Getting started
When you have been in pain for a long time, it is sometimes difficult to know where to start and what to do to change the situation. People can often be held back by fears about becoming more disabled or being a burden, doing themselves harm or the pain getting worse. These concerns can lead them to overdo activities, battle on and then have a setback. They can also lead them to avoid doing things and limit activities more than is needed.
Managing pain includes taking into account what is happening now. Sometimes it is very difficult to face up to the idea that you cannot do everything the way you used to (see Chapter 8 on Pacing).
Reducing the impact of pain on your daily life
Using your three targets to change, write down in your notebook what you would most like to change about your ‘typical day’.
What three things would be different if you managed your pain and life better?
Write down in your notebook what you would most like to change to achieve your targets:
• What physical activities would you change?
• What about enjoyable things (like hobbies)?
In reaching these targets, who would you spend more or less time with?
After you have written down your ideas, write down what would be better if things were different:
• What would be better about social activities?
• What would be better about household tasks?
• What else?
How do you or others see these changes occurring?
When you have put down your ideas, it is helpful to see that there are some points in favour of doing things in a different way.
Next, see if you can think of any advantages of things staying the way they are now. This may seem like a strange idea, but you may have concerns or worries about changing. These also need to be thought about.
What could be positive about not changing things?
For instance:
• It can simply seem too hard to make changes.
• It is nice to have people who look after us when we are ill.
• It can be an advantage not to have to go out with family.
Next, write in your notebook four reasons for things staying the same. Small or silly reasons are fine, as well as important ones.
Have a look at what you have written down so far, and think about the advantages and disadvantages of putting effort into changing. When everyday things are already difficult, it is important to have good reasons to try something new.
Now think about your most important reasons for changing, and your main concerns about what this would involve.
Write them in your notebook:
Do you have other concerns? If so, make a note of them in your notebook:
Now, spend a little time thinking about what you can and do manage. Try not to compare yourself with how you used to be before your pain. This can be quite a challenge! What are your strengths? Try to write down at least three. (The more you can find, the better you are likely to feel.)
What helps you to keep going? Write down at least three things.
Now you have had time to think about the advantages and possible disadvantages of making changes, think about how important it is to you that things change.
Put a mark X on the line below to indicate how important it is to you that your three identified targets from page 31 change.
Put a mark X on the line below to indicate how confident you are about changing your targets.
Put a mark X on the line below to indicate how ready you are to change now.
CHAPTER SUMMARY
• Pain can affect all five parts of a person: their body symptoms, their moods, their thoughts, their behaviors and their life situation.
• Understanding the impact of chronic pain will help you to be clear about your targets to change.
• It is important to focus on what can be changed, as the pain itself is often not very easy to change.
• In order to get started, you need to be clear about the advan-tages and disadvantages of making changes for yourself.
• Working through different chapters in this book will help you find out how to make these changes. You can choose to do this either alone or with support from a partner, family, friends or a healthcare professional.
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