Chronic Pain and...Mental, Emotional + Physical Distress, Oh My!

 (C'mon, You Laughed a Little...)

"Grief, no matter where it comes from, can only be resolved by connecting to other people."

-Thomas Horn

Thomas Horn won on "Jeopardy!" during Kids Week with an earning of 31,000 after wagering 12,000 during Final Jeopardy. His acting career kicked off when he was cast in the feature film Extremely Loud and Incredibly Close, which was based on the 2005 novel by Jonathan S. Foer.

If you or someone you love is in chronic pain, you have moved through grief or are currently grieving. 

Wait, what?

 

When we think of grief, we typically think of mourning the loss of a loved one, but in actuality, grief comes in many different forms. You can grieve the loss of a loved one, either to death or divorce, addiction or a breakup. You can grieve the loss of a beloved animal or even grieve moving to a new town or moving back home. You can grieve your last child moving out of your house to start their life or grieve infertility or a miscarriage. You can grieve losing a job, career or fortune. You can even grieve changing an identity through growth or because of a once foundational steadfast belief you no longer believe in. You can grieve coming to terms with the fact you're gay, bisexual, transgender or questioning your sexuality. 

And yep, you can grieve the loss of...you guessed it... your health. 

 

In it's simplest explanation, grief sets in when you are mourning a loss and/or change in what once was familiar in your life.

 

So what exactly is grief?

 

Elisabeth Kübler-Ross developed a model for grieving. The Kübler-Ross model, better known as the five stages of grief, theorized a series of emotions experienced by terminally ill patients prior to death, or people presented by the loss of a loved one. It's important to understand that Kübler-Ross later noted that the stages were not a linear and predictable progression, rather, they are a collation of five common experiences for the bereaved that can occur in any order.

 

 

 

 

 

Elisabeth Kübler-Ross identified the model for grieving which suggests

there are 5 stages of grief. They are

denial, anger, bargaining, depression + acceptance

Elisabeth Kübler-Ross developed a model for grieving. The Kübler-Ross model, better known as the five stages of grief, theorized a series of emotions experienced by terminally ill patients prior to death, or people presented by the loss of a loved one. It's important to understand that Kübler-Ross later noted that the stages were not a linear and predictable progression, rather, they are a collation of five common experiences for the bereaved that can occur in any order.

 

The 5 stages of grief are: 

 

denial, anger, bargaining, depression + acceptance.

 

Though the same individuals may be having the same experience, they move through grief in different ways and in different stages.

 

Becuase founder and IWLC, Christina H Chororos, understands this topic so well, KCPC was designed to help you and your loved ones move through the grieving process.

 

To learn more about Elisabeth Kübler-Ross, please click here.

The authors concluded, "Life phenomena like grief and loss caused by death and chronic pain, seem to have many qualities in common and may overlap each other. A common core containing emptiness, vulnerability and exhaustion is identified."

 

Wait...seriously?

 

"Loss caused by death is naturally connected to grief. However, loss caused by chronic pain may also lead to grief experiences. These losses have the potential to elicit existential difficulties such as lack of control and reduced predictability about life. Such changes may diminish the person’s well-being, hope for the future and ability to cope. Loss as a life experience may concern something irrevocable and the feelings connected to what is lost. As such, grief may be related to several losses caused by chronic pain, like loss of health, loss of work or social relations." 

 

 "Common for these phenomena is that grief influences the existential parts of life and is described as a reconstructive process following such suffering. The examination of grief caused by death and chronic pain reveals many similarities." (1)

 

Seriously. 

Hard to believe? Well, let's look at both experiences. 

 

The "Today Show" interviewed actress,  Kristen Stewart (a serious personal fav of mine) about her 2016 movie, Personal Shopper.

 

If you haven't seen the movie, her character significantly struggles to carry on after her twin brother tragically passes away. 

 

When asked about her character, Maureen Cartwright, Kristen Stewart eloquently explained grief and spirituality in a way that gets to the heart of the matter...Oh, and, echoes the above research!

 

"She's in the in the midst of the most devastating grief and loss - she's lost her twin brother and therefore feels like a fractured... sort of, half of a person. She can't interact with the normal default setting that everyone exists in because she doesn't really understand what existence is, therefore she can't - she can't... exist until she sort of, rebuilds herself after that devastating loss." ..."there's no individuality that defines her- she's just sort of, shell-shocked and, in the midst of an existential crisis that also includes the question of the afterlife and whether or not we are alone at the end of the day or if there is some sort of connection that we have that you could call spirituality."

 

 

 

 

 

 

"She's in the in the midst of the most devastating grief and loss - she's lost her twin brother and therefore feels like a fractured... sort of, half of a person. She can't interact with the normal default setting that everyone exists in because she doesn't really understand what existence is, therefore she can't - she can't... exist until she sort of, rebuilds herself after that devastating loss." 

 

-Kristen Stewart, The Today Show

(Personal Shopper)

You can see the full interview (and her cool haircut) by clicking here. 

 

The authors concluded, "Life phenomena like grief and loss caused by death and chronic pain, seem to have many qualities in common and may overlap each other. A common core containing emptiness, vulnerability and exhaustion is identified."

Institute of Medicine (US) Committee on Pain, Disability, and Chronic Illness Behavior; Osterweis M, Kleinman A, Mechanic D, editors. Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives. Washington (DC): National Academies Press (US); 1987. 9, Psychiatric Aspects of Chronic Pain. Available from: https://www.ncbi.nlm.nih.gov/books/NBK219250/

In fact, grief and chronic pain are so synonymous, that NCBI published a paper in which the objective was to discuss, "interventions related to loss by death of someone close, or chronic pain." 

 

You read that correctly.

Loss by death and loss by chronic pain are germane. 

For chronic pain sufferers, we lose so much, so quickly.

 

Suddenly, we can't go out for that run or attend our favorite spinning class - we no longer are able to do the housework before we have to go pick the kids up from school- or arrive early to the office - our loving relationships are now strained, stressed and tense- we lose interest in sex and our ability to sleep - once  patient and kind, we now are snippy and short- our unwavering faith begins to waver.

 

Until one day, we wake up and realize everything we once had...everything we once were...has vanished - leaving us with an unrecognizable life - in an unfamiliar body with an unfamiliar spirit. 

 

For our loved ones, though they don't lose the things we lose, they still suffer a significant loss. This can be a difficult concept for CP sufferers to understand - it most definitely was for me during the first few years of my illness. I was so focused on my own suffering, I couldn't see anyone else's perspective, grief and/or loss. 

 

Suddenly, the vibrant, active, loving, logical, funny, patient (insert the relationship you have with one another, e.g.,spouse/ provider/ parent/ son/ daughter/ grandchild/ best friend) is replaced by a stranger they now have to get to know all over again. Your world and theirs now revolve around your limitations, not your contributions. Logistically, household responsibilities, social engagements, and financial burdens abruptly shift. Emotionally, the support you once provided is now (rightfully) reduced, resulting in a disproportionate balance.  

For chronic pain sufferers, we lose so much, so quickly.

Until one day, we wake up and realize everything we once had...everything we once were...has vanished - leaving us with an unrecognizable life - in an unfamiliar body with an unfamiliar spirit. 

 

Though our loved ones love us and believe love is an unconditional two-way street, the reality is, bearing added weight is possible for a period of time, but longterm sustainability becomes exhaustive and unrealistic.

 

All of which, brings me back to my first statement: 

 

If you or someone you love is in chronic pain, you have moved through grief or are currently grieving.

 

 

 

 

For chronic pain sufferers, comorbid diseases can affect one or more of the following systems: the psychological system, musculoskeletal system, gastrointestinal System, circulatory system, endocrine system + neurological system. Oh good. ​

 

"It has been estimated that up to 50% of chronic pain patients suffer co-morbid mood disturbances, including anxiety and depression." (4)

But did you know chronic pain sufferers don't always contend with "just" grief and/or depression- sometimes emotional distress can be deceiving.

 

In mainstream society, depression is an over-generalized, loose term used to describe feelings of sadness, malaise, and hopelessness. 

 

In actuality, depression (and grief) fall under very large umbrellas in regards to mental health. The DSM-5 went through a major overhaul in 2013 in order to help clinicians more accurately diagnose and ultimately develop better treatment plans. With separate and distinct disorder categories, several subcategories now are clearly defined, especially when referring to depression and/or grief. 

 

As an example, there are now 8 subcategories of depression. Believe it or not, the 8 subcategories do NOT include other types of depression due to mood disorders like bipolar disorder, anxiety disorders or substance-related and addictive disorders. 

 

When other illnesses accompany chronic pain (or any chronic illness or disease) they're referred to as, comorbidities, concurrent disorders and/or co-occurring disorders. 

 

"Presently there is no agreed-upon terminology of comorbidity.

 

The term "comorbid" has three definitions:

  1. to indicate a medical condition existing simultaneously but independently with another condition in a patient (this is the older and more "correct" definition)

  2. to indicate a medical condition in a patient that causes, is caused by, or is otherwise related to another condition in the same patient (this is a newer, nonstandard definition and less well-accepted).

  3. to indicate two or more medical conditions existing simultaneously regardless of their causal relationship.

 

Comorbidity affects life prognosis and increases the chances of fatality. The presence of comorbid disorders increases bed days, disability, hinders rehabilitation, increases the number of complications after surgical procedures, and increases the chances of decline in aged people.

The presence of comorbidity must be taken into account when selecting the algorithm of diagnosis and treatment plans for any given disease." (2)

 

For chronic pain sufferers, comorbid diseases can affect one or more of the following systems: the psychological system, musculoskeletal system, gastrointestinal System, circulatory system, endocrine system + neurological system. Oh good. 

 

 

An example of these illnesses/diseases can range from depression, anxiety, insomnia, diabetes, to obesity. Sound familiar?

 

"It has been estimated that up to 50% of chronic pain patients suffer co-morbid mood disturbances, including anxiety and depression." (4)

 

 

As Kristen Stewart so beautifully pointed out while discussing her character's grief in her movie, Personal Shopper, "she can't... exist until she sort of rebuilds herself after that devastating loss."  

 

That very concept is what is at the crux of our work together- arming you with the tools to rebuild yourself after the devastating loss chronic pain has caused. 

 

If you believe that you or someone you love may be struggling with mental health in addition to chronic pain, Kairos Chronic Pain Coaching is equipped to address these simultaneously.  

 

Rather than surfacely and ineffectively managing the symptom of your feelings, by identifying where the root of your feelings originate, you can effectively address both cause and effect, thus increasing the likelihood of long-term happiness.

 

 

 

 The mental, emotional and physical body systems are intricately dependent on one another and so, when one system is impacted, so are the others. Which is why addressing each simultaneously has prompted institutes like National Institutes of Health (NIH; Bethesda, MD, USA) established the Office of Alternative Medicine (OAM) and leading medical schools including Harvard University (Cambridge, MA), Columbia University (New York, NY), University of California, Los Angeles, and the University of Pittsburgh (PA) now have departments devoted to mind-body research and/or mind-body treatment.

 

 

Rather than surfacely and ineffectively managing the symptom of your feelings, by identifying where the root of your feelings originate, you can effectively address both cause and effect, thus increasing the likelihood of long-term happiness.

 

 The mental, emotional and physical body systems are intricately dependent on one another and so, when one system is impacted, so are the others. 

 

It was for this reason, I specifically chose to become a certified Integrative Wellness Life Coach and why I ensured KCPC partnered full-time with a leading, licensed mental health professional. 

 

 

It was for this reason, I specifically chose to become a certified Integrative Wellness Life Coach and why I ensured KCPC partnered full-time with a leading, licensed mental health professional.

 

 

Cited Articles:

 

(1) + (3) Institute of Medicine (US) Committee on Pain, Disability, and Chronic Illness Behavior; Osterweis M, Kleinman A, Mechanic D, editors. Pain and Disability: Clinical, Behavioral, and Public Policy Perspectives. Washington (DC): National Academies Press (US); 1987. 9, Psychiatric Aspects of Chronic Pain. Available from: https://www.ncbi.nlm.nih.gov/books/NBK219250/

 

 

(2) Wikipedia contributors. (2018, June 2). Comorbidity. In Wikipedia, The Free Encyclopedia. Retrieved 20:01, July 31, 2018, from https://en.wikipedia.org/w/index.php?title=Comorbidity&oldid=844100306

(4) Bushnell M, Case L, Ceko M, et al. Effect of environment on the long-term consequences of chronic pain. Pain. 2015;156(0 1):S42-S49. doi:10.1097/01.j.pain.0000460347.77341.bd.

"We are experts in addressing the underlying issues that often perpetuate and worsen pain.

You and your physician are experts in identifying and treating the symptoms and disease itself.

Together, we will help you get back to you." 

- Kairos Chronic Pain Coaching

It's An Honor To Be a Member of The Following Organizations:

U.S. Pain Foundation
Integrative Wellness Academy (Wellness and Life Coaching School)
KCPC Professional Headshot Full Length H

Christina H Chororos, a decade-long deep infiltrating endometriosis (DIE) sufferer, founded Kairos Chronic Pain Coaching in the fall of 2018 and is a chronic pain and illness educator, speaker, and writer.

 

Christina graduated with honors from Lynchburg University with a Bachelor of Science in Human Development and Education in 2002. Additionally, she obtained an Integrative Wellness Life Coaching Certification from the Integrative Wellness Academy in the fall of 2017, and a Graduate Certificate in Pain Management from the University of Connecticut (UCONN) in the spring of 2020.

 

Christina writes for iPain Living Magazine, a quarterly magazine published by the International Pain Foundation. 

For more information please visit kairoschronicpain.com

Kairos Chronic Pain Coaching Offices 

567 Park Avenue I Suite 203 I Scotch Plains I NJ I 07076  

Phone: 1-833-936-1240

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Last Updated: August 2020