place.

If you do get help with mental health issues, the odds are it will be meds. That’s what we can have. Huge numbers of people are suffering depression and anxiety as a direct consequence of our messed up work culture and precarious lives. How can the answer to such system failures, be chemical? Use it to get by if it helps you, but don’t buy into the idea that meds are the answer here.

We have to stop blaming individuals for suffering and start talking about the way in which our culture is sick. We get less time off than your typical mediaeval peasant. The safety net of welfare is being eroded. We are punished for misfortune and poverty. We don’t have enough green space, enough quiet space or enough time to benefit from exercise. Many of us can’t afford to eat well. It is difficult to be mentally well in such a situation.

Mental health is a collective problem that needs solutions on a societal level. When we treat it as a personal problem to be solved at the personal scale, we add to the guilt and shame that makes people ill, and perpetuate the stories in our culture that are causing bodily and emotional sickness. Mental health is a cultural issue, a societal issue, a political issue.


Pain speculation

To be very clear, what I’m sharing in this post is speculation based on personal experience. I can’t point anyone at any evidence that backs it up. I’ll start with what we do know – that there does seem to be a relationship between inflammation based pain, and trauma history. People with fibromyalgia seem to be more likely than not to have trauma history. There is growing evidence that what happens around trauma doesn’t just impact on your mind and feelings and that there can be bodily consequences – hardly a wild though, it is all the same system after all.

One of the psychological consequences of trauma, can be hyper-vigilance. You’re always looking for threats, you can’t relax. Busy spaces, people behind you, noise, unexpected touch or sounds – all of these things can cause panic and ptsd responses for some people. But of late I’ve been wondering whether that really is a purely psychological issue.

I carry a lot of tension in my body, and this contributes to experiencing pain and stiffness. Anxiety and stress in the body manifest as fight/flight/freeze/appease responses – that’s been established. So, we might fairly assume there is some kind of process that precedes fight, flight etc. Normal people do not spend all of their time poised to run away, and get to be happier and healthier as a consequence. Cortisol and adrenaline are part of this mix, for sure. What if being on alert all the time is a bodily process? What if hyper-vigilance is something that happens not just in my head, but in my tissues? Could that be why I spend so much time sore and in pain?

If that’s so, then the next question is, how do I persuade my body to stand down? How do I persuade my body that I am safe enough now, and that I do not have to be poised to run away or ready to freeze and disassociate? How do I teach my body to feel safe? I shall be exploring this and will come back if I make any progress.


Druidry and Pain

There’s nothing in modern Druidry to tell us that pain and suffering are in some way good for us spiritually. If a painful experience comes along, there’s always scope to learn from it in some way, but no feeling of obligation. There’s no Druidic story that we’re here to learn specific lessons, or worse yet, that we agreed to those lessons before being born.

Ancient Druidry may well have included an element of belief in re-incarnation – the Romans certainly thought so, and compared Celtic belief to the philosophy of Pythagoras, because that was what it reminded them of. A Celt might agree to repay a debt in a future life. What’s interesting in this, is that what carries over does so by agreement. There isn’t some great weighing and measuring system that sets you up to deal with past mistakes or learn lessons, by the looks of it.

What the mythology tells us about Gods, punishment, suffering and learning is that it’s all very personal. It is the deals you personally made that you will be held to. It’s breaking your personal taboos that will land you in trouble. There’s no bigger system. Pain is personal too, and it may well be the price tag for a glorious, memorable life.

It isn’t noble to suffer. It doesn’t reliably make us better people. A bit of suffering can be good for improving empathy and compassion for others who suffer, but there are no guarantees. Pain can be a teacher, but only if you choose to accept it as a teacher and only if you have enough resources to be able to work with it on those terms. Pain is not spiritual punishment – unless you did something that brought it on yourself, as Celtic heroes seem to do, and then it’s part of your story.

In life-affirming religions, the physical world is a good place. Yes, it can hurt you and it will kill you, but in the meantime there are feasts to go to, there’s mead to drink and wine, and beautiful other people to try and shag, there’s adventure to be had, and passion and glory. Pain can be a consequence, but it’s part of being alive. In religions that value pain and suffering as spiritual experiences, this tends to go with a denial of the physical. If you’re trying to transcend the body, then making it suffer can seem like a tool for spiritual advancement.

But honestly, having done a lot of physical pain and emotional suffering along the way – it isn’t a great teacher. I’ve learned more from more nuanced opportunities. I can learn more and grow more when I’m not mostly shut down by pain. Often, all pain can teach you is how not to want to be in your body, how not to take joy in it, how to find this life miserable and restrictive and how to have happy feelings about death. There is pain in my life, but mostly I try and use my Druidry to help me overcome it, rather than trying to use the pain to fuel the Druidry – in which capacity it has very little to offer me.


Rest and healing

We live in a sleep deprived culture, and most of us do not get enough rest. However, in terms of healing, recovery, managing problems, dealing with the impact of stress on the body and supporting mental health, sleep and rest are essential. People who are ill or in distress tend to need more time to sleep and rest.

Where this gets complicated is if you are dealing with a long term chronic condition. How much rest is a good idea if healing and recovery aren’t going to happen? How much time do you devote to this kind of self care when it’s going to be an everyday issue, and how much do you push through? If you want some kind of life, to be able to work, maintain relationships and take care of your home then you can’t rest all the time, even if your body wants to.

If you rest all the time, you lose muscle tone. Your body becomes weaker and your stamina deteriorates. Most chronic conditions will wear you out and exhaust you, but if you don’t put up a fight to maintain what body strength and stamina you can, you have less to start with each day. People who are largely well will tell you not to exercise when already in pain, but if you are always in pain and it doesn’t go away, when do you exercise? How do you maintain heart health? How much do you push and when do you rest?

There are probably  no experts to consult. It’s possible they exist, but they need to be experts in both your specific condition, and in fitness and wellbeing. Most people working professionally in health and wellness are likely to know less than you do about what might work for your body. They may also think they know more than you do. I have, for example, had to explain to several yoga teachers why yoga is a very bad idea for hypermobile people.  My Tai Chi teacher had not knowingly taught a hypermobile person before and while he was brilliant and supportive, it was a process figuring out what to do with me, and he was not initially able to advise me. Equally, I’ve had health professionals tell me to get more exercise for my mental health with no scope for even having a conversation about how to handle body pain around that.

There are no easy answers here. I’ve written this not to offer answers, but to flag up the shape of the issues. For the person struggling with their body and often surrounded by contradictory and unhelpful advice it can be difficult to trust that you may be the most capable expert where your body is concerned. It may also be an awful discovery, but the odds are there is no one better informed about your body and energy levels and how to manage it than you are. Any advice you get may be valuable, but needs understanding on those terms.

For people who do not live with ongoing pain and fatigue, the issue is of recognising what you might not know. People who are largely well don’t always respond well to invisible illness in others. What you think a person can do and what they can do are not the same things. What a person could do one day isn’t a reliable measure of what they can always do. It takes time and patience to truly support someone with ongoing pain and fatigue issues. Don’t be the person who makes that stuff harder by insisting that you know better, when you might not.

Also don’t be the person who tells someone they must rest and heal and cannot do the things until they are properly well. Some of us will never be properly well, and the decision as to what it is worth hurting for, should be a personal one, and not for anyone else to dictate.


Taking pain seriously

I grew up hearing that I made a fuss about pain. It’s understandable in that what was going on with my body wasn’t really recognised  then, but still, it would have made a lot of odds if there had been a bit more kindness in the mix. PE at school was the worst – painful and also humiliating and with no sympathy at all. But, it wasn’t just school, and it included my doctor. I internalised the idea that I make a fuss and I learned not to take my pain seriously. Of course doing that means you can’t ask for help, relief, slack cutting or anything like that.

A few years ago, I saw a friend talking about hypermobility on Facebook like this was a thing that merited care and concern.  This surprised me. All of my body bends in ways it shouldn’t, but I hadn’t connected that with experiences of pain. I decided to educate myself, and discovered that hypermobility is a soft tissue issue. People like me damage easily, we feel more pain, everything takes more effort, and as a soft tissue issue it can impact on the gut and other things as well. It’s helpful when things make sense. It’s useful having some idea what to do to avoid hurting myself in the first place.

But more than this, it is validating of how I’ve experienced my own body.  I’ve experienced this information as permission not to be ok, and having spent the first thirty or so years of my life being given to understand that I make a fuss and must have a low pain threshold, this is a very big deal.

The pain is real. The pain is real enough that I am allowed to take it seriously. Taking it seriously opens the door to trying to avoid it, trying to get help, trying to manage it better. It also gives me space for the emotional impact both of living with pain and having internalised the idea that the pain I live with doesn’t matter and shouldn’t be taken seriously. It means considering that I’m not some kind of pathetic drama queen who over reacts. This is quite a shift in my self-perception.

Sometimes we do need permission. Especially if there’s been a big push in the other direction. Validation can be a powerful thing.  It’s another reminder that none of experience life in a vacuum. We’re all impacted on by each other’s words, deeds and ideas.  Wellness and healing are not isolated individual issues, they are community issues. The stories we tell each other about what our bodily experiences mean have massive impact, for well and woe.

I’m watching similar things happen around the growing recognition that trauma has real, measurable effects on the body. I think we’re moving away from old stories that hive emotions off as irrational and not situated in the body and that instead we’re moving towards recognition of people as complex beings where experience can impact on wellbeing.

We’re challenging the stories that are quick to write off some experiences as over-reacting – the medical profession does not have a good history of responding to female pain – and even worse if the women is poor, or Black, or all of those things. But this can change.  We can have new stories in which pain deserves care, and in which we don’t tell people off for making a fuss when they are suffering. We have to stop assuming that being a certain kind of person means something about whether we really feel pain or not  We can stop telling stories that block the way to getting some people’s pain taken seriously. We can do better and we can be better.


Just relax

Try to relax. I’ve heard it a lot of course. Maybe meditation would help. Try mindfulness. If you could relax, you wouldn’t hurt as much. This has come round fairly regularly over the last twenty years or so. As though I haven’t tried. As though I am so stupid that I let my body run away from me into a state of pain and misery that would disappear if only I made a bit of effort to relax. Sometimes, I’ve internalised this and added feelings of intense uselessness alongside the body pain. Oddly, that’s never helped me.

I’ve been meditating as best I can for the last twenty years. Pain makes it difficult to concentrate. Pain means that any body-focused meditation can turn into a very special sort of hell and mostly I don’t go there because it doesn’t actually help. The soreness and stiffness in my body is more complicated than can be fixed by just thoughtfully relaxing all those muscles. Also, when it’s pretty much all of the muscles, deliberately relaxing them isn’t that easy anyway. I know, because I’ve tried…  Repeatedly.

Yes, I have been told about the thing where you clench a muscle hard and then relax it. I have tried this. The odds are decent that the result of the deliberate tensing will be a rush of pain, maybe with a side-order of cramp. I am seldom persuaded that it’s worth the risk.

So here’s a radical notion. What if I, and people like me aren’t hurting because we’re doing it wrong. What if we have bodies that hurt, and cannot magically be fixed with that really easy thing you think we should be trying. What if that really easy thing, when tried, inflicts more pain? What if, living in our bodies as we do, we might be considered to have some tiny notion about what helps and what doesn’t? What if we are allowed to say no to quick fixes that don’t fix anything?

That would have scary implications, wouldn’t it? Because it might mean that your wellness is not entirely because of your reiki mindfulness yoga paleo-diet. It might be that you have been lucky so far. You might not always be lucky. Things might go wrong in your body that you can’t deal with by relaxing and being positive. Pain might be real after all and not all in my mind. Aging is out there as a possibility for all of us, with all the complicated gifts it brings. Bodies go wrong.

If the last twenty years have taught me anything, it’s that kindness is a good deal more helpful than ‘cures’. Accepting me as I am does far more to help me than yet another round of being told the one simple thing I should do to sort it all out. Being patient with my limitations helps me more than telling me why this is all my fault.


Softening the body

One of the notions that comes up in the Tai Class most weeks, is of softening the body. Relax into the posture. Soften. It did not take me very long to realise that this is a significant issue for me. I’m not physically soft. Often I’m very tense. Pain, anxiety, inflammation of tissues, and whatever else is going on in here conspire to make me stiff and tense. What would it even mean to become softer? What would I need to do in order to achieve that?

To make things more awkward, there’s a lot of stuff in my history around being told the state of my body is my fault. That I’d be healthier and experience less pain if only I could learn to relax and put some effort into that. Oddly, I’ve never found that being blamed for being tense has helped me shift towards being less tense. There was always a subtext of how I would be more useful to someone else by this means, also.

I have a lot of trouble letting go. I’m not emotionally present or expressive in most contexts. I may be making an effort not to let my face show what I’m feeling. I’m not good at opening myself to other people, or letting people touch me.

Softness would mean acceptance – largely of myself, to some degree of others. It would mean trusting people not to hate me or hurt me if I let them in close enough.

I can soften in terms of being kinder to myself. I’m exploring that with craft projects at the moment – slowing down, being gentler with my hands. If I’m not pushing hard all the time to get more stuff done, if I can drop pace with the typing, take more breaks from the mouse and keyboard, that helps with pain with in turn helps with stiffness. Taking care of me takes time, and to have that time I need not to feel under massive pressure to be doing things that don’t help me.

Trying to soften my body seems to call for a heart softening towards myself. Not seeing my body as a means to other people’s ends, not letting anyone treat me as a tool to use and not a person. Holding a sense of self-worth that allows me to be kinder and gentler with myself. Dealing with pain kindly, not pushing through it to be useful.

It’s turning out to be a complex process, but I’ve achieved odd moments of feeling myself soften –physically and emotionally. I have a long way to go and this might well be a rest-of-life sort of project. I realise that being softer would also mean being kinder to myself about the timescales in which I can make those changes. I have to ush out of my head the several people who have shamed and berated me for not being other than I am. They were never trying to help, they were only ever feeding the problem. Experiencing a genuinely kind and supportive space focused on physical activity has taught me a lot about how unhelpful some of my historical experiences have been.


What does self care even mean?

The encouragement to ‘practice self care’ floats round the internet a lot. Sometimes it rather feels that if you are still ill, still struggling, it might be your fault for not doing enough of the self care things – I doubt I’m the only one who feels this on a bad day. Self-care is a rather vague sort of notion and the prompt to undertake it rather assumes that what’s needed is fairly easy, or obvious… and often it isn’t.

If you only have mild problems, or only have one problem, then it can be easy to identify what would help. However, when you have multiple problems, what eases one can exacerbate another. Is loneliness making you depressed? But would going out to spend time people trigger your anxiety, or cost energy you don’t have, or are you in too much pain to do it? Then there’s no easy self-care answer to be had.

Trying to find the balance between being active enough to maintain some kind of health, and not wiping out your resources, is an ongoing issue for many people. Part of the trouble is that you don’t know upfront how far you can get. Will some physical activity ease the loss of energy due to depression, or lead to a panic attack that wipes you out entirely? Will the improved circulation from moving about help with healing, or will the aching muscles cost you too much? The big one for me is always, get on the trampoline to sort the dysfunctional lymph glands, or rest the sore muscles. I hurt either way, the question is, which will be worst, which outcome can I least afford? I don’t always get it right.

Sometimes ‘self care’ means trying to figure out the way forward that will hurt least, or deciding which hurt you can most afford. I’ll take body pain if I can gain some ground for mental health, most days. Except on the days when it’s the body pain causing my brain to shut down, or leaving me too open to panic.

Self-care is a lovely idea. If it’s easy to do, then the problems aren’t that big in the first place. If you can fix yourself with a few days off, a nice bath, a walk in the woods – then you were not in massive crisis to begin with. I’m glad for you, but please don’t assume that’s a measure of how anyone else is doing. And if you’re on the other side of this – if no matter how you try to look after things you can’t get on top of your problems, it isn’t your fault. Not everything can be fixed. Not everything can be healed and put right with enough care and attention. Sometimes there isn’t enough self care possible to change how things are.

Also, sometimes self-care isn’t the answer because people need caring for. If someone is over-worked, over-burdened, doing too much emotional labour, being put under too much pressure – it should not be on them to also save themselves. Pushing people towards self-care can be a way of avoiding feeling responsible for them. Sometimes, the answer is to get in there and ask what would help. Take some of the weight off their shoulders. Don’t leave them to fight all their own battles (sexism, racism, ageism, fat shaming, abelism and all things of this ilk are exhausting and take a real toll). Don’t imagine that telling someone to practice self-care is actually helping them – it’s just well meaning noise. If you want to help, make sure they have the space, the time and the resources to practice self care, because without that, telling a person to fix themselves is just adding to what they have to bear.