Navigating Chronic Pain with Acceptance and Commitment Therapy
Living with chronic pain can feel like an endless battle. The constant discomfort, the limitations on daily activities, and the emotional toll can make life seem overwhelmingly difficult. In my work with clients, I frequently hear how pain can turn a life worth living into one that feels completely hopeless. However, there is hope, Acceptance and Commitment Therapy (ACT) offers a path forward, giving techniques to manage chronic pain whilst promoting a more fulfilling and meaningful life.
Understanding ACT: More Than Just Pain Management
We often do everything we can to eliminate pain, and there’s nothing inherently wrong with this! If we can find a physical solution to our pain, then it makes sense to problem solve and find a way out of it. However, often in my work with clients, there are no clear-cut answers, and we are left with a pain that has no clear physical cause or find no relief no matter how many procedures we go through.
ACT does things differently in that it is not solely focused on eliminating pain from our lives but about changing our relationship with it. Instead of fighting against pain, ACT encourages acceptance and commitment to actions that align with our values. It helps shift our focus from pain itself to what truly matters in our lives whilst giving us tools and techniques to manage our pain more effectively.
Embracing Pain with Acceptance
One of the core principles of ACT is Acceptance. Imagine your pain as a guest at a party you're hosting. You didn't invite this guest, and you certainly don't want them to stay forever. But the more you try to force them out or tell them to get lost, the more disruptive they become. Next you might even start pleading with the pain, “if I stay home or avoid doing certain things, maybe you’ll stop?” but before too long our life gets smaller and smaller, to the point where pain starts controlling how we live and often worsens in its intensity. Instead, Acceptance skills teach us to acknowledge pain's presence without letting it dominate our lives.
For example, Sarah, a client dealing with chronic back pain, found herself constantly fighting her discomfort. Her life revolved around avoiding activities that might trigger her pain, leading to isolation and frustration. Through ACT, Sarah learned to accept her pain without letting it dictate her every move. She began to engage in social activities again, not by ignoring her pain, but by acknowledging it and moving forward with what she valued—connection with others.
Defusing Painful Thoughts
Our minds often amplify pain through negative thoughts and messages. “This will never get better,” or “I can’t handle this anymore” can become recurring themes that echo and magnify our pain experience or at best increase the amount of suffering in our lives. We become “Fused” to them and unable to escape their influence in our lives. The concept of Defusion involves seeing thoughts for what they are, just thoughts, instead of our natural tendency to buy into them or allowing them to dominate how we see or react to the world. Through learning Defusion skills, we can reduce the impact that these thoughts have on our behaviours, attention and how our body responds to pain.
Take John, who suffers from arthritis. His pain was accompanied by a relentless internal dialogue of defeat. By practicing mindful Defusion skills, John learned to view his thoughts as just thoughts, not as facts. He visualized placing his painful thoughts on leaves floating down a stream, allowing them to pass by without engaging with them. This simple exercise helped reduce the power these thoughts had over his experience of pain.
Living in the Moment
Mindfulness is another cornerstone of ACT. Chronic pain often pulls us out of the present moment, focusing our attention on past suffering or future fears. Mindfulness practices anchor us in the now, reducing the emotional impact of pain and helping us engage more in the world around us.
For instance, Maria, who deals with migraines, found herself constantly worrying about the next episode. This anticipation was almost as debilitating as the migraines themselves. Through mindfulness, Maria learned to ground herself in the present. During a migraine, instead of spiralling into panic, she practiced mindful breathing, focusing on the sensation of air entering and leaving her lungs. This helped her stay calm and reduced the emotional burden of her pain, preventing a full-on spiral into panic.
Clarifying Values and Committing to Action
ACT encourages individuals to identify what truly matters to them and commit to actions that reflect those values. This approach can be transformative for those with chronic pain, who might feel that their condition has stripped their lives of meaning.
Consider David, who had to give up his career as a carpenter due to chronic joint pain. He felt lost and purposeless. Through ACT, David explored his values and discovered that creativity and helping others were core to his sense of self. He committed to volunteering at a community art centre, where he could still engage in creative projects without the physical strain of his previous job. This renewed sense of purpose helped David navigate his pain with resilience.
Conclusion: A New Relationship with Pain
ACT offers a compassionate and practical approach to managing chronic pain. By accepting pain, defusing painful thoughts, practicing mindfulness, and committing to value-driven actions, individuals can reclaim their lives. Pain might still be a part of the journey, but it no longer has to be the driver.
If you're living with chronic pain, consider exploring ACT. It’s a journey of acceptance and commitment, not just to managing pain, but to living a rich, fulfilling life despite it. Remember, pain is an unwelcome guest, but it doesn't have to ruin the party. With ACT, you can find ways to coexist with pain and still enjoy the dance of life.
