Accepting Loss-Part Two

                                                                                         

It is very difficult to deal with the reality of acceptance whilst easy to talk about it. Pain sufferers find it very challenging that they cannot any longer manage an important ability they feel they should perform with ease. People with a chronic pain disability show no outward signs of their restrictions and others treat them as normal, expecting them to be able to do things normally too. Coping with the loss of usual functioning is difficult as can be the attitudes and beliefs of other people towards pain conditions. However, the conflict which exists cannot usefully be continued and sufferers benefit from working on acceptance of the situation.

In most things we have to accept the reality of what we are and what the present situation is. We can in many cases make changes to our situation to improve things and get closer to what we want to be. However, in some cases we are stuck with the situation we are in and we have no option but the accept it or fight against it. Fighting it generates, as we have seen, conflict which has undesirable consequences. Gradually moving towards acceptance can free us from this conflict and allow us, finally, to work at our difficulties in a productive manner.

Not accepting the situation means we cannot release ourselves from the conflict and can't take on our or others' suggestions for improvement. If I won't give in to the pain or let people down by admitting I can't do something then I won't see why I should do things any differently or accept a lower standard of performance of the job. This way the route to making the necessary changes can be blocked, getting in the way of our progress towards where we want to be. If we say This is the reality of the situation and I have to work with that we can step forward and begin change.

How we do this depends on the scripts we adopt to describe our lives. We all have these explicit interpretations of what is going on which we don't think about consciously. An example might be I am very fit and am able to manage my life and do sports and social activities without difficulties. However, in the world of low back pain and other pain conditions such as neck pain and fibromyalgia, the scripts are very different. A resigned script might be I am completely disabled by my pain condition and as there is no chance of me getting better this means I will never be able to do anything I enjoy again.

A negative automatic thought can repeatedly go round and round in our minds, and is one of the ways we can become depressed. New scripts can be deliberately written to replace the ones which typically recur naturally and cause negative feelings. We could say My pain condition does limit my activities to a degree but if I realistically manage and plan my life I can do most of the things that I wish to. This is a more realistic approach as situations are rarely entirely negative, allowing us to avail ourselves of the opportunities which might present themselves to try new avenues of changing for the better.

When our scripts describing ourselves are more realistic they are also more positive, though it is important not to generate unrealistic, rose-tinted scripts as they will be found out by us when we realise where we think we are is so far from reality. More positive scripts allow us to participate in the changes that we might want or that a health professional might suggest, ideas that previously were unacceptable due to our inability to recognise where we really were in terms of our physical or mental state.

We are more likely to choose adaptive solutions to our problems if we have our assessment of our situation close to the objective reality which others see. We can then stop the continually stressful pushing ourselves and ease off the pressure to some extent.

About the author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapists, physiotherapy, physiotherapists in Manchester, back pain, orthopaedic conditions, neck pain and injury management. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

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