Once I knew a woman who was a hair stylist.  She was actively engaged with her village of family and friends, extremely socially active.  She was extroverted, ambitious, and stopped in her tracks by neck pain following a car accident.  Two years later, after trying everything she was offered and still no relief, she was devastated that she couldn’t get back to her work, life, or friends without flaring up her pain.  She slowly started to withdraw from her friends.  She stopped working.  She was too afraid to exercise.  And eventually she began to have a hard time doing even small everyday activities.

It might sound shocking to someone who hasn’t yet experienced chronic pain, but this cycle of pain, followed by fear, withdrawal, and avoidance of flare-ups is so common.  It was this exact story that I heard on repeat many times throughout my day as a pain psychologist. And as a person with chronic pain, I also understood it. Why would we ever try to return to the activities and people we love if it’s just going to turn the pain volume UP?

When we’re talking about living well with chronic pain, it’s not the same as living without it. And the biggest mountain to climb? Preventing flare-ups.

When I talk about flare-ups, I mean pain that is severe and lasts hours to days, interfering with doing the things that you want. For most women I’ve talked to, it’s not just pain that shows up with their flare-ups. It’s also symptoms like brain fog, fatigue, a struggle to focus, and low mood.

So, naturally, they cancel their whole lives. They literally stop everything for a day or two or a week and spend time in bed or immobile. What is the harm in pressing pause?

And here’s where I share with them the thing that they already know but that has not fully registered in their minds as something they need to change:

Sometimes complete rest for extended periods of time can be as harmful as pushing through and not resting at all.

In fact, like many things in life, extremes don’t work very well. Pushing ourselves mentally and physically at an extreme AND resting at an extreme can trigger a negative pain cycle.

Once we acknowledge the need to fall somewhere in the middle of extreme active management of pain and extreme passive management of pain, it’s impossible not to see the need for pacing.

And you probably have heard of pacing before - it’s hard not to if you struggle with conditions that fall within a chronic illness sphere or if you’ve seen a medical professional at all about some form of chronic illness. Many hold this tool up on a pedestal as one of the most important tools when it comes to managing long term conditions, including chronic pain.

Still, many women share with me that they’ve tried pacing many times but have yet to find a way to make it truly work for them. They have yet to find an explanation that makes real sense for them in their real lives. These are women who have had their diagnoses or symptoms for a decade or more.

Often, pacing has been explained to them briefly as “just do less”. Many women hear “you need to accept your pain and expect less of yourself now”. Stay active but make sure you rest. Huh?

Now, when you’re a high achieving, high performing, highly extroverted, woman like the hair stylist I knew, not having actual pacing skills or knowledge of how to actually do the pacing meant she was digging herself into that boom-bust cycle even harder. Because she was only stopping to rest when she pushed too hard.

Like many, she hadn’t been able to connect with the idea of pacing and wasn’t given any helpful information about how to employ it in her unique life situation or in a way that connects her with the things she uniquely valued. What followed was grief, frustration, the negative emotions that come with high standards associated with perfectionism, nothing good.

What are the main barriers that show up when medical professionals bring up pacing and lifestyle management (that are shaped so much by the psychological elements of living with chronic pain)? Time, education, and perhaps lack of experience of having to actually pace themselves? When we hear “do this” without validation for the grief and frustration or an empathetic “how to”, we feel defensive, angry, helpless. The burden is on us to figure it out without any tangible or helpful tools to achieve this.

In my experience, when I gave women the tools for figuring out how to prioritize, design, and pace their days according to their values, they reported that quality of life skyrocketed. Not only that, but their lives had blossomed larger, to the point that their lives were bigger than their pain. They thought about their pain less. Some forgot about their pain for days at a time. Some reduced the frequency and intensity of their flare-ups, and some got rid of them completely.

Reflection:

Have you ever had that paralyzing feeling - where you want so badly to return to your life, but fear of flare-ups keeps you stuck?  Like pain is making your life smaller and it feels hard to life the life you really want (or used to have)?

Have you recently (or many times) tried to increase your activity levels and expectations of yourself, only to end up in a physical and mental crash?

I’d love to educate you on the important elements of pacing and give you tips on how to implement them until they become second nature.

For a limited time, you can grab my free video tutorial to get you started:

3 Simple Steps to a Balanced Day... Without the Flare-Ups.

This free video tutorial is dedicated to helping women with pain begin to find confidence to return to the moments, activities, and people they love the most.