Pain, communication and relationships

This chapter aims to help you to understand:

•   How close relationships can be affected by pain

•   How to manage difficulties in relationships

•   How to change behavior

•   How to communicate and share your concerns

•   How to deal with sexual problems

•   How to make sexual relationships easier

ADVICE ON USING THIS CHAPTER

This chapter is divided into Part 1 (‘Communication and Sharing Concerns’) and Part 2 (‘Chronic Pain and Sexual Relationships’). You can make use of whichever parts of this chapter you feel are relevant to you. You might want to read it with a partner, or leave it for them to read by themselves. You could also show them the other chapters that you have worked through, such as Chapter 1.

Part 1: communication and sharing concerns How close relationships can be affected by pain

Pain has an effect on people around the person with chronic pain. For example, you might find yourself saying ‘ouch’ or wincing when you see someone else twist his or her ankle. People usually ‘feel for’ the person who is feeling pain, and will often try to help.

Sometimes, people feel closer because they are facing problems together. But sometimes communication becomes more difficult, or even breaks down. Family, friends or partners might be concerned about you. People close to you might know exactly when you need help, when you need to be left alone and when you need to talk. Or it may sometimes seem as if sympathy has run out. You might feel that they have never really understood how your pain condition affects you.

For a short while, being looked after can help, for example, when you have a severe setback. But friends or family members may try to do too much for you. And after a while, if you are ‘looked after’ all the time, it can make it harder to feel in control of your situation or that you have a useful role to play at home or in life.

It can be hard to talk clearly about your feelings or thoughts, especially if you are feeling frustrated, anxious or depressed. Pain can make it harder to make the effort to go out and be with people. Withdrawing from others is a common response to chronic pain and it can be a helpful coping method. However it may also become an unhelpful habit. If used too much, it can lead to isolation and loneliness.

Learning to communicate or talk about what is helpful to you, saying ‘no’ and negotiating compromises and solutions are all very useful skills. And they are needed even more if you are managing chronic pain.

Think about your present situation. Do you:

•   Feel as if others just don’t understand what you need?

•   Find it hard to say ‘no’ when you want to?

•   Find it hard to ask for help?

•   Find that other people tend to do ‘too much’ for you?

•   Want to be able to negotiate better or compromise more?

•   Feel that other people’s compassion or sympathy has run out?

•   Withdraw from social situations or activities more?

•   Feel like your role at home or at work has been taken away or undermined?

Some families talk about these things openly, and are good at finding compromises or solutions that work for them. For others, talking about emotions or thoughts does not come easily. Maybe they have never tried it, or it has not seemed necessary or important before now.

Talking to each other can be more difficult when there is a person in the family who has long-term pain. Perhaps there is a fear of hurting the other person’s feelings, or starting another row? Either way, it can be difficult for all the people involved.

Many people with chronic pain say they have become more irritable since the pain started. They also report becoming depressed or angry or worried more easily. Sometimes all these moods occur together. At a time when you most need to be close to people around you, being irritable can get in the way. Sometimes, getting angry with yourself for being short-tempered makes it even harder to deal with frustrations and solve problems.

Steve described his situation like this:

. . . My partner Nicole is a very caring person. She would do anything for anyone, especially me. Since I’ve been in so much pain, I seem to bite her head off for helping. Then I get so angry with myself for shouting, and then feel too cross with myself to ask for help when I need it. I never had so much trouble talking with her before . . .

One person may assume that the other doesn’t want to talk. The partner or family member may think that he or she knows what the person with the pain is thinking because they know that person well. But this type of attempted ‘mind reading’ can often lead to difficulties, conflict or misunderstandings.

Sometimes the family members or partner don’t know how to help. They may be coping with many changes in their partner, parent, or son or daughter because of their pain. These changes could include:

•   The loss of the person as they used to know them

•   The loss of doing things together

•   The person in pain having a lot of mood swings

•   Things having to be done differently about the house or at work

•   Changed finances

•   Changed roles

•   Getting less help

•   Doing more at home

•   Having to work different hours or having to give up work

•   Having to get up at night to care for the children

•   Needing to plan outings more carefully

•   Feeling a general sense of loss because expectations of the future have changed

It can be hard to cope with the distress of a person you are very close to, or whom you care about a lot, when they experience periods of severe pain. You may feel powerless, especially when it is difficult to talk about these issues.

If you are the person in pain and your mood is low, or you seem irritable, other people may feel hurt, or even rejected. They might feel that their efforts to help are not working. And they may give up on inviting you out, because you have said ‘no’ several times. Most of these problems can be eased by talking about them openly. If you need to talk things through, try to choose a time when you are not likely to have extra pressures or interruptions. If it seems difficult for both partners to feel listened to, it can help to agree to listen carefully without interrupting for five minutes, and then let the other person do the same. (For more ideas, see Chapter 10 on problem-solving.)

It is hard to cope with the impact of pain, and the many changes it can bring. It may seem as if you are losing control of many parts of your life. However, becoming aware of what is happening is the first step in learning to cope with chronic pain and its effects.