The Consequences of Avoidant Behavior for Pain and Friendships

One of the things I’ve learned from both reading and experience: in dealing with chronic pain, you often develop avoidant behaviors. When you realize that certain movements or positions cause pain, and you learn ways to avoid doing them. This is not always a good idea. Because the evidence strongly suggests that chronic pain is in many cases largely neurological, avoidance of pain-causing movements can actually make it worse. The more you avoid a movement, the more you build that association of that movement with pain and fear of pain. That association can feed the neurological pain response by itself. By this pattern, avoidance of a movement in order to avoid pain can actually make pain worse, because fear of that movement increases stress and that stress increases pain which increases fear, and through those means, the pain is self-reinforcing.

The really tricky thing, for me, is to know when my experience of pain is telling me something useful and when it isn’t. To know when I’m experiencing pain due to an injury, or due to a malfunctioning neurological feedback loop. If I call my brain’s bluff and it isn’t a bluff, I get injured. If I don’t call my brain’s bluff and it is a bluff, the pain stays. Anyone who follows me on Twitter probably sees the #ptrecord hashtag I use to record my daily exercises, and how some of them occasionally fluctuate in reps and time spent. What you are seeing on that hashtag is, largely, me running experiments to try and discern which of my limits are due to physical weakness or injury and which are due to brain problems. If you ever see a significant spike in a type of exercise, it is probably because something happened that made me realize that the level of pain or soreness I experience as a result of that exercise was my brain bluffing, and I suddenly felt safe experimenting with much higher levels of exercise.

It occurred to me the other day that something similar happens in an entirely different area of my life.

I have a history of, in some ways, not being very trusting of my friends. I’ve written before in this blog about how to take care with consent, about how to communicate, etc. In part, I think I’ve always had a propensity for developing those skills because I care deeply about people. There’s another part, though, which is that I tend to be terrified of fucking up.

In my own self-evaluation, I am an unusually controlled person. I almost never act or speak impulsively. Or rather, if I do, it’s because I did an analysis and decided to permit myself to act on an impulse. I have almost no memories of making bad interpersonal decisions because I wasn’t careful enough to think them through. I have memories of making decisions that I would not make now, because I have more data about the effects of those decisions now than I did at the time. The thing is, if I were again limited to the data I had on hand at the time, I would make most of the same decisions based on the on-hand data. When I do fuck up, it is generally at my own expense, and rarely at the expense of others (except insofar as the depression that results from not taking very good care of yourself takes a toll on those around you). Also, generally, I’m much more prone to want to take on the emotional baggage of others, compared with asking others to help take on mine.

I put in a lot of effort not to hurt people. I put in a lot of effort to help people with their shit. I put in a lot of effort not to compel people to have to deal with my shit. Even when I’m intensely angry or frustrated or hurt, I’m reasonably talented at not letting the emotional impulses that result from those feelings leak out at other people. It’s a good skill, but it also often means people don’t know when I’m dealing with tough shit. It means that I don’t have as many opportunities to vent emotional frustration by just letting the impulses reign, even for a bit, because I refuse to give those impulses the opportunity to do damage to the people around me. And it, in some ways, means that I genuinely have no idea how resilient a lot of my friendships are.

Because really the way you learn that, more than anything else, is you see what happens when a strain is put on them, which is something I tend to be terrified of doing.

See the connection with the chronic pain? It’s a cycle. I’m unsure how resilient my friendships are, which makes me apprehensive to ever trust a significant amount of weight to them, which means I don’t have any experiences to inform me on how resilient they are, which means I don’t know how resilient they are. Ad infinitum.

So what do you do, right? You try, in increments, to test them a bit more. You try trusting people to take on some of your shit. And you hope that you don’t have to discover too often that you overestimated.

Not the easiest thing in the world, really.

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2 comments on “The Consequences of Avoidant Behavior for Pain and Friendships

  1. Pingback: Needing People | Research to be Done

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