Category Archives: Question
We Cope, Not Hope (results)
Disease as an adverse interruption of life is the prevalent interpretation of chronic pain conditions. But there are different ways to cope with pain, and there are different ways to regulate emotions associated with chronic diseases. Because most patients with chronic conditions are unable to ‘solve’ our persisting pain by ourselves (in terms of recovery or repair) and to find distance to negative emotions associated with pain, we have to find strategies to adapt to a long-lasting course of illness.
We have to find ways to maintain physical, emotional and spiritual health in spite of often long-lasting courses. Thus, our coping with chronic pain is an ongoing process which includes appraisals of stress, cognitive, behavioural, and emotional coping responses, and subsequent reappraisals of stress.
One of the most frequently used concept on adaptation strategies for patients with chronic pain diseases differentiates active and passive coping:
- Active coping (i.e., problem solving, including collecting information and refocusing on the problem, or regulation of emotion by focusing attention on the emotional response aroused by the stressor) is associated with less pain, less depression, less functional impairment, and higher general self-efficacy;
- Passive coping (i.e., avoidance and escape) is correlated with reports of greater depression, greater pain and flare-up activity, greater functional impairment, and lower general self-efficacy.
Although the importance of decreasing maladaptive and encouraging adaptive coping responses is emphasized by innovative treatment programs for chronic pain (if you can get in!), one nevertheless has to ask which adaptive coping strategies were of relevance for the patients.
I asked the same question of you: Which of the following coping strategies best describes the way you cope with your chronic pain?
The answers (so you don’t have to return to the poll) were:
- Trust in Divine Help in response to disease addresses non-organized intrinsic religiosity as an external transcendent resource to cope (i.e., trust in a higher power which carries through; strong belief that God will help; faith is a strong hold, even in hard times; pray to become healthy again; live in accordance with religious convictions).
- Trust in Medical Help addresses patients’ reliance on an external medical source of health control (i.e., trust in the therapeutic potentials of modern medicine, take prescribed medication, follow advice of medical practitioners, full confidence in doctors and therapists).
- Search for Information and Alternative Help refers to external sources providing additional information or alternative help (i.e., thoroughly informed about disease; get thorough information how to become healthy again; find people who can help; search for alternative ways of healing).
- Conscious Way of Living addresses cognitive and behavioural strategies in terms of internal powers and virtues (i.e., healthy diet; physical fitness; living consciously; keep away harmful influences; change life to get well).
- Positive Attitudes refers to internal cognitive and behavioural strategies (i.e., realization of shelved dreams and wishes; resolving cumbering situations of the past; take life in own hands; doing all that what pleases; positive thinking; avoiding thinking at illness).
- Reappraisal: Illness as Chance addresses a reappraisal attitude referring to cognitive processes of life reflection (i.e., reflect on what is essential in life; illness has meaning; illness as a chance for development; appreciation of life because of illness).
- Escape from illness (i.e., fear what illness will bring; would like to run away from illness; when I wake up, I don’t know how to face the day)
The study, which started all of this, had 579 participants – we had 239 (not too bad). The study also asked demographic type questions but I decided not to make it too long a poll so we could have more answers.
From highest reliance to lowest here are the results from both the study and our poll:
We (as a group) seem to be much more aggressive, active participants in the search for sufficient condition management.
Most study patients tended to externalize the process of disease management, i.e., the chronic pain disease was regarded as an adverse interruption of life, and patients called experts for help (i.e., medical doctors or therapists), and followed their advice or relied on the effects of prescribed remedies, which alone is a rather passive strategy. However, if you add (internal) cognitive-behavioural changes (i.e., patients may change distinct aspects of their life, try to become more consciously, healthy, physically fit, use distinct diets etc) or try to think positive (resolve cumbering situations of past, realize shelved dreams and wishes etc.) – both are active strategies.
In face of an insufficient manageability of chronic pain, some patients may call upon ‘more powerful’ external others (i.e., Trust in Divine Help), because the conventional resources of help seem to be (subjectively) exhausted.
In general, both groups relied on external powerful sources to control their disease (i.e., Trust in Medical Help; Search for Information and Alternative Help), but also on internal powers and virtues (i.e., Conscious Way of Living; Positive Attitudes).
In contrast, Trust in Divine Help as an external transcendent source and Reappraisal: Illness as Chance as an internal (cognitive) strategy were valued moderately.
Escape from Illness (which is not regarded as an adaptive coping strategy) was highly associated with depressive disorders.
The researchers came to the conclusion that to restore a sense of self-control over pain as well as the conviction that you are not necessarily disabled by disease and that pain is not necessarily a sign of damage is a major task in patient care. Changing negative/maladaptive illness interpretations and depressive or avoidance coping by means of an intervention and encouraging social support by means of patient support groups may at least improve quality of life.
Apart from effective pain management, a comprehensive approach is needed which enhances the psycho-spiritual well-being, i.e. self-awareness, coping and adjusting effectively with stress, relationships, sense of faith, sense of empowerment and confidence, and living with meaning and hope.
Further studies are required (of course!), particularly longitudinal studies to measure changes in the weighting of adaptive coping strategies and interpretations of disease with respect to pain intensity, and comprehensive intervention programs.
F.Y.I. – The utilization of the different adaptive coping strategies did not significantly differ with respect to gender, while the educational level had a small impact on Trust in Medical Help, which was the highest in patients with a lower educational level. Age had a significant impact on Trust in Divine Help, Trust in Medical Help and Conscious Way of Living. The duration of the condition had no significant impact on the adaptive coping strategies.
An obvious result showed that patients from the outpatient clinic had significantly higher scores for Trust in Medical Help and Escape from Illness than patients from the rehabilitation clinic or patients attending the mind-body program, and were also in Search for Information and Alternative Help. This may indicate higher need for external help.
Related articles
- Coping vs Hoping (fibromodem.wordpress.com)
- Chronic Counsel (fibromodem.wordpress.com)
- Half of us with chronic pain do not seek help from a GP (mirror.co.uk)
Coping vs Hoping
In response to a research study I found, I wanted to ask you guys the same question – to see if our results match the study. The answers may need explanation; and you will find then below the poll.
After we have answers, I will publish a precis of the research study as compared to our answers
- Trust in Divine Help in response to disease addresses non-organized intrinsic religiosity as an external transcendent resource to cope (i.e., trust in a higher power which carries through; strong belief that God will help; faith is a strong hold, even in hard times; pray to become healthy again; live in accordance with religious convictions).
- Trust in Medical Help addresses patients’ reliance on an external medical source of health control (i.e., trust in the therapeutic potentials of modern medicine, take prescribed medications, follows advice of health professionals, full confidence in doctors and therapists).
- Search for Information and Alternative Help refers to external sources providing additional information or alternative help (i.e., thoroughly informed about disease; get thorough information how to become healthy again; find people who can help; search for alternative ways of healing).
- Conscious Way of Living addresses cognitive and behavioural strategies in terms of internal powers and virtues (i.e., healthy diet; physical fitness; living consciously; keep away harmful influences; change life to get well).
- Positive Attitudes refers to internal cognitive and behavioural strategies (i.e., realization of shelved dreams and wishes; resolving cumbering situations of the past; take life in own hands; doing all that what pleases; positive thinking; avoiding thinking at illness).
- Reappraisal: Illness as Chance addresses a reappraisal attitude referring to cognitive processes of life reflection (i.e., reflect on what is essential in life; illness has meaning; illness as a chance for development; appreciation of life because of illness).
- Escape from Illness (i.e., fear what illness will bring; would like to run away from illness; when I wake up, I don’t know how to face the day”
Related articles
- Reappraisal Defuses Strong Emotional Responses to Israel-Palestine Conflict (psychologicalscience.org)
Attention Single, Divorced and /or Friendless
Firstly, some facts (this is not me feeling sorry for myself, just facts):
I am single (read divorced and/or friendless depending on your situation)- I am sick (with no cure on the immediate horizon)
- I have only one friend who actually visits with me
- I have no particular interests outside my home
So, I was thinking, is this my lot in life forever? Will I ever meet a prospective partner? How will I meet a prospective partner? Does he deserve a partner who is continually unable to meet her responsibilities? Okay, forget a partner, how about some new friends?
These questions sent my mind racing – I can’t drive more than about 10 kilometres before my arms, shoulders and head start to hurt; I can’t go to parties (even if I was invited) because the noise and other distractions are too much for me to handle; there are no clubs or groups in my area that I wish to join. So, what is a FM sufferer to do?
Why, take to the internet, of course! ‘How to meet new people’ was my search term:
Succeed Socially.com offered a list of places to meet people
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Through your friends, significant other, and other people you already know
This point obviously will not work for one in my situation
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Work
I am still unable to work
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Volunteering
As I am unable to be reliable in a work situation, I am unable to commit to volunteering. I used to volunteer regularly at a local legal centre – it was incredibly satisfying and I miss being able to help others.
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Classes
I go to my self-help hydro groups, where the closest person in age to myself is about 25 years older than me. They are a lovely group at Hydro but I doubt greatly that we have very much in common outside being ill and/or disabled.
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A club or organization
The appeal here is obvious. You join up and you instantly know a group of people who share a similar interest to yours. But what happens if you no longer have any interests? Other than researching fibromyalgia, spreading awareness about fibromyalgia and raising funds for fibromyalgia research. Kind of sounds like I should join or start my own fibromyalgia support group, right? But, with this type of group, it would probably take all our efforts just to turn up to meetings, let alone maintain friendships outside the group.
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A sports team or league
Are you kidding?
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Through your religion
I am not religious. I believe in a higher being but I do not know of a public denomination which shares these same values.
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Through your kids
Another moot point for me
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Your living situation
Living in a large building with lots of other people your age around is better than being in a small place with no one who’s similar to you. Guess what my situation is? I live in a block of units (alone) where, currently, there is no-one with any similarities to me at all. How can this happen? (rhetorical question!)
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Your family
No real help there, although my grandfather (before he died) tried to set me up with a 71-year-old ex-doctor.
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At a party
Too much noise, too many people, just TOO!
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An individual sport
How many FM sufferers do you know who do a sport? And I’m not one of them.
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Online
Hmm…what would my ad look like:
SWF in chronic pain, with control freak tendencies, seeking understanding, compassionate friends with low expectations.
Would any of you answer that one?
There were a number of other suggestions but you get the idea…so, tell me, fibroMAGICians, what do you do?
Related articles
- Coping With Friendlessness (thewaveofthoughts.com)
- Poem about being a loner II (grannyslittleprojects.wordpress.com)
Embracing (and loving) my Bills
I LOVE paying bills! Am I nuts? Or what?
Unpaid bills stress me out big time BUT the relief and sense of satisfaction, when I press confirm on the keyboard and wait to receive my receipt number, leaves me feeling back in control of my life.
Are you seeing a continuing theme here?
I NEEDED to de-clutter my house to feel like I was gaining control over my life…
I LOVE paying my bills for the exact same reason…
Am I a control freak?
The phrase was first used in the late 1960s — an era when great stress was laid on the principle of ‘doing one’s own thing’ and letting others do the same.
Control freaks are often perfectionists, who believe if they are not in total control, they risk exposing their own inner vulnerabilities. When a control freak’s pattern is broken, “the Controller is left with a terrible feeling of powerlessness … But feeling their pain and fear brings them back to themselves”.(Patricia Evans, Controlling People (Avon 2002) p. 129 and p. 274)
I know that I NEED to control my own environment (and I’m very lucky as I live alone and can do so) because I feel powerless against my Fibromyalgia. I take all the appropriate medication; I pace myself as applicable; I supplement my diet with numerous vitamins and minerals; I have embraced a multi-modal treatment plan; and I have all the tools in my toolbox to help control my pain YET, if my body decides it wants to FLARE, there is nothing I can do about the pain and fatigue, except to give in to it. So, of course, I feel powerless – don’t you?
Many control freaks (now using the term without any derogatory meanings) are Type A personalities. Hmm…many sufferers of FM are Type A personalities.
Coincidence? Could FM be your body’s alert system to take it easy, to stop and smell the roses, to let the universe handle the world around you?
Related articles
- Resist the Temptation to be a Control Freak (conversationagent.com)
- How To Tame Your Inner Control Freak (forbes.com)
- Control freak! (lilyroseyolyz.wordpress.com)
- Controlling Control (venturegal.com)
