Knowing the Benefits Isn’t Enough to Elicit Lifestyle Change for Chronic Pain… So What Is?
By Carol Jeffrey
The World Health Organization (WHO) has defined “health” as not merely the absence of disease but as a “state of complete physical, mental, and social well-being.” That’s a rather rigid utopian view, however; an increasing amount of research is showing that patients fare much better when a multifactorial treatment approach is used to combat disease. In sharing my experience, I will expound on the physical, mental and social factors associated with making a healthy lifestyle change for chronic pain in our mindset and diets.
Whenever I heard the word “diet” my thoughts went directly to lack of comfort food, deprivation and fear of failure, but these were misguided thoughts. This reminded me of a study which showed that one’s mindset could alter a person’s visual acuity. “Because the letters get progressively smaller on successive lines, participants expected only to be able to read the first few lines on a traditional eye chart. When the participants viewed a shifted and reversed chart, they were able to see letters in which they previously couldn’t identify. This showed that mindset manipulation can counteract physiological limits imposed on vision.” (Believing Is Seeing…, Langer E, Dept. of Psych, Harvard.) Shifting my view allowed me to see not only the gains of feeling better from eating a well balanced diet, but the losses that I had incurred from making poor nutritional choices. I used this information to reframe the word “diet” into new thoughts of nutrition, health, and well-being. The success of healthy eating depends not only on our mindset, but understanding how the mind-body connection affects our eating habits.
Let me briefly explain what the mind-body connection is about. It’s important to “be present to one’s self” in a way that fosters self-awareness and acceptance…this allows us to change. I used to work in a physician’s office, and I usually scarfed down my lunch between patients and phone calls. This ended up being a mindless task of squelching my hunger pains with food devoid of nutritional value, leaving me lethargic by the end of the day. Often, after the long commute home I would be too tired to cook, so I’d stop for fast food, only to ingest more food devoid of nourishment. My mindlessness carried on into the late evening when I would find myself absentmindedly munching on snacks as I relaxed. My poor eating habitsextended Into my weekend, not due to lack of time but due to the social pressures of eating out with friends…where healthy food choices were limited. I was not psychologically present while eating nor mindful of my food choices.
Unfortunately, prolonged psychological stress, years of detrimental lifestyle, and poor eating habits had greatly contributed to my poor health. This eventually led to physical disability, unemployment, and the inability to do many of the things that I once loved. I was finally ready to break this cycle, and needed to become aware of the circumstances which led to my poor lifestyle choices and eating habits. I began paying attention to my internal dialogue (i.e., I don’t want to let them down, I’m expected to “…” I know I should choose the salad but I’ve had a difficult day so I deserve to eat what I want. I’m feeling anxious…Ice cream is always soothing. I’m not overweight so it isn’t like I’m pigging out). When I quit accepting my excuses, I became more mindful of my thoughts and choices, and discovered that I had much more control over my health than I had previously realized.
By this time I had reframed my thoughts about diet, understood the mind-body connection, was mindful of my choices, realized I had control over many aspects of my health. Yet, I was still depending upon my physician to heal me, or at least make me feel better with pharmaceuticals. Which leads me to the next issue I needed to address.
I had been encultured into believing that it was my physician’s job to heal, and the pharmaceutical company’s job to relieve my pain. If I failed to get better, it wasn’t my fault, or was it? “In 2012, the pharmaceutical industry spent more than $24 billion on marketing to influence physicians, and over $3 billion in advertising to consumers.” (Cegedim Strategic Data) Traditionally, very few non-M.D. or non-D.O. practitioner appointments or treatments have been covered by insurance. These practices enculture and direct us into accepting the limitations that Western medicine on its own has to offer. It also moves us further away from more natural treatments and the means of self-healing. The strategies used by insurance and BigPharm are contrary to obtaining optimal health, since integrative medicine has shown to be most effective in managing disease. Now that I understood why I was so dependent on my physician, what could I do about it?
Fabrega Horacio, Jr. wrote an interesting article (Sickness and Healing and the Evolutionary Foundations of Mind and Minding) which shows how non-human primates (i.e., chimpanzees) are reliant on self-healing behaviors that not only remedy illness but prevent many illnesses, through social functions and diet. I had been relying on my doctors to heal me and a pill to ease my pain, instead of taking personal responsibility, and using preventive and self-healing behaviors…like the chimps. I understood that eating a healthy diet along with living a well balanced life was essential for pain reduction, but I still wasn’t motivated to change.
Pain is fundamentally unpleasant, and is designed to protect by promoting motivation and learning. I was now enlightened to the fact that my lifestyle and poor diet were fueling the raging fire within my damaged nerves. However, like many others, I have an aversion to change and even though the reward of pain relief should have provided enough motivation to elicit change…it wasn’t. It is said that most people are motivated by one of two things, “inspiration” or (in my situation) “desperation.” My chronic pain was extremely difficult to handle, but it was the lack of being able to engage in life that made me desperate enough to make changes. My attitude and desire toward change had evolved from I wish, I want, to I must. My reason to change had now been clarified and my need for change had transformed from I should, I intend, to “I am” making a lifestyle change for chronic pain. However, what would keep me motivated? This is where goal setting came into play.
“Remember the word ‘SMART.’ Successful goals are Specific, Measurable, Achievable, Realistic and Timely.” This is based on research conducted by Dr. Edwin A. Lock of the University of Maryland.
- Specific: I asked myself what my life was currently missing and what I wanted in my life. Connecting life goals to specific health-related goals clarified the reason I wished to be well and what I would do once my health improved. Thereby answering the questions what, where and why.
- Measurable: I then determined how I would accomplish and measure my success. (i.e. Add three new organic, non processed foods to my grocery cart each week. Actively work with my doctor on natural pain relief techniques at each visit. Exercise as tolerated but do it two times a week. Do one thing each day to prepare me for a less stressful career.)
- Achievable: I then asked myself if I had the skill, tools, and resources needed. (i.e. I researched YouTube, and I borrowed books from the library to learn about natural pain relief techniques, meditation, healthy diet, etc., and sought out physicians who practiced integrative medicine.)
- Realistic: To avoid frustration, I focused on honest goals that I believed were obtainable. There was plenty of evidence to show that changing my lifestyle and eating a healthy diet would decrease my pain and improve my quality of life. It was realistic to train for a less stressful career. Total health and no pain was impossible; however, controlling diet, decreasing narcotic use and learning healthier ways of dealing with pain were within my control.
- Timely: I gave myself one year to turn my health around and begin a new career. This goal challenged me but it was possible. I set daily, weekly and monthly goals which were frequently reviewed and revised as necessary.
There aren’t any shortcuts to change, including a lifestyle change for chronic pain. I had to reframe my negative thoughts, become more self-aware and mindful of my decisions, accept personal responsibility for my health, incorporate self-healing behavior, determine what would motivate me, set and commit to my goals.
The rewards of an improved quality of life came by default as I achieved my goals. I have not yet reached the utopia of health that the WHO refers to, but I have significantly decreased my pain level and again live an active and meaningful life. This article reflects my journey, but more importantly, I hope it encourages and guides you to make your own changes so that you too may live life to its fullest.
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