Our Christmas

Whatever holiday you celebrate, this time of year seems to revolve mostly around family, friends and re-connecting. There are lights, a sense of giving, and celebration. It was the one time of the year when my mother would calm down and we could relax for a few days. We had a quirky Christmas by any measure but it also added to the charm of it. We never put up our tree until Christmas Eve. After dark we would go to several Christmas tree lots and find a forlorn tree. They were always pretty bad. But we had some ornaments and bubble lights that seemed to make up for it. We covered almost every inch of the tree in tinsel. It worked and I loved sitting in the room with the tree and gifts. My father would take time out of his 100-hour work week as a small town doctor to spin the car on the empty, icy streets in downtown Newport, New Hampshire. We caroled with our church group for a couple of weeks, which was both fun and frightening, asking people for donations. A few times my father had the owner of the Western Auto store open it up on Christmas Eve to do our Christmas shopping. Over the years our family somehow seemed to rally together and enjoy Christmas. In the midst of a chaotic childhood it was magical.

Christmas 1964

Christmas lost

Then it wasn’t. Anxiety began to creep in without me recognizing it and when I tried to relax I would experience it even more strongly. As I dove deeper into depression in the midst of my chronic pain ordeal, Christmas became increasingly miserable. One of the hallmarks of anxiety and depression is that you feel that everyone else has it made except you. I was obsessed by what I did not have and became emotionally and socially isolated. Much of it was in my head as my friends were still around. I had no way of reaching out to them. As I interacted less with people my anxiety increased. I was convinced that no one wanted to hang out with me. My world was dark and the magic of Christmas made it worse.

The nightmare of Christmas

Christmas can be a nightmare for people suffering from chronic pain. One of the major causes of pain flare-ups is personal loss, and I see it in my patients every week. It takes only a few minutes to figure out which loss is driving the flare-up. The losses are significant and often catastrophic, such as losing a spouse, child, job, physical function, or reputation. Christmas magnifies this problem in that you are now reminded of a lifetime of losses. There are many friends and family who are no longer with you. There is also the loss of small children running around the house, jumping up and down to open their presents, and the knowledge that those days will never return. For myself, there were many holidays where I skied steep and deep powder and now my knees are not working so well.

What could have been

A friend of mine sent me this piece from Wikipedia:

Sehnsucht is a German noun translated as “longing”, “pining”, “yearning”, or “craving”, or in a wider sense a type of “intensely missing”. Sehnsucht represents thoughts and feelings about all facets of life that are unfinished or imperfect, paired with a yearning for ideal alternative experiences. It has been referred to as “life’s longings”; or an individual’s search for happiness while coping with the reality of unattainable wishes. Such feelings are usually profound, and tend to be accompanied by both positive and negative feelings.

Loss is permanent

As I discussed loss with my patients I have slowly realized that it is not possible to fully get over a deep loss; and the harder you try, the worse the pain. You are still thinking about it. The better alternative is to realize that you don’t have to get over your loss and understand it is now part of the fabric of your life. It is healthier to continue to acknowledge it, live with the unsettling emotions and continue to embrace your life. Remaining stuck in your pain is just another creative way of holding onto the victim role.

Then it hit me that living a successful life involves navigating loss. The list of losses you will experience over your lifetime is limitless. Memory, strength, endurance, friends, family, prestige, jobs, reputation–you can choose to dwell on them or understand that loss is at the core of living, with the final loss being your own existence.

Can you honor your life by enjoying the magic and connection of the holidays? Or will you get mired in the quicksand of frustration, consumed by what was or what might have been?

The post The Two Faces of Christmas first appeared on Back in Control.

The post The Two Faces of Christmas appeared first on Back in Control.

Anger

It is my observation that the whole system of care ignores the most significant factor that contributes to the development of chronic pain—anger. Anger is universal and part of the human experience. Some argue for the necessity of anger. In any case, it is not going away any time soon. Anger provides a useful survival mechanism. When you are threatened and feel anxiety, you will take evasive or avoidance action. When that ability to escape is lost, you will become angry, which increases your body’s physical reaction and mental focus to solve the problem.

Control

The antidote to anxiety is control.

Loss of control = anger.

The current disability system strips the worker of control. Additionally, at least in Washington State, the injured worker is at the mercy of a medically unsophisticated claims examiner. That examiner has final say in everything. As “enlightened” as I am, I cannot discuss a case with an examiner for more than a few minutes before I feel like I am losing my mind. I cannot imagine having my well being, as well as my livelihood, at the mercy of this system.

Dealing with the Anger

It will not matter what systems are designed to “incentivize” workers to return to work, unless this core issue of anger is addressed. You don’t have to incentivize any living creature to jump out of a cage. You just have to the door. Anger not only traps workers so they cannot fully engage in their care, but it also robs them of the ability or motivation to become engaged.

Although anger can be a useful survival mechanism, it is usually destructive to you and everyone around you.  Your anger imposes its own will on the immediate surroundings, and you lose all ability to rationally interact with your environment. The consequences are often disastrous. The most well designed programs are not going to be effective unless the wall of anger can be penetrated.

Anger and Frustration with Workers Compensation 

The post Anger and Workers’ Comp Webinar first appeared on Back in Control.

The post Anger and Workers’ Comp Webinar appeared first on Back in Control.