Chronic pain can significantly affect our lives. It can result in not being able to engage in activities we loved to do. It impacts our relationships with loved ones. The limitations brought on by pain, can lead us to question our identity and certainly our quality of life.
Years ago, I worked with a gentleman (we’ll call him Marcos) who was in his late 30s and loved to play soccer. Actually, “loved to play soccer” does not even begin to describe what this sport meant to him. He grew up playing soccer with his father. He even brought in a picture of his five-year-old self taking a shot on the goal, with his father as goalkeeper. He played on competitive club teams throughout his childhood and adolescence and was known for his stellar performance on the pitch in his communities and schools, from elementary through college and beyond. My heart was broken with his as I sat with him, listening to these stories, knowing that a recent back injury, surgeries, and pain, would prohibit him from likely ever playing competitive soccer in this way again. He was referred to me for depression…
Marcos no longer saw his friends, all of whom played soccer. He could not bear to imagine them going to or coming from a game. He no longer spent time with his kids (playing soccer or other games), because of his pain. He stopped making plans with anyone because his pain was unpredictable and he assumed he would have to cancel anyway. He became increasingly irritable with his wife and children and fell behind at work. He was angry with life and felt he got “a raw deal,” comparing himself to those who did not have to deal with chronic pain. He spent most of his evenings and weekends in bed.
And there we were, sitting together, tearful in my office, as he shared these joys that he had lost with his injury and subsequent pain.
The International Association for the Study of Pain defines pain as the following:
“Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or in terms of such damage.”
Sensations + Distress = Pain
Our relationship to pain and our life with pain matters. If I rate my sensation of pain as a 6 and my distress in response to my pain as a 3, then my total pain = 9. Our thoughts, feelings, and behaviors affect the pain that we experience and can influence the degree to which we suffer.
I was struck by Marcos’ passion, the sparkle in his eye, when he talked about soccer. We discussed what he loved about soccer: the memories of playing with his dad and now his kids, the camaraderie with teammates and the fans, the adrenaline, the culture, the skill, the exercise, being outdoors. I was curious with him about the fact that most of what he loved about the sport, did not require him to be out there, playing competitive soccer! I offered more information about the impact of our response to pain and worked with him to change his relationship to his defeating thoughts. We invited his wife in to a session and we provided him with encouragement and support and within a few weeks, Marcos started watching some soccer on TV. He then met up with a few of his friends after one of their games and found himself excited and laughing, hearing them recount the play-by-plays. He began attending the games and acting as an assistant coach. He started to play goalie for his own kids. Perhaps not surprisingly, Marcos’ depression began to lift and his report of his pain became more manageable, despite not going away….