Ten Steps To Overcoming Chronic Pain
by Mark Grant MA

Chronic pain is a serious problem but is often made worse by misinformation, negative attitudes and beliefs, outdated ideas, negative emotions. It is recognized that chronic pain is often mismanaged, not because we lack adequate treatments, but because of fear and ignorance. These steps are designed to help you mentally cope with chronic pain in the best way possible.

1. Make sure you understand what kind of a problem pain really is.

Chronic pain is different to other medical problems, which can often be treated relatively easily and successfully. Chronic pain is a complex illness, caused and maintained by a combination of physical, psychological and neurological factors.

These multiple causes make it difficult to pinpoint any one cause for pain, or any one treatment. Pain is also often dismissed or poorly treated because of the 'baggage' of old ideas about pain - for example, pain where the physical cause is unknown is often under-treated. This is despite the fact that the role of neurological factors means pain can occur in the absence of external causes and that such pain should not be dismissed or considered abnormal.

The medical establishment has struggled to meet the challenge of pain, and now recognizes that this problem cannot be overcome without combining input from other disciplines such as psychology and physical therapies. Pain is also a subjective experience which is impossible to accurately measure. Pain involves a range of emotional reactions including anxiety, fear and depression.

2. Acceptance

Chronic pain is so awful that sometimes it's easier to escape into wishing it had never happened, or hoping for a miracle cure. If persistent, these common reactions to pain can actually become a bit of a trap. You need to face the reality of what's happened, and find constructive ways of dealing with it.

Acceptance means more than just intellectually knowing that you have pain, it means actually allowing yourself to feel the anxiety, fear, anger and grief that go with pain. Acceptance is a process, which requires progressively acknowledging all your feelings, and getting your physical and emotional needs.

In order to accept and go through the negative emotions associated with chronic pain, you must have adequate safety and support. Safety means having adequate control over your pain through the right combination of medical, physical and psychological treatment inputs. Support means having adequate emotional support from family and friends giving you a feeling of containment and security.

The end product of acceptance is reduced pain, inner peace, less anxiety and better coping.

3. Take Control.

After many months or even years of pain and failed treatments, its easy to slip into feeling hopeless and that nothing can be done. Pain sufferers are often the butt of negative treatment and it's easy to end up feeling angry and victimized. They often have some justification for feeling this way.

Maybe you didn't cause the pain, and maybe you aren't happy with some aspects of your treatment, but guess what? - life isn't fair. Blaming others for your problems, however well-justified, turns you into a victim and is like giving away control of your life. You are allowing yourself to be led by your emotions, but you do have a choice. Take the easy path (which isn't really so easy) and simply blame others, or take control and get information, communicate assertively with your doctor, practicing pain-management strategies such as regular exercise, pacing and relaxation and stress-management.

You need to decide whether you want to be a victim or a survivor, a passenger or a driver. Your pain is no-one else's problem but your own. You do have rights and even responsibilities as a health consumer and a patient. Because chronic pain is difficult to detect or measure, you need to be an informed, active participant in your treatment.

Don't be afraid to ask questions, don't be afraid to tell the doctor what you think and what you want, don't be afraid to ask for stronger pain relief.

4. Have a good working relationship with your doctor.

An open and trusting relationship with your doctor is essential. This means being able to tell your doctor how you feel, ask questions and feel listened to and understood.

The doctor-patient relationship must be a two-way street. Although you rely on your doctor's "expert" opinion for treatment advice, he depends on you for accurate information on which to base his decisions. It is your responsibility to describe your symptoms as accurately as possible and to report back regarding treatment outcomes, even if unfavourable.

Under-reporting of pain has been identified as one of the biggest causes of mismanagement of pain. The doctor-patient relationship can be undermined by bad communication, ignorance, arrogance and fear. For example, many people are actually afraid to tell their doctor how they are feeling for fear of being labelled as weak or a complainer. Other patients report down-playing the severity of their pain because they don't want their doctor to feel like a failure!

You should feel that you can talk to your doctor, that he listens and respects you, and be satisfied that he is working competently and thoroughly on your behalf. You also have a right to change doctors if you are dissatisfied.

5. Never ignore pain.

In the treatment of chronic pain it has become fashionable to recommend ignoring pain (after medical investigations are complete) in the belief that it is only pain and there is nothing physically wrong.

This approach represents a pendulum-swing away from the old fashioned notion of prescribing bed-rest in favor of maintaining activity. The idea is that inactivity only leads to depression and does not help the problem anyway.

However, with certain types of pain, this can lead to a cycle of aggravation, sleep deprivation, exhaustion and increased pain and suffering, particularly if you are someone who typically ignores pain (ignoring pain is of course, what causes most repetitive strain injuries).

The other problem with ignoring pain is that every time pain occurs, it leaves an imprint in your nervous system, a kind of 'pain memory'. These repetitive pain experiences lead to over-stimulation of the nervous system and the generation of spontaneous pain signals, leading to a cycle of stress and pain. There are thus sound reasons for wanting to avoid pain, but again, total inactivity is not the answer. The best approach is a balanced one with paced activity levels and avoiding undue aggravation of the pain.

6. Have a balanced approach to physical activity.

It can be tempting to adopt a "do nothing" approach, in the hope that you may avoid further pain. As we have indicated, since chronic pain is partly caused by neurological changes, avoiding activity will not stop the pain. Avoiding activity also leads to muscle wasting and a build-up of waste-products in the tissues, which can actually exacerbate pain.

At other times, you may feel frustrated and force yourself to complete relatively major tasks (eg mowing the lawns) knowing that it will hurt later. This may cause you to have to take two days of bed rest to recover. This "all or nothing" approach is inappropriate and ineffective in the long run.

You need to pace activity levels. You can do this on your own, via "trial and error" or with a bit of 'coaching' in the form of professional help. The support and guidance of a sympathetic health professional is highly desirable to maintain motivation and deal with fears and obstacles along the way.

7. Sleep! Sleep! Sleep!

Loss of sleep caused by inadequately managed pain can lead to a cycle of fatigue, depression and irritability. Inability to sleep, or waking up feeling tired, are signs that your pain is not being managed properly. Developing a restful sleep pattern is essential to coping with chronic pain. Improving your sleep will give you more energy and help you feel more able to cope.

There are many things you can do to get better sleep including relaxing, perhaps by taking a hot bath, listening to music or playing a favorite relaxation tape before going to sleep; self-hypnosis; a good mattress; posture; medication; and good overall stress-management.

8. Make sure you have adequate support.

Many chronic pain sufferers become isolated, alienated from loved ones, their work-mates and society. Inadequate social or emotional support can lead to isolation, depression, and increased risk of suicide. People who normally pride themselves on being independent and not needing others are particularly 'at risk'.

Unfortunately, the negative reactions of others can discourage chronic pain sufferers from talking about their problems or seeking help. The unhelpful reactions of people you thought you could rely on can be very disappointing, it's another thing that falls into the 'life isn't fair' basket.

The reality is it's simply ridiculous to expect yourself to be able to cope on your own with a chronic illness that robs you of your ability to work love and play. Having adequate emotional support greatly increases your ability to cope.

Talking to close family and friends is vital. A family talk with your doctor of psychologist can also help by enabling them to learn more about your condition and talk about things in a neutral environment.

9. Don't expect people who don't have pain to understand what it's like.

It's frustrating, and easy to get angry when others don't seem to understand. However, because chronic pain sufferers often have no visible injury, it is easy for family and friends, and especially children, to forget there is anything wrong. They may also 'forget' because it is hard for them to have to live with the knowledge that a loved one is in pain.

So don't expect people who don't have pain to understand what it's like and be prepared to have to remind others about your limitations. Children especially cannot be expected to understand the implications of a condition like chronic pain. It's a lesson that has to be repeated many times.

10. Forgive yourself.

The lost ability to work, love and play caused by chronic pain can create feelings of guilt and failure. Become aware of your own expectations, and any feelings of shame or guilt and examine them critically. Chances are you didn't ask to be in pain.

Repressed feelings of shame lead to resentment and later emerge as anger. Feeling guilty can also be a subtle form of self-indulgence - when you engage in self-blame you are really wallowing in self-pity.

Forgiveness and letting go of guilt will be easier if you choose a proactive approach by adopting these 10 Steps.


From Unlikely Words Tumbling, more words on Bill Murray than you can shake a gopher at.


There’s a Bill Murray interview in the latest Esquire that has some good stuff. There’s also a few parts that should have been cut.

I’m not trying to be coy. It’s just practical for me. When the phone started ringing too many times, I had to take it back to what I can handle. I take my chances on a job or a person as opposed to a situation. I don’t like to have a situation placed over my head.

For hardcore fans, here is a big profile of Murray from 2004 where he talks about not enjoying the making of Steve Zissou:

“A fireplace.” Murray sounds sardonic; I’m unsure if he’s joshing about the fireplace. He spent five months in Italy this past winter making The Life Aquatic with Steve Zissou, due out this Christmas, his third film with director Wes Anderson. Apparently, fireplace or no, it wasn’t fun, at least for Mr. Bill. All the action takes place on a boat—Murray’s character, Steve Zissou, is a Jacques Cousteau type seeking to avenge his partner’s death by shark—but Murray won’t discuss the awful details.

“It’s like talkin’ about war stories,” he says. “I can’t even think about it. My impression of Italy before doing this job was that it’s one of the greatest, most beautiful places in the world. After this job, if you say ‘Italy’ to me, it’s like a whole lotta cockroaches in one room—you don’t know what to deal with first. It was by far the hardest job I’ve ever had, and I always work hard. I work the same hard on all of ‘em. But this one—I’ve been kidding about it, saying they almost broke me, and they may have and I just don’t know it yet.”

Well, I say, I’m sure it’s gonna turn out to be a good—

“God damn it,” Murray snarls, “the movie better be the greatest movie ever made. If it’s not, I’m gonna kill Anderson. He’s a dead man. If it’s not the greatest movie ever made, or in the top ten, he may as well just move to China and change his name to Chin, and he better get himself a small room in a small town—and even then, I’ll hunt him down.”

And then, because I love you all very much and I was bored yesterday, I went looking for as many Bill Murray articles as I could find.

August, 1984. Bill Murray and John Byrum. Rolling Stone
November, 1988. The Rumpled Anarchy of Bill Murray. New York Times
July, 1990 Bill Murray. “Quick Change” artist. rogerebert.com
February, 1993. Groundhog Day Review. NYTimes.com
January, 1999. A conversation with actor Bill Murray. Charlie Rose
February, 2001. Bill Murray. Salon.com
December, 2004. Life enigmatic with Bill Murray. USA Today
December, 2004. Never Out Of His Depth. Washington Post
February, 2005. Shotgun Golf with Bill Murray. ESPN
October, 2005. Pearce meets Bill Murray. The Guardian
June 2010. Bill Murray: The Man Who Knew Too Much. BlackBook
July, 2010. Bill Murray: The Curious Case of Hollywood’s White Whale. EW.com
July, 2010. Bill Murray. The Moviefone Blog
August, 2010. Bill Murray Is Ready To See You Now. GQ


An x-ray showing a Buzz Lightyear action figure lodged in the anal cavity. The patient explained that it got stuck when it was inserted and a button was accidentally pushed, extending out the wings.

from nzafro
(via pleatedjeans)

My brain = bunny.


His simple joy in singing this song coupled with his over-sized hat make me identify strongly with this stranger.


"This is the threat to our lives. We all face it. We all operate in our society in relation to a system. Now is the system going to eat you up and relieve you of your humanity or are you going to be able to use the system to human purposes? … If the person doesn’t listen to the demands of his own spiritual and heart life and insists on a certain program, you’re going to have a schizophrenic crack-up. The person has put himself off center. He has aligned himself with a programmatic life and it’s not the one the body’s interested in at all. And the world’s full of people who have stopped listening to themselves."

— Joseph Campbell
5 Causes of Suffering: Patanjali’s Yoga Sutras

Ignorance of who we really are (we are beings of unconditional love and bliss, but we forget that)
Egoism: Our ego fools us into thinking that our labels/title in life define who we are: Intellect, Business Exec., Lawyer, Teacher, Mother, Daughter, etc. We develop programs which have nothing at all to do with who we really are but are merely what we do. Who we are is a much more esoteric force and is often buried deep inside the body we live in and which we observe.
Attachment: This is our need to cling to what brings us pleasure. When we attach our happiness to having a person or a thing and that disappears, what follows is great suffering. Learn to let go.
Resistance of what we do not want. This is the same as denial. We create all forms of ways to avoid both what will lead to freedom from pain because we do not want to go through the passage of looking at what we might not want to deal with.
Fear of death. If this weren’t present in most of us, we wouldn’t hold on to all the reasons we work so hard to build in safety nets, both physically and emotionally.


“The problem, often not discovered until late in life, is that when you look for things in life like love, meaning, motivation, it implies they are sitting behind a tree or under a rock. The most successful people in life recognize, that in life they create their own love, they manufacture their own meaning, they generate their own motivation.

For me, I am driven by two main philosophies, know more today about the world than I knew yesterday. And lessen the suffering of others. You’d be surprised how far that gets you.”
— Neil Degrasse Tyson


We work in the dark - we do what we can - we give what we have. Our doubt is our passion, and our passion is our task. The rest is the madness of art.
—  Henry James
Row of Trees, Jan Mankes, 1915


"Where is home? I’ve wondered where home is, and I realized, it’s not Mars or someplace like that, it’s Indianapolis when I was nine years old. I had a brother and a sister, a cat and a dog, and a mother and a father and uncles and aunts. And there’s no way I can get there again."

Kurt Vonnegut


To all that is chaotic
in you,
let there come silence.

Let there be
a calming
of the clamoring,
a stilling
of the voices that
have laid their claim
on you,
that have made their
home in you,

that go with you
even to the
holy places
but will not
let you rest,
will not let you
hear your life
with wholeness
or feel the grace
that fashioned you.

Let what distracts you
Let what divides you
Let there come an end
to what diminishes
and demeans,
and let depart
all that keeps you
in its cage.

Let there be
an opening
into the quiet
that lies beneath
the chaos,
where you find
the peace
you did not think
and see what shimmers
within the storm.

—John O’Donohue

from To Bless the Space Between Us


“Hope thou not much, and fear thou not at all.”

A poet of some notoriety, Algernon Charles Swinburne kept society and his critics inflamed. “An unclean fiery imp from the pit” said one of Swinburne’s Poems and Ballads (1865) - a book considered to be "unclean for the sake of uncleaness." Thought of as bawdy and anti-Christian, the book was viciously attacked in the press. Swinburne came close to criminal prosecution.

Many critics could still recognize his lyrical ability and mastery of many different forms of poetry.

The “libidinous laureate of a pack of satyrs” was a son of the English aristocracy. A small man, he made up for his lack of height with a mane of ill controlled red hair.

As a poet and critic, he became enmeshed in the Pre-Raphaelite movement via his association with the Rossettis (Swinburne dines with Lizzie Siddal and Rossetti on the evening before she died), William Morris and Edward Burne-Jones in the late 1850s(whom he met at Eton and Oxford) .

His beatings with a birch branch would lead to an obsessive love of erotic spanking and a group of poems known as the “birching poems.”

Oscar Wilde said of him: “It has been said of him, and with truth, that he is a master of language, but with still greater truth it may be said that language is his master…. Words seem to dominate him. Alliteration tyrannizes over him. Mere sound often becomes his lord. He is so eloquent that whatever he touches becomes unreal.”
Juan Manuel Castro Prieto, Jeune fille Surma, √Čthiopie, 2005
from Uncertain Times


Living on Wheels

Fiscally quite screwed, I'd often said I'd end up living in the back up of my pick-up truck. No van down by the river for me!

Deciding to see how viable that really was, I discovered that many people already are living that way. Many families already are. Some in major cities.

Most convert the truck with camper kits or self-made campers you can get plans for or you can come up with your own. This certainly increases the amount of room and, in my case, the amount of books I could have with me.

But some manage with tents, retreating to the cab of the truck when the weather become untenable. Thought I'd say "untentable," didn't you?

The advantages of moving south when it's cold may sway  those who have to learn to live with a lot less.

And moving on to where the dumpster diving brings glory and food for the table. A redolent night for all. Kick back from the wheel well and you are at your ease.

How can anyone live in that small a space? There are some ways of expanding it.

This gentleman's idea is brilliant as well as aesthetically pleasing. Plans here.

And there is a walk-in door truck cap that provides easy access to your on wheels abode.

It can be amended to include a tent that doubles your living space in whatever place your are currently calling home.

Problematic are:

1. Most cities/states have laws against living in your vehicle. Perhaps this will change as more and more people lose their homes. For many, paying rent and trying to pay down debt (student loan/credit cards) is overwhelming. I've little doubt that homelessness will be a growing issue in the years to come.

2. Where do you do your doo doo?  If you build a camper onto your truck, it will be more of a matter of gray and black water disposal. Camping sites will let you dump your dump for a small fee. Otherwise, paying for overpriced java to earn you a visit to the porcelain goddess.

3. Showering. This was a sticky point for me. I like being clean. Being ridiculously filthy doing whatever one is doing is fine. But one must be clean after. There are camping sites and many truck stops have showers for rent.

4. Safety issues. Especially for women, living on the road can be a dangerous proposition. And there is no shortage of weapons to chose from as protection. Stun guns, pepper spray, etc. But laws very from state to state. 

5. Mail can be as easy as having friends collect it all for you or renting a mail box from UPS or USPS. Since most  bills can be paid online, life on the road is easier than it was years ago.

The rules of the road are covered very well here.