A Willingness To Let Pain Be, Dropping The Struggle
By Mathew Richardson
When I was going through chronic pain 10 years ago, there was a distinct turning point when I turned from someone in chronic pain, to being a person again. In the months before this day, all I could focus on was pain, it consumed me day and night. My life revolved around my pain, how to get rid of it and what it meant for me, my family, my future. When I am low, I tend to ruminate, focusing on the past and future and not in the present moment. I was missing life without being aware of it and the future was dark, if I could see it at all. I wanted to get rid of the pain and I could not control it. I started withdrawing from life to protect myself, I stopped doing the things that made me, me. I stopped exercising, gardening, I stopped playing with my kids, stopped putting my daughter on my shoulders and my mind was always on the pain.
A seed of change was planted a few days before my darkest day with chronic pain, when a family member mentioned that she was struggling with depression and had gone on antidepressants. This was the first day I started acknowledging to myself that I was depressed. Until that point it was all just pain. Two days later I woke up and I remember laying there in bed, thinking if I died at that moment, I would not care. It would have been a relief.
It is amazing how one day can be so influential in shaping your life. On this day, I decided to let pain be, bringing acceptance around it and shifting my focus to my mental health and living life again. I was not aware at the time how important this decision of accepting the pain was, until many years later. In Acceptance and Commitment Therapy (ACT) we would call this creative hopelessness. Creative hopelessness is when you stop trying to control emotions or feelings and putting your energy and attention on what really matters to you.
Creative hopelessness is a name I do not necessarily like, as it gives them impression, we are creating a hopeless future, but the term refers to the hopelessness of trying to control emotions and feelings. Instead, it is a willingness to let them be – dropping the struggle and switching the focus to who you want to be, what you stand for in life.
“Creative hopelessness is a process in which one becomes aware that trying hard to avoid and get rid of unwanted thoughts, emotions or feelings this tends to make life worse than better. The aim is to increase a client’s awareness of the emotional control agenda and the costs of excessive experiential avoidance; to consciously recognise and acknowledge that clinging tightly to this agenda is unworkable” (Harris, 2019)
I do not count the pain experience from 10 years ago as being a negative experience. It triggered a cascade of learning and defines a lot of what I do today in the clinic. This experience allows me to build stronger relationships with people with persistent pain. I help them on their journey to a better and more full life, despite their pain. I won’t rush in and explain creative hopelessness with people; I build a relationship and slowly plant seeds with language around willingness and acceptance. When it is appropriate I bring up letting pain be, dropping the struggle to focus on their values and making life bigger despite pain.
A finger trap is one way I explain creative hopelessness to people. (I don’t always use the finger trap as I adapt for every person.) I give the person a finger trap, and they look at me questioningly. I incorporate the person’s story into the finger trap exercise like so.
This script I run through, but remember, this is a guided discovery so give the person time to think:
Person in pain: They look at it with curiosity.
Mat: “Place your fingers in the trap and try and get out of the trap”. Most people will try and pull their fingers out of the trap, and they get more stuck. “Imagine this is you with pain. You have been fighting it and trying to get rid of it for years. Most therapies you have tried give you short term relief, but how does it work in the long term?”
(Get person to reflect)
Person in pain: Usually, the reply is not well.
Mat: You have stopped doing what you love (reflect on the costs of experiential avoidance). While we are focused on getting rid of pain, your life is on hold. Are you willing to try something different?
Person in pain: Hopefully, the person will say “yes”.
Mat: “Is there another way you can get out of finger trap?”
Allow your fingers to gently come together and give yourself a bit of space. We can find some wriggle room to get out of the trap. (Reflect on this). Stopping the struggle with the pain and bringing a focus on what make your life bigger will move you towards the person you want to be (include what the person values).
Deciding to move forward in spite of their pain involves “…comparing their ideographic model of pain with both the cost of pursuing a “return to normal” and the rewards from engaging in what is essential to their self-concept” (Thompson 2019)
My personal experience of creative hopelessness was a powerful moment in my life, even though at the time I did not realise it. Focusing on what is important to me and dropping the struggle with emotions and feelings enabled me to put my energy into living life again. The skills I learnt through mindfulness in the months to come after this time, were some of the most rewarding and challenging skills that I have learnt in my life. If you are practitioner, what you say and do in the clinic may help or hinder the person in pain from moving forward on a journey of living well with pain. Consider how you may apply creative hopelessness principles to bring your client’s focus back to life.
Harris, ACT Made Simple, New Harbinger Publications, 2019
Thompson, Gage, Kirk, Living well with chronic pain: a classical grounded theory, Disability and rehabilitation 2019
The idea for the finger trap came from a workshop with Bronnie Lennox Thompson and Alison sim in 2019.