Helping others to understand chronic pain

Good communication is an important part of maintaining the changes that you make on this programme. This can be difficult because:

• It can feel like you’re trying to describe an invisible condition.
• You may feel that unless others have experienced it themselves, they can’t understand what it’s like to live with it.
• You might think that others don’t believe you.
• You may feel you have to cope alone. Some family/friends may ignore your pain or get fed up hearing about it.
• Sometimes friends/family become overprotective and want to do everything for you. They can tell you what you should or shouldn’t be doing.

When these situations arise, unhelpful cycles can be set up:

We can help others understand this cycle by using good communication.

There are three main styles of communication:

1. Aggressive: This means trying to get what you want regardless of others around you. For example, shouting or snapping, not listening to others, being unwilling to compromise.
2. Passive: This means not saying how you feel or what you need. For example talking very quietly, apologising all the time, keeping things bottled up.
3. Assertive: This is a way of communicating and behaving in any situation where you would like to express your feelings, ask for what you want or say no to something you do not want. It means saying what you think and feel in a calm and clear way. For example listening to what others say, telling others what you want and talking things through.

When people feel emotional it is easy to become either aggressive as a way of getting yourself understood or passive as you try to control your emotions.

Usually people use a mixture of these styles.

It is not uncommon, if you never talk about your pain, to snap at people when you can’t stand it or to feel people don’t listen if you give long-winded explanations. A more assertive approach can be helpful.

Assertive communication

Most of us are unskilled when it comes to assertiveness. You may act assertively in some situations, but have difficulty making requests or saying no to family members or close friends. Many patients with chronic pain problems have special needs for support from others, but often do not ask for it. You need to become aware of your own feelings, needs and wants and communicate these to others. Try to develop nonverbal assertive behaviours, for example holding an open posture and keeping eye contact. Also try to develop assertive verbal behaviours, for example using ‘I’ statements when stating your feelings and making requests, making sure you do not demand, command or make ultimatums.

Summary of effective ways of communicating

1. When explaining to others about your condition, try to decide in advance the main points you want to get across.
2. Use handouts to help you.
3. Explain feelings calmly and clearly (even if that’s not how you’re feeling inside). People don’t know what you’re feeling unless you tell them.
4. Acknowledging others’ thoughts and feelings is important too.
5. When implementing changes, explain to others what you’re doing and why.
6. Ask others to support you in changing. They could remind you to pace and plan.
7. If you say ‘no’ to a request, it is helpful to explain why.
8. Try to recognise how you are communicating things and remain assertive.
9. Don’t expect to become assertive immediately. It will be more difficult at some times rather than others.