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Chronic pain and illness at the time of a pandemic? The gift of acceptance.

Everyone is worrying about their health during this time of the COVID-19 crisis. As I walk out of my apartment, I see people with their masks on. They move out of each other’s way in the streets of a once busy city. I think about the fear and anxiety they must be experiencing. Are they working? Do they live alone? Do they have support? As a psychotherapist and as a sex and couples therapist, I get curious about people and relationships. I often wonder, “do they already have an illness and are they even more fearful since the pandemic started?”

When chronically ill, you are always fearful. But since the start of the pandemic, health anxiety is on the rise. Everyone worries about their health at some point in their lives, but when you already have a chronic illness and the news is telling you to be extra safe, the worry may become excessive. The anxiety can become all-consuming, and the harder you try not to worry about your health, the worse it seems to get. When there is worry, there is avoidance. You may try to avoid your thoughts by pushing them away or you are constantly wrestling with them.

So, what does avoidance look like? Avoidance is the act of avoiding a particular experience due to some feared outcome. Research has proven that avoiding a situation, taking steps from it, or numbing oneself to the feelings brought up by that experience actually makes a person mentally averse to the situation. Research tell us that avoidance does not reduce chronic pain, but it actually increases the pain. For example, if you suffer from fibromyalgia and you are in the middle of a flare up, you may be afraid to walk because your muscles are sore and you may fear falling. Instead, you stay in bed all day avoiding just to walk across the room. With avoidance comes the risk of deconditioning, a prolonged lack of exercise or movement causing the body to become deconditioned. With deconditioning, wide-ranging structural and metabolic changes occur. The heart rate may rise excessively during physical activity, bone and muscle atrophy occur, physical endurance wane, and blood volume declines. What we find here is the fearful thought driving the behavior of avoidance, leaving the pain to become worse.

Avoidance behaviors are captivating. They look like the right answer all of the time because they are a place for comfort, but comfort can lead to more pain and negativity. I have found in my work that avoidance is quite common when one is first diagnosed with a chronic illness, but I have seen it throughout the course of the helping process. You may find temporary relief with avoidance, but it has the risk of causing you to live a life restricted with pain.

What is the opposite of avoidance? Well, it is acceptance and this can be quite powerful during this time of uncertainty. With acceptance, comes psychological flexibility with our thinking. Psychological flexibility is the ability to be in the present moment with full awareness. Once we are able to achieve this way of thinking, the better one can address and cope with painful thoughts and feelings associated with chronic pain and illness. Therefore, during this time of fear, it is helpful to be present, open up, and do what matters. This may involve the practice of mindfulness meditation, calling/ skyping friends and family, reading, listening to music, baking and cooking, organizing your home, and seeing a therapist to help you cope. The greater our ability to be fully conscious, to be open about our lived experience with chronic illness, the greater our quality of life because we can respond far more effectively to the problems and challenges life inescapably brings.


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Dr. Lee

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