Thoughts on the Possible Application of Ideas on Pain Perception to Other Senses and Experiences

Mild trigger warning: some discussion of eating disorders.

One of the main things I have learned in reading about modern pain research is that pain relates to your brain’s opinion on what is happening to your body and whether or not you should be doing anything about it. You can have a horribly bad injury and feel no pain if your brain doesn’t think that that pain would help you in some way, and you can feel an incredible amount of pain without any injury if your brain thinks that that pain is protecting you in some way.

My favorite story about this comes from a book called “Painful Yarns” by Lorimer Moseley (a wonderful book that I highly recommend that relates a number of stories clinicians and patients can use as examples of or metaphors for how pain works). It’s a true story about a man who came into the emergency room with a hammer through his neck, experiencing no apparent pain, but who then, in the process of joking around about the hammer through his neck, banged his knee on a table, and started yelling about the pain in his knee.

There is a certain sense in which I have found that it sometimes makes sense to think of pain like a hallucination. Pain can have little or nothing in common with the volume of danger signals you may be receiving from your tissues. Phantom limb pain, for example, is obviously not the result of physical tissue injury. It is, in a way, a hallucination.

JT Eberhard has written before about getting visual hallucinations as a result of having an eating disorder. It strikes me that, if I assume similar types of preprocessing happen with the physical perception of pain and the visual perception of the world, this type of hallucination makes a lot of sense from a “Your brain is trying to protect you” perspective. Cultural contexts and conditioning can have a significant impact on pain, and I see no reason to suppose they might not have a parallel impact on things like visual hallucination. If your brain has learned to perceive any weight gain as a massive threat to your well-being, then visual hallucinations that exaggerate weight and weight gain might be, from the perspective of your brain, a sensible protective mechanism against any chance of any actual weight gain.

Just to be clear: I’m not saying the hallucinations would be in any way actually good. I am saying that your brain might employ them as a protective mechanism. Very big difference. I assume very similar things about my chronic pain: I assume that my brain “thinks” that creating this pain is protecting me in some way, even if the reality is that it makes my life unambiguously worse and does not actually provide any useful protection from anything.

One of the things that seems to help when I’m dealing with back pain is to concentrate on the fact that I know it isn’t providing me any useful information, and doesn’t reflect any actual threat to my tissues. Doing this regularly over an extended period of time has seemed, in the past, to have an ameliorating effect. I largely attribute the couple of months were I was having little-to-no back pain to a long period of doing that regularly. Pain is a product of the brain, and while generally your brain does its own thing, there are times when, if you are deliberate and patient, you can have some success talking it into or out of things.

This is all a long way of saying that I have started thinking about more and more of my experiences through the lens of what my brain’s opinion might be.

Yesterday, I was feeling a little insecure, and worrying about things it didn’t really make sense to worry about. Over the last month or so, one of the things that I have found myself being occasionally insecure about is not getting timely responses to texts. If I’m exchanging texts, and I say something and then don’t get a response for a while, I start to worry that I have, without realizing it, said something that offended someone. The fear doesn’t make a lot of sense, particularly in light of the fact that I, myself, am not always particularly good at responding to texts in a timely manner. In thinking about how I might stop being anxious about this, an idea occurred to me: could I treat this anxiety in a way that parallels the way I sometimes treat my pain? If my anxiety about texting is constructed out of a perceived threat to my well-being, could the same type of self-talk have a similar ameliorating effect on it?

I have come to believe more and more, lately, that all of the ways I perceive the world undergo so much extra-conscious preprocessing that it makes no sense to think of any of them as even remotely resembling a direct, raw feed of incoming data. I have come to think of them more and more as powerfully subject to context and to my brain’s opinion on what is going on around me. I am beginning to wonder, more and more often, how many aspects of my perception of the world might, correspondingly, be subject to the same types of influence that my pain seems (at least occasionally) to be.

Food for thought. I intend to try thinking about my insecurities from this angle more often, to see if it helps. I think it might end up being a very useful perspective to take.

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Life Update and Rambling

This week has been hard.

One of the unfortunate patterns that tend to crop up regularly with me goes like this: I have an injury I have to manage, which means I can’t do the normal things I do for exercise. I spend a while frustratingly trying to figure out some form of exercise that won’t aggravate whatever particular injury needs healing time. When I finally figure something out, I get excited about doing it, I do it a bunch, and I get injured in a way directly related to the new form of exercise.

This has actually happened to me quite a lot. When you really enjoy exercise, it takes a tremendous amount of willpower to take it slow when you find a form of exercise you can actually do after being without it for a long time.

This is how I ended up with tendonitis in my legs as well as arms. So that has been incredibly difficult.

I also, recently, started trying out a new technique for coding without having to type. It has been going pretty well, overall, but I had a day earlier this week where my tendonitis got fairly bad, anyway, which was incredibly discouraging. When you think you’re doing everything right, and pain still gets worse, it’s tend to be a very getting-the-rug-pulled-out-from-under-you kind of moment. None of my physical symptoms seem to have been going particularly well, lately, and I can’t really say anything new about that except that it really sucks, and it makes me wonder if any of the things I’m dealing with right now will ever get better.

A few weeks ago I started trying to do regular meditation. In general, this is what I’m working on right now. For the next few weeks, at least, I think my primary objective in terms of self-treatment will be to continue the meditation practice.

In other news, I have been figuring out things with a new casual partner, recently, and thus far that has provided some excellent moments and insights. It is pretty unusual for me to find people who are as enthusiastic and scientific about explicit consent and feelings conversations as I am, and I have found myself a combination of appreciative of and entertained by how similar New Partner and I are in this regard.

The result has been a lot of, “Seriously, this kind of moment would only happen to me.” things happening.

Though I am still having trouble feeling like some of my friendships are one-sided with respect to mutual engagement, I have also met a few people recently who have been proactive about spending time with me. I think, for the first time since I moved out here, I’m starting to have moments where I feel like friends who I have a satisfying level of interpersonal resonance and initiative-taking with are not in anxiety-inducingly short supply.

I always worry when I’m spending more time talking about personal things that people will get tired of this blog being about me instead of Topics Of Interest. Paradoxically, I think that the reason I have managed to keep up with this blog (unlike the other previous times I tried and failed to maintain blogs) is because it provides that sort of outlet.

One of the reasons I like writing about difficult personal stuff, also, is that I know that it’s possible that my life will get better.

A friend of mine and I used to wonder whether or not the kinds of awesome relationship resonance that we looked for in serious partners was actually ever possible. A little while ago, she ended up getting married to someone that she had found that with. I got to hear about it, and I got to be there at the wedding, and one of the greatest things about that was that it helped and still helps me to stay optimistic about finding similar things for myself. It helps me, now, in part because I knew this friend when she was despairing just as much as I sometimes do about finding awesome serious relationships. I knew her before she had found one, and I watched as the thing that we worried didn’t exist happened to her.

It’s hard to be pessimistic about never being able to find something when you have watched someone else be just as pessimistic as you and then find that something.

If my life gets to a point where it doesn’t feel like all of my decisions are ruled by what is least likely to aggravate pain symptoms, and where I generally feel more secure about my life and relationships, I want to remember this period. I want to have a record of exactly how bad things were, how frequently I despaired about things, and how hard everything was day-to-day.

I want to have that record so that I don’t fool myself about how hard things were, so that I can use it as an example of how things can get better when things inevitably get difficult again, and so that I can provide an example to others like the example that my friends marriage gave me.

If things do get better for me, I want to have this record of how bad they were so that other people dealing with depression and chronic pain and other difficult things can look at my example and be more optimistic, because, no, it really was that bad before, and it really did get to here from there.

In the meantime, while I am spending a lot of my time feeling shitty about pain or money or relationships or whatever else, I do have the respect of a lot of people whose respect I think matters, and for reasons that I think reflect an accurate perception of who I am, and that is an accomplishment that a lot of people never manage in their lives. So there is that.

I keep almost ending this post and feeling like the end is either unrepresentatively negative or unrepresentatively positive. So I’ll just end by saying that there are some shitty things going on and some nice things going on, and that overall life is pretty fucking difficult right now and… it goes on, I guess.

Meet The Antagonist

“There are things I’m not doing. Things that might have a chance of helping, but I just don’t have the energy to do them. I’m spending too much of my willpower already just getting my work done and getting through my days.”

“Do you think anyone would blame you for that? Do you think anyone you know is the kind of person who would think badly of you for not having the energy to do everything that might help all at once, when things are as hard as they are right now?”

She was right. I don’t think anyone I know would think badly of me for the things I’m not doing right now that might have a chance of making my pain problems better. I don’t think any of my friends would assume I was just being lazy, or any such thing.

So, who is it that I am arguing with? Why, when I think about the things I’m not doing, do I feel like I need to have an explanation for why I’m not doing them? Why, if no one I know would question how hard I have tried, am trying, will try to get through the stuff I’m dealing with right now, does this argument play out in my head so often? If I haven’t allowed anyone into my life who would demand explanations for why I’m not doing more, why do I feel compelled to come up with the explanations anyway?

Who is this antagonist that I am so obsessed with satisfying?

When I put this question to my brain, an answer surfaced almost immediately: the anthropomorphization of culture.

There isn’t anyone in my life who would ask these questions of me. But the culture that I grew up in asks them all the time, and the voice of that culture lives in my head.

I will never fully understand the anxiety that some ex-religious people feel over the idea of going to hell, even years after they have de-converted. But in having this revelation yesterday, I feel like I have come a little bit closer. There is a voice in my head whose words and attitudes have nothing to do with mine. There is a culturally constructed antagonist that I feel the need to satisfy in spite of knowing that so much of what it says is bullshit.

At the very least, now I know how to think about it. I’m going to think about this voice like a god. It is the voice of something imagined, something that doesn’t exist, but that I have been taught to believe in. It’s the god of culture. I haven’t beaten it yet, but now I know how to think about my enemy.

A Lie Of Omission

“it seems like we both have a lot to process. Do you want to call it a day?”

I really did. The conversation was dying, settling into a silence full of my disappointment that a relationship was off the table and her not having a whole lot else to say.

And yet, as I contemplated leaving, I realized that as much as I wanted to have some time to think about everything, I really didn’t want to be by myself. I suddenly needed a friend a lot more than I needed to go home and think.

I told her that something else had come up, emotionally, for me. Something that had nothing to do with her or the conversation we had had earlier. I asked if she was up to just being an ear and a shoulder for a bit. She told me she was, and offered a hug I gratefully accepted.

I started to cry. She held me as I waited for the sobs to subside, feeling the utter helpless frustration accumulated over the last few months boil over and out. When the first wave of crying subsided, I tried to explain.

“I should call it a day. It would have been a good idea to call it a day. I need to process things, and I can’t think of anything else to talk about. But I don’t have anything else planned after this today. That means that even if I think it’s a good idea for me to go home and be by myself and think, what happens when I do go home is that I have to find a way to fill the five hours between now and when I can go to sleep with things that won’t hurt.”

The crying began again. Around the waxing and waning of tears, I talked more about the things I been worrying about with respect to my chronic pain. There never seems to be a whole lot to say about dealing with chronic pain. The pain is there, it’s always there a little more or a little less, sapping your strength, and when someone understands that there is nothing else interesting to say.

So I talked about my worries. I talked about not knowing how or when to make a decision to take time off from work. I talked about worrying about what happens if I were to go broke doing so. I talked about how frustrating it is that my current physical issues happened on such an off chance. The perfect type of work at the perfect time for me to be careless enough to forget the risks involved in having a body prone to repetitive stress.

I talked about how no one told me things could be like this. No one told me things were ever this hard for anyone. I grew up in a world where things were solved in the space of an hour minus advertising minutes. I grew up knowing that depression and poverty and hardship were things that existed, but only in the abstract – knowing it in the same sense that I know a few of the names of people who signed the Declaration of Independence – knowing it like I know trivia facts.

No one told me when I was growing up that the world was broken. No one told me what it meant – no one forced me to really appreciate what it means that people suffer. It took me a long time to learn that there are people whose lives we can’t fix and people whose brains we can’t fix, and people whose circumstances some don’t even have any interest in fixing, and what that really, really means for those people.

I wasn’t told, not really, that anyone’s lives could be as hard as I have recently found mine. This in spite of the fact that there are so, so many people whose lives are immeasurably more difficult than mine has ever been. I have spent so much of my time feeling like everyone has things together but me because the world I was shown while I was growing up did not have people like me in it. I had to learn for myself that this reality wasn’t new — that depression wasn’t something that had sprung into existence with my generation. That it has always existed, it’s just that no one thought it was important to tell me. The fact that the world I see around me — full of friends and friends of friends struggling to keep their heads above water, mentally, physically, financially — this world isn’t new. The novelty of this world in which people suffer and die at the hands of chance and the indifference of people who should know better — that novelty exists because of the single crowning lie of omission. That novelty exists because, by way of omission, I was taught that real suffering doesn’t exist. I was taught that the word “civilization” had something, anything in common with the world I live in.

It’s difficult to put into words the sense of betrayal that this realization comes with. If I had known what suffering and hardship really were, and how much more common they are than I knew growing up, I would have started trying to fix the world sooner. I wouldn’t have spent and wouldn’t be spending so much time feeling like my problems are my failures. I would have understood just how many people I share my experiences with, and would have been better able to believe that my problems are things that happen to people everywhere, and taken solace in our shared circumstance, instead of feeling like I was the one person who just couldn’t figure out how to get things right.

We need to teach our children that the world is broken. We need to teach them that it’s broken and that no one, but no one, can fix it but us. We need to teach them this because the alternatives are for them to grow up and be hit by the reality of it full in the face without warning, or to be dealt a bad hand and be one of the ones who has to go through the long process of learning that they aren’t alone and it isn’t their fault, or to never know, and never really understand what the fact of human suffering really means. To never understand how much we need to fix things, and, as a result of not knowing, to unknowingly perpetuate the state of brokenness in which so many people find themselves.

The world can be, and sometimes is, an amazing, wonderful place. But it is also, at times, hell. We can make it not that way, but first we have to acknowledge that it is, and to take on the responsibility of being honest with others about the fact that it is.

The Indescribable Redundantness of Chronic Pain

The thing that I find hardest to describe about chronic pain is how redundant it is.

Of all the lines in Allie Brosh’s last post about depression, the one that resonated most powerfully with me was when she described wanting to commit suicide as being like wanting to mute an unbearably repetitive noise. I get emotional reading that line every time I look at that post.

I wish I had a metaphor of some sort to describe what it feels like having dealt with chronic pain for a decade. I find it impossible to describe the feeling in writing, because I can’t think of a way to describe it that isn’t incredibly boring. Interesting written narratives have variation — unexpected things happen, changes happen, and if they don’t your story is boring. The problem with the story of chronic pain is that it is boring.

I have woken up with some amount of pain in some part of my body almost every day for the last 10 years. Every day that pain is just as real, just as visceral, and just as distressing as on any of the other days. It isn’t like a montage, where you get to watch a few isolated scenes of the months or years over which you’ve dealt with it. It isn’t just there when you talk about it, or write about it. It is there, with you, as real as anything else in the world is, for every single one of the days you’ve had it. Every. Single. One. It gets really old, and then it gets old again, and then it gets old thinking, “This is really getting old.” Then thinking that gets old. The day after that happens, you wake up with pain again. And the day after that. And the day after that. And the day after that. For hundreds, and then thousands of days in a row.

It’s like being around a friend who has that completely unfunny joke they like to tell for reasons that utterly escape you, but instead of just being annoyed by it at social events, that friend is there with you every morning when you wake up, telling that same stupid fucking joke, “Ha ha, good morning, you’re in pain again!” and chortling to themselves as though they’re the cleverest human being in the universe. And you want to smash their face against a wall. It’s not funny, it never was funny, but they don’t care, and it keeps happening, and there’s nothing you can do about it.

For ten years.

It is unbearably repetitive.

Some days you try to pretend it’s funny, grin and bear it, try to “Well, that’s life” yourself into some sort of Zen-like acceptance of your circumstances. Others you rage, but there is no real life person you can blame, whose head you can satisfyingly smash against the wall until they apologize, over and over again, for making you this way. There’s no one you can punish.

Other days it just strikes you depressively dumb, and you just sit and wish it would all go away.

Depression and Chronic Pain Are More Similar Than I Realized

I recently realized that the way I think about chronic pain and the way I think about depression are a lot more similar than one might expect. I think of both painful sensations and painful emotions as outputs of the brain, and my first reaction to both is to ask myself, “Does this pain make sense?”

A little history: there are two things I think of as significant turning points in my struggles with back pain. The first is when a physical therapist I was seeing told me there was nothing wrong with the tissues of my back – that it was almost certainly a brain thing. The second was when I bought and read through Explain Pain by Lorimer Moseley and David Butler, which is a book about how pain is a product of the brain, not just the tissues of the body (and I cannot possibly recommend it highly enough for anyone dealing with chronic pain).

I recently had a spread of maybe one or two months where I considered my back pain largely defeated. I was able to imagine, for example, taking a plane flight to New Zealand (an 18 hour plane flight is one of the worst scenarios imaginable for exacerbating chronic pain quickly and powerfully), without worrying about the risk of being suicidally depressed (on account of the pain the flight would result in) by the time I stepped off the plane. This, as a measuring stick for how my pain is doing, has proven to be a useful metric.

I attribute that recovery (and the fact that I’m not doing nearly as badly as I could be given my recent back pain flareups) to my having absorbed the knowledge and the implications of my pain being a brain problem and not a back problem.

Take another example: I had shoulder pain for about a year, up until a couple of months ago. This pain, which I supposed was a physical injury, was such that I would get nervous about whether or not turning the steering wheel of my car was perpetuating the “injury”. I haven’t had any problems with shoulder pain since I decided it was probably a brain problem, and started doing weightlifting again — exactly the same regimen that had caused the problem in the first place (although, to be on the safe side, I started it at a very low weight). I don’t experience shoulder pain at all, now. It was, as far as I can tell, entirely a brain problem. It may have been an injury, initially (there was a clear starting point where I may have been weightlifting overzealously), but it probably was only an injury problem for a maximum of six months or so.

My brain is prone to pain problems, even when there is nothing somatically wrong with me. These days, when something hurts, my reflex isn’t to assume that I’ve injured something. My reflex is to say, “Hang on a minute, does this pain really make sense? Or is it just my brain being weird.”

Does this sound familiar to anyone who has dealt with depression?

It’s almost the same thought process I use when dealing with depressive feelings. I think of both physical and emotional pain as happening in three parts: the trigger, then the pain, then the explanation. Ideally, in a well-functioning brain, the explanation correctly identifies the trigger. With depression or chronic pain, however, it is important to operate under the assumption that the explanations your brain likes may not have anything to do with the actual triggers.

The explanation that my brain likes for my back pain is that I’ve injured my back, but the things that trigger back pain for me are not injuries. My shoulder pain made me feel like I had an injured shoulder, but whatever was triggering that shoulder pain wasn’t an injury (at least for the majority of the duration of the pain). The explanation that my brain likes for my depressive emotional pain is that I don’t add anything of value to the world, but in actual fact the triggers for emotional pain for me are almost always stress, and only sometimes is that stress related to my sense of contributing to the world.

I treat physical and emotional pain in almost exactly the same way these days. Both of them are products of my brain. Both of them are things that my brain is historically very bad at attributing to causes that make sense. Therefore, the explanations that my brain comes up with for both of them are worth eyeing with a healthy dose of skepticism.

Life Update/Brain Dump

I have a lot of posts in the works right now, but I’m not particularly feeling like writing about any of them, so I think it may be time for a life update/brain vomit post to get through some of the things that are clogging up my brain.

Life is, well, going. In light of having recently had a pretty bad dip in terms of my depression, I’ve been looking for a therapist. So far I’ve found one that I like who is out of network with respect to my insurance, and I’m doing the best I can to find someone who is in network (and will work for me) with less success.

Work’s been a little bit better than usual lately in spite of the tendonitis, because I’ve been working on some new stuff, and learning interesting shit as a result of it. Also, when I’m learning new shit, it means more time spent thinking, and thus correspondingly less time spent typing, which is a little healthier.

I feel like I have some emotional processing to do about the previously mentioned mini breakup. I’m not sure exactly what the processing entails, but there are definitely Unresolved Feelings of some sort or another that need to be figured out.

There are some Interesting Things for me coming up. Next week the girl from the threesome story from a while back will be back in town, and in about a month I will finally officially receive my BS. It will be nice to have college forever behind me in writing as well as practice.

The tendonitis is still making my life difficult, and still scary, although perhaps less so than a few weeks ago, now that I’m feeling fairly optimistic that it at least isn’t going to suddenly get massively worse. I’m having some internal struggles with feeling like my life isn’t going anywhere, strongly connected to the fact that the tendonitis means that my work and free time options are incredibly limited. I’m trying to be optimistic that it will eventually get better somehow, and having very mixed results. It’s hard to be optimistic that a pain issue will get better when my previous significant pain issue lasted for 10 years, and still isn’t completely better.

On that note, I had my first significant back pain flareup in a while a few days ago, which was absolutely terrifying. The last thing I need right now is for that to start getting worse again. I’m guessing (and hoping) that it was a result of my having been experimenting with some rigorous exercise lately, because if that’s what it is, then it’s reasonable to expect it was a temporary thing resulting from the ramp-up – a thing likely to go away once my brain realizes that I know what it’s doing, and am capable of calling its bluff, even in the context of doing rigorous exercise.

I have been feeling a little less out of control with respect to my life circumstances and my depression over the last week or two. I’ve been getting a little bit better, I think, at not catastrophizing, and I’ve been putting together backup plans in the event that some of the catastrophes I’m afraid of happen. Knowing I have friends who will put me up if I end up completely failing at life is incredibly comforting, though I hope I never have to avail myself of them.

I’m not really sure where my life is going at the moment, but, as someone very wise recently said (in so many words), I’m open to the possibility that it isn’t all hopeless bullshit.

Having Chronic Pain Is…

I kept reading about Blog Against Disablism Day yesterday, and it didn’t occur to me until this morning that maybe I could contribute something to it. I recently reread John Scalzi’s “Being Poor Is…” post from back in 2005, and thought that might be a good way to contribute something. So this is going to be my “Having Chronic Pain Is…” post. I can only write accurately about the things that apply to me in particular, but if anyone else feels like contributing additional things in the comments, feel free. All of the below have been my experience at one time or another, and I’m sure I’m not alone. These are some little pieces of what it’s like:

 

Having chronic pain is…

Having chronic pain is being unable to sleep because of the pain, and knowing that because you didn’t manage to sleep, the pain will probably be worse tomorrow.

Having chronic pain is 10 years of going to doctors and physical therapists, all of whom have different diagnoses, most of which amount to, “Well, you’re hurting for some reason”, but in slightly more scientific-sounding terminology.

Having chronic pain is choosing where to live and what to do based on what will or won’t be sufficiently stressful to cause flareups.

Having chronic pain is knowing more about what works and doesn’t work than your doctor, and trying to decide whether or not you should say so when they prescribe something with no basis in evidence.

Having chronic pain is deciding whether or not to go to a movie with friends based on whether or not you will be able to endure the pain that will result from sitting for that long.

Having chronic pain is deciding whether or not to visit a friend based on whether or not the process of traveling to see them might cause a flareup.

Having chronic pain is choosing between celibacy and flareups.

Having chronic pain is never being sure if it hurts today because of the usual variation in symptoms, or that thing you did yesterday, and knowing that if you avoided every “thing you did yesterday” that might have caused pain, you would never do anything at all.

Having chronic pain is wishing there were fewer hours in the day, because you can only spend so long moving around, and you can only spend so much time being still, and the day is too long for the maximum allowable amount of both.

Having chronic pain is seeing motivational posters about pushing yourself to get fit, and wishing it could ever be as simple as that.

Having chronic pain is enduring as much pain as you can possibly stand before telling your supervisor that you really can’t unpack any more boxes, because it hurts too much.

Having chronic pain is realizing that for some conditions, our modern medical industry doesn’t know all that much more than it did 100 years ago.

Having chronic pain is having things you’ve already tried recommended to you over and over again.

Having chronic pain is trying every form of exercise and exercise equipment you can imagine to try to find some form of exercise you can do without pain.

Having chronic pain is feeling sorry for disappointing your physical therapist by not getting better in spite of everything they’ve tried.

Having chronic pain is being stressed out about being stressed out, because you know the stress will lead to pain, and being unable to break the cycle.

Having chronic pain is trying to decide whether or not (or how) to tell your doctor or physical therapist that you know that the treatment that they are prescribing doesn’t work — and knowing that you may have to tell them that about the next thing, and the thing after that.

Having chronic pain is choosing your job, your home, and your leisure activities based on what will cause pain instead of what you enjoy.

Having chronic pain is being prescribed painkillers for when the pain is bad, and not taking them when the pain is bad, because if you did, you’d be taking them all the time.

Having chronic pain is trying the bullshit remedies because there’s nothing else left to try.

Having chronic pain is debating about whether or not spend money that you can’t afford to spend on treatment that probably won’t work against the off chance that it could be the one that will.

Having chronic pain is never being able to travel.

Having chronic pain is wishing you believed in the bullshit remedies, so at least you could get the placebo effect out of them.

Having chronic pain is having the pain be the last thing you are aware of before you go to sleep, and the first thing you’re aware of when you wake up in the morning.

Having chronic pain is making decisions based on what will cause pain that you can endure versus what will cause pain that you can’t, rather than on what will or won’t cause pain.

Having chronic pain is feeling very strange, and realizing that what you’re experiencing is the sensation of not being in pain, and that you had forgotten what that felt like.

Depression and Extrapolating From Too Little Data

One of the things I’ve noticed about dealing with depression and chronic pain is that my brain is incredibly talented at extrapolating from tiny amounts of data (“By the third trimester, there will be hundreds of babies inside you!”). When I feel really depressed, I feel like I will always be really depressed. When my pain symptoms are getting worse, I feel like they’re going to keep getting worse until I can’t handle it anymore. When they’re getting better, I often feel like they’re going to keep getting better. I realized recently what the common thread is in these cases.

I tend to extrapolate my present experience out to the future when I don’t know how to change how I’m feeling right now. If I’m depressed and I can’t snap myself out of it, I assume because I can’t change it now that it’s not going to change. If I’m experiencing pain symptoms and they’re getting worse and I can’t get them to stop getting worse, I assume they’re going to continue along the same trajectory. This is in spite of the fact that both depression and pain symptoms, by their nature, tend to fluctuate both up and down. They do this all the time in my own experience, and yet I still have trouble remembering that when things start to go bad.

Maybe it’s because I’m catastrophizing, and the worst-case scenario when depression or pain is ramping up is that it will keep ramping up, so that’s what my catastrophizing brain focuses on. Maybe it’s just that my brain is bad at statistics in general (this hypothesis is easily reinforced by the ways that I know my brain tends to extrapolate about other things, e.g. “This feels terrible, and it will always feel terrible, and I will never date again!” after my first relationship ended). Either way, I find that identifying a mental habit problem and talking about it explicitly tends to be a very useful step in changing the habit, so here is a blog post.

Problem identified: When things, like depression, or chronic pain symptoms, feel like they’re going to last forever, it’s usually just because there isn’t something you can do immediately to make them stop, and your brain is being bad at prediction again.

Snapshots: A Bad Moment and a Good Moment In Dealing with Chronic Pain

A knock at the door. I open it, greet the delivery guy, sign for the package, and take it to my room.

I didn’t expect to have to buy this. It was one of the things I was worried about, but I told myself I was being stupid. My old computer was operating just fine, as far as I could tell. My old computer that I purchased way back when, partially for the purpose of not aggravating repetitive stress when I had it before. It was working fine, and there was no reason to think it was going to suddenly fail on me now that I genuinely needed to be using it for work. No reason to think I would have to shell out the obscene amount of money it would take to replace it before I got over the tendinitis.

Yet here I am, a couple of weeks after the hard drive crash that I told myself would not happen decided now was the time to happen. After the thing I kept telling myself I was being stupid to worry about stupidly happened. I am opening a snazzy new computer that cut deeply into my savings; a purchasing decision that was made easier, if not less stressful, by the fact that if I didn’t end up purchasing it and my symptoms consequently worsened, I would lose a lot more money than even this thing cost. I try to be excited about having a new computer in the first place. It sort of works.  The nerve-racking thing is that if I get worse even using this machine, then I’ve cut into my savings to the point where I will have a lot less time available between ultimately deciding to take time away from work and running out of savings completely.

I’ve actually gotten by better than I expected while waiting for this thing to arrive by cobbling some ergonomic computer accessories together into a relatively non-aggravating setup. I wonder if the purchase was a mistake, and I could have kept getting by indefinitely, or even gotten better just on the setup I currently have. I remind myself that if I get better, I’ll be able to work more, and this expenditure won’t particularly matter in the grand scheme of things.

I set it up and test it out. The setup is nerve-racking, because it requires the typing and other movements that I’m trying to minimize throughout the day. Will this mean I’ll feel worse today than other days, or will the symptoms be fickle and stay constant? After a basic setup, it seems to work well. It is much faster than anything else I own at the moment. Now to install the work software, and get it ready to use. We’ll see how this goes…


I’m reading my blog stats. I see a single hit on a very, very old post documenting how my back was doing about a year ago. I read it out of curiosity. It talks about how I’m slowly working up to sitting for longer periods of time, and I remember that when I started this blog, I could barely sit still for half an hour without agonizing back pain. These days, I don’t generally think about how long I sit unless it has been a very, very long period. I reflect on the weirdness of the idea that I can have come this far in terms of back pain and forgotten about it. I reflect on the fact that in spite of all of the physical therapy that I went to for my back, the single most important thing in terms of my improving to the point that I’m at right now was learning that the pain that I experience did not indicate any actual physical injury located in my back. I still experience back pain, sometimes severe, but it doesn’t scare me like it used to. I endure it, because I know what it is, and I know, roughly, what it is and isn’t indicative of.

My shoulders are doing better, too. Again, not through any particular physical activity, but through the realization that the pain I was experiencing in them was almost certainly not a result of injured tissues. I started working out with weights again, called the pain’s bluff, and in the five or so weekly workouts since, have had little to complain about.

There are, it seems, at least a couple of physical ailments I’ve managed to relatively triumph over.