By Jeannette –
In light of the opioid overdose epidemic, there has been much discussion lately about “pain acceptance.” There have been cries from doctors for patients with chronic pain to “accept” their pain.
However, are the talking points truly referencing acceptance, particularly active acceptance, or is what they are calling for really resignation by chronic pain patients? In my opinion what is being requested is for patients to resign to their conditions. Doctors and other providers are doing so because they, too, have become resigned, they feel helpless due to the limited treatments at their disposal, prescribing restrictions, and many are likely tired.
They are no longer taking action steps toward change even while they may understand the plight their patients are in. While grieving the deaths of patients suffering and even committing suicide, it certainly would be easier for them if patients also resign to the fact that their hands are tied. It certainly would be easier for them to deny the patient experience, the need for change, and the emotional impact it is having on them as providers. It would be more comfortable to blame the victim.
Yet this type of resignation is very different from acceptance. Acceptance is anything but passive. Active acceptance takes continuing strength, effort, and resolve to do something and/or work through emotions, even when it is difficult. It is actively recognizing, feeling, and acting with the knowledge that this condition, disease, accident etc. has happened, altered life, and presently is not going anywhere. It is actively recognizing that there are new limitations, there have been unplanned losses, but still courageously progressing with that knowledge. It is actively admitting there are aspects of chronic pain and illness that are out of our control.
At any rate, then it includes looking for what is in our control and continuing to do those things. Letting go of control and then choosing to act on those things still in our power, is not passive resignation, but active acceptance. Of course, there are many days I certainly don’t feel like doing this and maybe I would rather roll over and succumb to the anger and grief that comes with chronic pain.
There are two aspects that I focus on in my journey with acceptance. One is the grieving process, working through difficult emotions toward acceptance of my “new normal,” letting go of the anger that chronic pain is present in my life, facing the beast that it is. I work on taking actions to do what I can do, and not focus on what limits chronic pain has created or the losses I have endured.
Next, I take actions to find new purpose, fulfill my life ideal in spite of new limits, by creating goals, no matter if they seem small, to achieve my purpose of helping others. Then I work on finding balance in my treatment approach to chronic pain and illness, weighing out when am I continuing a treatment that won’t be effective just to fight; do I need to let go? When am I fighting for a pain level that is not achievable in that limb or on that day? When am I fighting and pushing too hard to surpass the limits I now have? When am I in a period of resignation, when I could be doing more to look for better or new treatment? When am I not partnering with my doctors and communicating effectively, because of emotions or fear of stigma and, my own moments of resigning to “this is as good as it gets?”
Fear is the enemy of acceptance and a friend to resignation. If we don’t stand up and say “yes this has happened to me,” I have chronic pain, I have chronic illness, and this is likely not going away for me today, we cannot bravely and actively advocate for ourselves, we cannot look at anything beyond pain and disease, failed treatments and frustration, we cannot use the resources at our disposal, we cannot see the things we can do even on days we are homebound, we cannot stand up for ourselves, we cannot see we may still have a purpose, although a different one. Furthermore, we cannot see past anger, blame, grief, loss, despair, etc.
Personally, it meant actively letting go of things I simply could not control at the present moment, while choosing to focus on what I could still do, while focusing on self-advocacy as well as social change. Active acceptance was saying for today I have chronic pain, but it will not take everything from me. I will not “lay down,” even if I am physically laying down in a flare. I will ask, while still understanding I have these conditions, what will I actively and courageously do, so it does not take my spirit. What do I need to change, even if I can’t change that this beast will still be here?
I realized that while chronic illness took my career for now, it could not take my ideal and purpose, which was and is to help others. I realized that although it put me on a rougher road, that will need different goals to achieve my ideal, it cannot take that away and I will still live by my ideal. At my worst point, I was able to help others through a card mission, doing research on support groups for others, helping make graphics for a non-profit or even to lift others spirits and bring awareness to these conditions; slowly I began to blog or write op-eds.
As I progressed through the emotional impact and received some better physical treatments, I began to volunteer and advocate more actively and use my voice, hosting my own events with the help of others, attending advocacy events, helping with campaigns and outreach, etc. It is possible to come to terms with a chronic illness without resigning to it, it is possible to actively accept your journey, it is possible to have a voice.
Passive acceptance and resignation does not benefit patients, this idea of succumbing to pain and disease is not good. It certainly is important to acknowledge it, to see how it has changed our paths, but it is not helpful to limit action steps to progress on our path with this journey. Whether it is actively taking steps toward managing the emotional impact, whether it is advocating on any level toward social change in relationship to pain research, funding and care, whether it is supporting others with similar journeys, we must continue to take courageous control of what we can do and do that thing, despite that today we accept that we have chronic painful conditions.
There are certainly those requesting resignation, that is simply an effort to silence our voice and take the power we have. Then there are those who simply are misguided in their attempt to discuss helpful, active acceptance, or are unclear in their explanation. I urge you that even as you let go of anger, grief, denial and come to understand that for today your pain isn’t going anywhere, that you never let anyone or the pain itself take your voice, determine for you the active steps you will take toward self-care, or try to define your self-worth. Please don’t let anyone tell you that while you’re are already living with chronic pain, a debilitating condition, that you have to live within that pain.