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Tips for Managing Chronic Pain in Primary Relationships

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Note: this is part 2 of a 2-part series on optimizing primary partner relationships in the context of chronic facial pain. Read part 1 here.

Use Therapy

If you have a history of childhood abuse or neglect, and you haven’t talked this out in therapy, you need to do this. It is not necessary for the therapy to focus on your experience of pain in order to help your pain.

Get Treatment

If you suspect that you have depression or anxiety, it is essential to get treatment. Successful treatment may necessitate use of a medication. While primary care physicians can successfully treat mild depression or anxiety, moderate or severe symptoms should be evaluated and treated by psychiatry. Again, it is not necessary for this kind of treatment to focus on your pain in order to help your pain. Mild depression and anxiety can be successfully treated without medication through participation in cognitive behavioral therapy.

Psychotherapy

Catastrophic thinking related to the experience of pain needs to be treated in psychotherapy. Treatment is optimal when the psychotherapist has experience in pain management.

Your Partner’s Catastrophic Thinking

Keep in mind that catastrophic thinking can develop in the partner as well as the pain patient. When this occurs, it is just as important for the partner to seek treatment as it is when catastrophic thinking develops in the pain patient.

Listen

Remember that it is hard to see catastrophic thinking as distorted when you are in the middle of it. If your partner suggests that you are worrying too much, try not to see this as unsympathetic. Your partner may be right. The only way to know for sure is to engage in the work of psychotherapy. This work may not need to last longer than a few sessions.

Awareness

Awareness is key to managing chronic pain. Even in the best of circumstances, where relationship satisfaction is high, lack of emotional awareness can create a context where pain behavior usurps the communication process and threatens the relationship. This inevitably leads to a cycle of increasing pain and disability. While it is very difficult to do, it is essential to differentiate the emotions of fear, disappointment, and anger within the relationship from those emotions that arise in response to pain. This will keep pain from taking over a central position in the relationship.

Seek Connection

It is natural to feel comforted when your partner obviously understands that you are in pain. The experience of pain can be emotionally isolating. No one can feel your pain as you do and this can lead to loneliness. Even in the context of a healthy primary relationship the unshareable nature of pain is deflating. Thus, when your partner sees and acknowledges your physical suffering this can feel connecting and emotionally relieving. Nonetheless, it is critically important that you continue to seek connection in ways that have nothing to do with pain.

Talk it Through

The crushing loneliness of pain is an important issue in its own right, and it is often helpful to talk about it. These discussions are most helpful in the context of psychotherapy with a pain management specialist. The therapist has discussed the experience of chronic pain with many people. She or he has developed a specialized understanding of the difficult emotions that are universal among chronic pain patients. You do not have to take care of the therapist. There is no expectation of reciprocity. This eliminates the guilt that can accompany frequent discussions of pain-related negative emotions with your partner while at the same time easing the loneliness of chronic pain.

Express Yourself

Mind-reading is error prone. Do not expect your partner to know what you need or feel without verbally expressing your emotions. Work to identify what it is that you are feeling then express these emotions in words.

Vary Topics

Do not let conversations become dominated by discussions of your pain. In every primary relationship there is a shared emotional life that is both complex and impossible to fully understand without honest conversation. Pain-related experience is but one part of this emotional life. If conversations frequently focus on your pain to the exclusion of other topics, the relationship will be starved of the resources needed to keep it alive.

Communicate about Actions

Do not allow your partner to do for you what you are capable of doing for yourself. Do not do for your partner what you know they can do for themselves as a means to communicate your concern. Communicate your concern with words. Commit to having a loving honest conversation about the problem at hand to determine what is reasonable to expect of one another, especially when the limits of the patient’s ability are not clear. The point is to shield the patient against the loss of personal agency and to protect the partner from falling into the exclusive role of primary caregiver.

Ask for Specific Help

When you are experiencing pain, it is your responsibility to do what is necessary to secure comfort. This may take the form of verbally asking for help. When asking for help, be as specific as possible about what it is you need. Being responsible in the context of chronic pain may take the form of limiting your activity without expecting your partner to similarly limit their activity. It will certainly entail doing things that you are generally frightened to do as much as it will entail avoiding things that you know will cause you discomfort.

Be Clear

Do not confuse care-taking with love. While these things are often related, they are not the same.

Reassure

A loving partner will attempt to remain connected as you experience the intense pain of trigeminal neuralgia. Understand that this experience is as terrifying for them as it is for you. Their experience of helplessness can be as great as yours. As soon as you are able to authentically move away from focus upon your pain, do so. This will be reassuring for you and your partner.

Infuse Your Life with Meaning

Lastly, remain as functional as you possibly can. Work to retain activities that bring you pleasure and infuse your life with meaning. Chronic pain can be psychologically cancerous. The psychological effects of chronic pain can overtake your life and reduce you to being nothing more than a pain patient. The threat of this occurring is universal among chronic pain patients. Losing yourself to pain is not a product of emotional weakness or egocentricity. You must work to prevent this process from unfolding, and this work very often requires professional support. Reaching out for professional help is not a sign of failure. It is a sign of personal power.

Note: this is part 2 of a 2-part series on optimizing primary partner relationships in the context of chronic facial pain. Read part 1 here.

This article originally appeared in the Winter 2017 edition of the FPA Quarterly Journal, written by Leesa Morrow, PhD. Dr. Morrow is a clinical psychologist with extensive experience working with TN patients. Dr. Morrow is a frequent presenter at FPA conferences.

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