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  • Writer's pictureMelanie Albin PsyS. LMFT

Coping with Illness and Pain

Updated: Jun 27, 2023

Coping with an illness and chronic pain are two of the most difficult problems to manage. Often, they leave us feeling alone. I am one of those sufferers and I will try to give information here that I've learned, and as a therapist, the knowledge I have, that I hope will help. My techniques are derived from how the brain works and I've applied that for coping with illness and pain. I will explain the way the brain works when I teach the techniques to help you understand how and why they work.

The brain is complex, and we still have a lot to learn about its inner workings. We can also look at nature for answers about how we work physically. What we do know about pain is that we have to stop the pain cycle or interrupt it somehow. #copingwithillnessandpain

Medication will likely have to be used for pain to be interrupted. If we do not keep ahead of the pain, it's hard to stop the pain cycle. It will take experimenting to find the right medication and the right dosing. It may take a combination of medications. It's critical therefore to find the right doctor. Finding the right doctor who has experience with our illness can take time and effort. Researching our illness empowers us with the knowledge to find the right specialists we need for treatment and rehabilitation. Teaching hospitals are great resources and often have clinics although staffed by residents, they are supervised by experienced physicians. Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. They also can help you cope with side effects from medical treatments. Their availability does not depend on whether your condition can be cured. Their teams aim to provide comfort and improve the quality of life for people and their families. This form of care is offered alongside other treatments a person may be receiving.

Palliative care is provided by a team of healthcare providers, including doctors, nurses, social workers, chaplains, and other trained specialists. The team works with you, your family, and your other providers to add an extra layer of support and relief that complements your ongoing care. To find a Palliative Care doctor, you just need to be referred by any of your doctors.

We have learned how to make changes in our bodies through biofeedback. When we have pain or are under stress, our body changes. Our heart rate may increase, we may breathe faster, our blood pressure rises, and our muscles tighten. Biofeedback helps us make slight changes in our body to help relieve pain or reduce tension. We will be able to decrease our heart rate and breathing, and relax our muscles, which can make us feel better.

Neuroplasticity is the ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury. Neuroplasticity refers to structural and functional changes in the brain that happen as a result of new experiences. Because of the plasticity of the brain, the brain can “rewire” and “re-organize” itself after brain damage as new connections are formed and neural pathways to damaged brain areas are terminated. We know that the more we focus on something, the stronger the connection becomes in the neuropathway in the brain.

It appears unimaginable that we could focus on something else when we are in pain. A simple example is, if we put an ice cube on our leg, the experience of cold on our leg is stronger than our pain, so it temporarily moves our attention and our brain's conscious experience to the ice cube instead of our pain. So momentarily the pain is subdued. The idea is we have to create something louder than our pain to focus on. Watching an intense movie, for example, may temporarily take us out of focusing on the pain. It doesn’t mean the pain is stopped. It’s just that we are not consciously attending to it, so the idea is to not focus on the pain and focus on something else so that the connection does not get reinforced over and over. Another example would be focusing on something that would relax your muscles because when we are in pain, we tighten up every part of our body which makes pain worse.

Imagine you are in a relaxing place. When you do, your body thinks you are in that place. And it relaxes you as if you are in that place. #usingimagination2relax #how2relax

Another thing we know about the way our brain works is if we are thinking or imagining we are in a relaxing environment, our body thinks we are there. It can be difficult to focus on guided imagery when we are in pain. But if we put an ice pack or a heating pad on our forehead and focus on breathing deeply and as we breathe more and more deeply, we feel the sensation of cold or warm on our body, that is temporarily louder than our pain. As we get more and more practice doing this, we make that pathway stronger and stronger. We can use guided imagery with ocean sounds, whale sounds or any nature sounds that transpose us to a different environment. While we are imagining we are someplace else, we can tell ourselves that each muscle group is relaxing starting with our head and moving down to our feet. This is progressive relaxation which can facilitate pain relief. Many different guided imagery videos or audio tapes or YouTube mindfulness meditations are available to assist in this process.

Our thoughts will flow intruding into our imagery. Gently bring it back to your imagery. Our thinking can quickly turn on our adrenaline. When we think or say out loud, I have to hurry, our body sends a surge of adrenaline to us so we can run there. (Which we haven't needed since we lived in caves). Only, we are not running, so we don't need that burst of adrenaline. So now we feel irritable and then, anxious. Our body's only way of helping us is to trigger adrenaline. Our body responds to our thinking as if it is literal and it's happening now. Adrenaline impairs our thinking. The brain donates its thinking to give us more energy to physically get us there. The goal is to keep our adrenaline off unless we are in a life-threatening situation. Running our adrenaline constantly is hard on our hearts and lungs we are overworking. It's one of the major factors that contribute to heart attacks. Having our digestive system interrupted or turned off causes constipation or diarrhea. We don't have to wait until we have a moment by ourselves, take a moment in your car when we are stuck in traffic or standing in line at the grocery. Take some relaxing breaths. Breathe in deep from your abdomen, out through your mouth. Breathe in good energy, breathe out stress. Tell your body to relax. The more we do it, the more we will benefit from it.

If we are in the car with our kids, have them do it too! Teachers can do it in their classrooms. Children are great at imagining so teach them early how to use their imagination to relax.

Feelings are like waves that flow in and out of our conscious awareness. The feelings associated with illness and pain are the same feelings we experience when we experience a loss. I believe that our feelings are hard-wired into us because it is my observation that there is never a deviation from these feelings no matter what kind of loss it is or what the circumstances are surrounding the loss.

Verbalizing feelings has a process. We will go through stages of grief exactly like grieving a death of a loved one. The feelings of sadness, anger, and guilt are always associated with any loss or illness. In addition, recovery from a loss proceeds through four stages,

  1. denial,

  2. the feeling stage (sadness, anger, and guilt),

  3. recalling positive memories before our illness or pain

  4. acceptance

Processing through the stages of grief does not go sequentially, rather we pop in and out of the denial, feelings of sadness, anger, and guilt, and the memory stage, what we could do before our illness and how we were; until we pass six months when the denial stage ends.

The denial stage gives us time to incorporate our loss of health before we sail headlong into the feeling stage where we experience intense sadness, anger, and guilt. These feelings don't go sequentially either, they go back and forth with memories of better times before illness of things we may no longer be able to do. And they pop back and forth from one feeling or one memory to the next.

The third stage is the memory stage. The memory stage is memories of healthier times before our illness and pain. They can be flashbacks that are intrusive and trigger feelings of sadness and anger because the illness may prevent activities previously enjoyed. For example, I am unable to travel and drive to activities to have the full social life that I had before my illness. Pain prevents us from accomplishing hobbies and interests interests interests even daily activities.,

Ideally, painful feelings and memories can be acknowledged and verbalized so that over time results in a decrease in frequency and intensity. There are three ways to process feelings and memories,

  1. verbalize them to someone we trust

  2. acknowledge and express them through crying, journaling or

  3. express them creatively through art, music, dance, or poetry.

Feelings can wash over us at inconvenient times. And when we're caught in an undercurrent, we feel like we are drowning. We can use coping skills (see coping skills below) to pull us out of our feelings. Choose a more convenient time to talk to someone about them or permit yourself to experience them. Stuffing or swallowing feelings results in stomach and digestive problems, lack of appetite, and depression. Think of the stomach as a balloon, when we think or talk about our feelings, we're letting air out of the balloon. If we stuff feelings, they will leak into our dreams. Unprocessed losses turn into a depression that is just under the surface.

I recommend joining a group of people who are suffering from the same illness or pain. Facebook groups as one example. The amount of information we can learn is invaluable because people will be in different stages of the illness and will have information to help our progress. And who better to understand our feelings than fellow sufferers? We can verbalize our feelings in this group and be understood and supported. We will feel less alone in our journey. Talking to a therapist can also help to process our anger and sadness.

It takes anywhere from 2-4 years to process a loss. The more we process our feelings, the less intense and the less frequent, they become over time.

Memories of things we used to do that we can no longer do because of our illness may trigger sadness and anger. When we process feelings, it triggers our adrenaline. To turn off our adrenaline, always follow processing feelings with any of our coping skills to rebalance ourselves. Use whatever pace works taking control of when and how much to process at any given time. See my coping skills blog below for your convenience.

Any new loss will retrigger our feelings. Our feelings are all categorized in our brain in the same place, just like a single file on a computer so when you open it up, all of the experiences we have had that caused that same feeling, come tumbling out. If we haven't processed our feelings from this loss, they will be retriggered when another loss occurs, and they will have the intensity that we left.

The last stage is acceptance. It is when we have adapted our lives to take lives care of ourselves. Changing and increasing coping skills, changing exercise and physical activities, changing hobbies and interests, changing daily routine needs, and taking into account our limitations. We have to learn how to reach out for support, which might have been unnatural.

Coping with stress is all about turning off our adrenaline, which is our body's only way of helping us. This is true when we are in a stressful situation and when we are thinking about a stressful situation. This includes when we are processing the loss of a loved one or loss of health or pain. When our adrenaline is running, we are irritable and then become anxious. Adrenaline speeds up our heart rate and our breathing and it shuts down our digestion and immune system. The stress cycle ends with us feeling depleted or depressed. We are more apt to get sick when our stress cycle is running because our immune system is off. It's off because our body pulls all our resources to fight or flee. #copingwithillnessandpain

Anytime our stress level is higher than our coping techniques, we feel irritable and anxious and then depleted and depressed.

There are 4 categories of coping skills:

  1. exercise or physical activity

  2. hobbies or interests

  3. friends and support

  4. relaxation

If you are under normal stress, (stress is the amount of change you are experiencing), you want to use each category 3 x a week for 20 minutes each. Two coping skills every day for average stress.

If our stress level is higher than normal, and coping with illness and pain is higher than normal stress, we want to increase our coping skills to match our stress level. If we feel irritable, then our adrenaline is still running, and we want to add more coping skills. What is higher than normal stress? Any problem that needs solving, a job change, promotion, divorce, and loss of health or pain. The death of a loved one is the highest stress level that exists.

Each of the 4 categories of coping skills work differently to turn our adrenaline off. Understanding how they work, helps us decide which category to use.

When our stress is from an illness or pain, we have to replace many of the coping skills we had previous to the illness.

  1. Exercise and physical activity including cleaning because it uses up our extra energy. (Adrenaline = Energy) Exercise and physical activity will use up energy as long as we are not thinking about what triggered the stressful situation or problem. If we continue to think about it, our body will trigger more adrenaline because it's the only way our body has to help us. If it's a problem that needs to be solved, don't think about it before going to sleep because our body will just produce more energy because our body thinks we need to stay awake to solve it right now. Look for options earlier than bedtime. There are at least 3 options for every problem. See the problem-solving blog for more information. I've adapted the information at the bottom of this blog post because encountering a new illness is also a problem to be solved. Walking, yoga, and swimming are examples.

  2. Escaping with hobbies or interests. Hobbies and interests work because when our mind is occupied while we are doing our hobby with friends or by ourselves, we are not thinking about whatever we were stressed about. After 20 minutes, our body turns off our adrenaline.

  3. Friends and support can work in two different ways. First, spending time with friends can be an escape. Or second, talking about it can be helpful in two ways. If stress is a problem that needs to be solved, more heads are better than one when looking for options to solve a problem. And second, feelings can be processed. Talking about it" is letting air out of the balloon".

  4. Relaxation. We want to choose ways to relax that get our heart rate lower than it is when we are resting. As an example, watching fish in an aquarium works because the movement is slower than our heart rate. Taking a bath with candles and listening to spa music where music is designed to slow our heart rate like Bach. Use progressive relaxation (telling each muscle group to relax starting with your head to your toes) or use visualization (imagine we are someplace relaxing). Inconsequently, when our heart rate is lower than it is when we are resting, our body thinks we are asleep, and it reboots our immune system.

In summary, use at least 2 coping skills a day, from each category, for 20 minutes each. Add more coping skills when we are having higher than normal stress on a particular day, or a particular time in our life. The goal is to keep our adrenaline off, so we are not running the stress cycle. (Triggering adrenaline and then being exhausted). We want to have at least 3 or more different types of coping skills in each category, to choose from on any given day, to create balance in our life. Three or more ways to use up our adrenaline, yoga, walking, and cleaning. Three or more types of hobbies; playing with dogs, watching movies, reading a book. Three close friends that we can confide in and three or more friends we can do activities with. And three different ways to relax; guided imagery, massage, or acupuncture. We have to consciously add them into life and when we lose interest in one, we replace it with another.

If we were to only have one coping skill in each category, it is too limiting. For example, if it is one type of exercise, it's too demanding physically on one part of our body, like running, we injure our knees or only walking it's too much strain eventually on our feet. If we are limited to one friend, when that friendship ends, it's devastating. If shopping is our only hobby, then we overspend because we are always going to that activity, when we need an escape.

My coping skills and my distractions from my pain are snuggling with my 3 dogs, enjoying my goldfish and koi pond (see video of it pictured above), watching my 55-gallon aquarium with goldfish and koi (pictured below), listening to my zebra finches and my canary, growing indoor and outside flowers and plants, and listening to books from the library on my phone. They are some of my coping skills that bring me joy. They help pull me out of my experience of pain into the present moment.

Unfortunate as it is, our illness is a problem that needs to be solved. I apply my problem-solving techniques to having an illness below. See my problems solving blog for more details about problems solving skills.

Problem-solving skills in a nutshell: At least 3 options exist for every problem.

That includes our illness. We have to make decisions about treatment that leads to the best outcome. We need to learn about our illness to know what physician's specialties we need to seek out. Research can be done online and in consultation with experts. Finding a knowledgeable team of doctors to treat us takes time. Physician-narrow specialties require diligence on our part to find, the whole of what we need, to facilitate healing. For optimal healing, it is an ongoing process of acquiring knowledge and scheduling appointments with different specialists.

Since even thinking about a problem triggers adrenaline which then starts the stress cycle, we want to turn our adrenaline off after researching or problem-solving our illness. We can take some deep breaths and imagine we are in a relaxing place. Or spend 20 minutes exercising, cleaning, or doing a hobby or interest for 20 minutes. Any of these will turn off the adrenaline and the stress cycle. Once we have at least 3 options for treatment, think about or list the pros and cons of each option. Then, think about or list the short- and long-term consequences of each option. Then we are in the best position to decide on an option. And we can stop thinking about it for now because unless we come across new knowledge that requires action or another option, we don't want to worry about it, which only turns on the adrenaline, which will then turn on the stress cycle.

In summary, coping with illness and pain takes enumerable skills. First, our illness is a problem to be solved. We have to research our illnesses to gain information and knowledge that will empower us to find the specialists we need to treat us. Our team may consist of three or four different specialists, a pain management doctor, and a physical therapist.

We have to increase our coping skills during our illness and if we have chronic pain continue to have increased coping skills to distract us and bring us momentary joy or pleasure. We have to create hobbies that keep us from focusing on the pain. We can find support from other people who suffer from the same illness.

It takes two to four years to process the feelings associated with having an illness. Allow ourselves to feel and verbalize or journal, anger and sadness without getting stuck in our feelings. Follow our expression of feelings with coping skills to pull us out of them. This processing will let air out of the balloon, so our feelings become less intense and less frequent over time rather than stuffing or swallowing them which would create long-term depression and digestive issues.

It will help if we consciously keep our adrenaline off by matching our coping skills with our stress level. We can use visualization and relaxation techniques to decrease pain and turn off the stress cycle. The more we practice relaxation and guided imagery the more our body learns how to relax and the easier and more effective it is to relieve pain. We can turn off our adrenaline by simply telling ourselves either out loud or silently "I'm calm and relaxed" and our body will respond then by relaxing. The more we have practiced it, the deeper our body will respond and relax.

Find medication that breaks the pain cycle. Take it regularly to keep ahead of the pain. It may likely take a combination of medications. It will take trial and error to find the correct medication and the right dose to keep the pain from breaking through. Find a knowledgeable doctor and communicate with them to find what works.

The more we keep our focus off the pain the better. Consciously pull your mind away from reinforcing the pathway from the pain to the brain. Interrupt it with medication, coping skills, guided imagery and relaxation, exercise, watching a movie, taking a bath or shower, listelisteningusic or a b, ook or talking to someone. Find positive affirmations thencourage youent.

Think of things to be grateful for. Thinking about what we are grateful for actually attracts more things to be grateful for.

Universal laws exist that affect us every day. The Law of Attraction. "We attract to our lives, what we focus on" Every aspect of our lives is governed by Universal Laws. Not only "The Law of Attraction" but "The Law of Cause and Effect" "The Power of Expectancy" "The Law of Belief" "The Law of Love" "The Law of Guidance" "The Law and of Balance" (Bringing balance to your life.) and "The Law of Multiplicity". "The Law of Multiplicity is the effect of our actions multiplied. If our intention, thought or action is kind to ourselves or others, that kindness comes back to us multiplied. #weattracttoourliveswhatwefeelgrateful4 #feelinggrateful #thelawofmultiplicity #lawofmanification lesser-known and understood law is the "Law of Manifestation" Our thoughts if held onto long enough, create our reality. If we want something and we hold onto wanting it, the universe cannot bring it to us because we are focused on the wanting of it which is the absence of it. Believing it so strongly that we already have it and being grateful for it, if it's in our highest good, the universe will manifest it for us. The easiest-to-understand book about Universal Laws that I have found is "Your Life Why It is the Way It Is and What You Can Do About It" "Understanding the Universal Laws" by Bruce McArthur.

My self-help book was inspired by my patients who wanted to know if I had written down what I teach in therapy. After three patients asked me, I began writing it down and it turned into this book. I offer a philosophy of healing holistically, physically, emotionally, cognitively, spiritually, and interpersonally."Total Wellness" and "How to Live a Peaceful and Harmonious Life".

Message me if you are interested in purchasing a copy of my book. You can mail me a check and I will mail you a copy.

Please see my blog about my journey with Ramsay-Hunt Syndrome.

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