Definition

Some say that chronic pain is “in your head” or “psychological” pain. Your pain is not imaginary pain. Your nervous system is ablaze and you are physically experiencing pain. We could measure precisely how much with a functional MRI scan. (Measurement of brain activity)

I’ve been thinking about the central nervous system from a different perspective.  I’ve also been thinking about mental states and I have a term to describe the experience of chronic pain. I call it “The Abyss”.  This is the equation:

The Abyss = Anxiety x Anger x Time

Anger drives anxiety and creates irrational neurological circuits. This circuits become ingrained in you. You feel angry and anxious all of the time, and you don’t know how to escape this inner plight. When you take the usual anxiety associated with life and add in the anxiety associated with chronic pain, you can lose control of your life.

The Losses

You lose control over your happiness, your ability to engage with your career, family, friends, and hobbies. Loss of control = frustration and anger. Think of what you have lost control of:

• Pain
• Finances
• Ability to be physically active without limitations
• Ability to enjoy good music, food, hobbies, etc., without the experience being marred by pain
• People do not believe you and often the harder you try to convince your friends, family, peers, employers, and health care providers the less you are believed.
• You are at the mercy of a claims manager who has little medical training and no concept of how your life personally is being affected by the chronic pain.
• You may have undergone a failed operation or series of operations.  You are angry at series of events that led you decide to have the surgery as well as the outcome.  You cannot go back.

The more legitimate your anger is, the harder it is to let it go.  Nonetheless, it will drive your anxiety and soul right into the ground.

No Way Out

Imagine pain, anxiety, and anger multiplied over time. If you can, you’ve got a clear idea of the Abyss. There is a repetition of anxiety, pain, and frustration with no hope of escape. Your soul is being pounded into the ground by a pile driver as you remain in your dismal body. Your life is being systematically destroyed, but in some cruel cosmic joke, you’re alive to bear witness.

It’s ironic that you have achieved what you thought would be a successful and full life.  You had not anticipated this possibility of your life being consumed by pain.

The dark place that develops in your mind is usually deep. My patients cannot find words to describe the depth of frustration they feel being in the Abyss.

With full engagement you will climb out the Abyss. It is a consistent outcome. We just can’t predict the time frame.

BF