People with a good sense of humour sometimes think of severe chronic pain as “another *%[email protected]!! growth opportunity.” But pain isn’t just an opportunity for personal growth. Sometimes, growth may be the way out of the pain.
Personal growth is a strategy that I recommend as a general method of trying to cope with and facilitate difficult and/or mysterious recovery. On the one hand, personal growth may be directly relevant to the neurology and physiology of chronic pain, which often involves a neurological phenomenon called “sensitization” — an over-active alarm system that needs to be calmed and soothed, the sensitivity dialed down.
And personal growth can also be a wild goose chase — growing up more isn’t easy, nor is it necessarily relevant to chronic pain. Worst of all, people often face nearly invincible hardships in their lives, problems that are going to continue to be extremely stressful almost no matter what they do.
But sometimes personal growth heals the body when all else fails … and of course it’s never a waste of time to try to grow up a little more.
It is more important to know what sort of person has a disease than to know what sort of disease a person has.
What is “personal growth”? And do I have to eat granola?
“Personal growth” might sound like something that’s just for hippies, but it’s an important and sensible concept that I decided to get comfortable with a long time ago. It’s just the process of increasing self-awareness and self-actualization — knowing and being more like yourself — and breaking down self-limiting behaviours at the same time.
Personal growth is more popularly known simply as “growing up” or “getting older and wiser.” And smarter. Knowledge is part of wisdom, and informed, rational confidence — a cousin of placebo — has great importance in managing pain.
Once a danger message arrives at the brain, it has to answer a very important question: “How dangerous is this really?” In order to respond, the brain draws on every piece of credible information — previous exposure, cultural influences, knowledge, other sensory cues — the list is endless.
~ Pain really is in the mind, but not in the way you think, Moseley (TheConversation.com)
Why should I grow personally?
Sometimes — not always, but often enough to make it worth trying — when you embark on a personal growth “journey”, chronic pain and other mysterious or stubborn physical problems change or fade away. It may never be clear exactly why.1 But it is clear that chronic pain often has more to do with general biological vulnerability than any specific troubled anatomy.
Regardless, personal growth is something most people end up doing sooner or later whether you like it or not! Pain has a way of herding people into self-improvement. You might as well take credit for it, and you might as well get started sooner rather than later. And it’s a nice perk that it can never be a waste of time — getting wiser is good! — even if it has no effect on your medical problems.
Chronic pain has forced me into the same good habits that everyone else is after. I make sure I sleep and eat well. I don’t work too hard. I don’t drink much. I prioritize balance. For most people, an imbalanced life means burnout in a few years time, but with chronic pain this can happen almost immediately. … I am in many ways stronger, whether I like it or not.
~ How chronic pain has made me happier, Heaton (RobertHeaton.com)
Pain is also an extremely personal challenge in the sense that it is private and even isolating. There’s just you and the pain, trapped together inside your skull. With chronic pain, there are no outward signs, nothing to “prove” how much pain you’re in, not even a way to compare directly with someone else’s pain. Pain is also a more “creatively” produced experience, more volatile than most other sensations.2
I think about the meaning of pain. Pain is personal. It really belongs to the one feeling it. Probably the only thing that is your own. I like mine.
How can personal growth affect health and pain?
Everything we experience — pain included, pain especially — is an expression of who we are and who we have been. If you could magically change everything about your personality, you would become someone else and probably trade all your current problems for new ones — even some diseases and consequences of old injuries might well vanish, obsolete manifestations of your old self.
The hope of personal growth is that, if we change enough, we might just change the part of us that is hurting — probably without even understanding the connection. Mysterious problems sometimes just go away when we work on ourselves.3 Getting away from bad relationships is a good specific example — they can actually make chronic pain worse.
Manual therapies are usually aimed at a target tissue, with the goal of changing something specific in the body, whether that’s realistic or not.4 Personal growth, on the other hand, is general. It has the potential to affect — and change — almost anything about you.
Rob Heaton again:
Whilst the problem is superficially a physical one, the real challenges faced by someone with chronic pain are mental. Mental state is the biggest modulator of physical pain. Things hurt more when you’re stressed or sad, and the increased pain makes you both stressed and sad. The way out of this vicious circle is a wholesale change to how you perceive fear, suffering and setbacks.
Practical example #1: pain, alcohol, and sleep deprivation (oh my)
Just as a sugary diet and lack of exercise are powerful factors in diabetes — an obvious equation we are all pretty familiar with — some habits and life patterns are also strong predictors of the chronicity and severity of pain. Smoking and sleep deprivation both directly make pain worse. Alcohol is more complicated: it’s a common coping mechanism and a sleep destroyer, which does substantially worsen pain. This is the stuff of vicious cycles: pain, alcohol, sleep loss, more pain, more alcohol, more sleep loss …
What starts out as an understandable coping mechanism — a couple of drinks at the end of a hard day — can eventually turn you into your own worst enemy.5 Assuming you even know that the alcohol is a problem in the first place, it’s a difficult vicious cycle to escape, but unfortunately it’s rare for chronic pain patients to even recognize the nature of the challenge in the first place without some wise and expert counselling.
People do sometimes succeed in retreating from alcohol abuse for a wide variety of other reasons. In this way, personal growth can lead to changes that significantly improve chronic pain, without the reason for the improvement necessarily ever being understood, or even actually “curing” the problem.
Personal growth casts a wide net, and may improve or eliminate many things that were, collectively, making a relatively minor problem into a horrible one.
Practical example #2: ditching toxic relationships
Bad relationships can happen to the best of us, but let’s not sugarcoat this: it happens to the “worst” of us a lot more often. People with a lot of rough edges are way more likely to get mired in dysfunctional romances and marriages. And wriggling free of them is one of the most obvious benefits of growing as a person. Even relatively easy cases take guts and new emotional skills. And the tough cases? Those can involve harrowing risks, career reboots, professional help, and so on. Breaking up with a difficult jerk is one of the most intense of all personal growth challenges.
But what does a bad relationship have to do with your health? Better to ask what it doesn’t have to do with it. Partners are influential. For example: empathy and sympathy affect pain! Reassuring touch from a loved one is a pain-killer, and its absence is a pain amplifier.6 More surprisingly, a 2017 study clearly showed that people with chronic, painful knee osteoarthritis did better if their spouses were openly sympathetic and helpful, compared to those whose spouses were “punishing” or even merely “solicitous.”7
That’s huge: a direct aggravation of chronic pain, just from being married to a bit of a jerk! And it’s the tip of the iceberg.
Grow as a person, DTMFA… and actually feel better.
Before you diagnose yourself with depression or low self esteem, first make sure you are not, in fact, just surrounded by assholes.
Pain management versus coping
Chronic pain “management” involves partial or temporary symptom relief. The more the better, wherever and however you can get it. Sometimes personal growth leads to actual management of pain, which is the main point of this article.
But there’s a more reliable additional benefit: personal growth is very likely improve “coping” and “acceptance” — that is, learning to live with and work around symptoms, reducing their impact and reducing suffering (distinct from pain), and living better in spite of symptoms. (This is often known these days as Acceptance and Commitment Therapy, ACT, a spinoff from Cognitive Behavioural Therapy, CBT. Too many acronyms!)
There’s some overlap between management and coping, of course. The terms are informal, plenty of wiggle room, and everyone puts their own spin on them. But I want to highlight that basic distinction between partially effective treatment and symptom harm reduction — both valuable concepts for chronic pain patients, regardless of how we label them.
The best evidence for treating persistent pain points towards improving general health, as opposed to fixing specific “issues in the tissues.”
~ Playing With Movement, by Todd Hargrove, p. 217
How to “do” personal growth
There is no one way of doing personal growth, but here are some guidelines:
- Make sure you know how pain works, in particular. No single topic for study offers greater potential benefit. Although it is not possible to think pain away, there are some great tricks to “hack” pain neurology that are well worth knowing about. See Pain is Weird.
- You will have to be deliberate about it. It won’t be enough to just tell yourself it’s time to grow up and get your shit together. You’ll need to accept the premise that there’s work to be done, and do it. Take action to solve problems in your life.
- Human hang-ups and self-limiting behaviours are all about being in a rut, being stuck in your ways. One way or another, you will need to challenge yourself with unfamiliar experiences, show emotions previously unexpressed, and generally be willing to do and experience things you are probably uncomfortable with. (Hint: other human beings will have to be involved. Most of our ruts involve limiting our relationships in some way.)
- You will need expert advice, perspective, and instruction. Ignorance is the largest single barrier to personal growth: most of us simply do not understand what makes people tick, least of all ourselves. We need to consult people with vast experience. Read books, go to workshops, and find any wise-seeming mentor who has worked with a lot of people: a psychologist, an athletic coach or teacher, a leader or manager, a clergyman.
- Intense sensations may be a powerful catalyst for personal growth, which is one reason why massage and bodywork may be valuable services and tools for this goal. Whether it is the specific goal of therapy, or simply a natural side benefit, strong and novel sensations can change your sense of yourself, how it feels to be in your skin, and perhaps bump you out of some other sensory rut, which may in turn give you some better leverage on your emotional ruts — because physical and mental states affect each other fairly strongly. Even just the close contact with another person may constitute an emotional earthquake for you.
- Anxiety, stress, depression — all related and overlapping — are probably the largest single category of mental health challenges that hold people back in their lives. They’re such a big deal collectively that many of us could focus on them for the rest of our lives and consider it “personal growth.” But these familiar bogeymen really are only part of personal growth. Working on them is like fixing a broken engine. Personal growth goes beyond that: it’s more like building a better car. But you have to fix the engine first!
Or you could take a shortcut …
There are an infinite number of ways of going about personal growth. However, going to Haven is one the best and simplest. But not easy. And not cheap.
Haven is an unusual school on Gabriola Island, on the west coast of British Columbia, Canada. Started in the 1970s by a pair of creative psychiatrists,8 Jock McKeen and Bennet Wong, Haven now hosts many “experiential” workshops. It’s much less “new agey” than some other famous West Coast institutions (Hollyhock, Esalen) that basically just rent space to any motivational speaker or spiritual guru who can draw a crowd. In contrsat, Haven is devoted to education, and it is an actual diploma-granting school for counsellors. But regular people study along with them.
Haven’s founders believed that life is a fine art that must be learned — and can only be learned from other people, including people with much more experience.9 The best course to start with is called Come Alive, a “crash course” in a lot of their basic ideas. This is the shortcut.
And here’s another handy shortcut tip: the good news about using personal growth as a general approach to healing is that it’s not unusual for your primary health concerns to be directly associated with your biggest personal hang-up. If you go to Come Alive, for instance, you might want to think about focusing on whatever your most obvious “damage” is. This simplifies things quite a bit!
The bad news: why all of this is so damn hard
In our privileged lives, we are uniquely smart enough to have invented these stressors and uniquely foolish enough to have let them, too often, dominate our lives. Surely we have the potential to be uniquely wise enough to banish their stressful hold.
~ Robert M Sapolsky, Why Zebras Don’t Get Ulcers, 2004, p. 408
Surely! But, unfortunately, it’s often very difficult. Here’s a hot tip, something to watch out for. There’s this terrible catch-22 in personal growth …
If you were the kind of person who could easily change the thing about you that makes you hurt, then you probably wouldn’t have the problem in the first place.
There’s a reason that people don’t routinely experience surprising recoveries from deeply intertwined psychological and physical suffering: it’s really, really difficult.
About Paul Ingraham
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
- Haven is a world-class educational facility on Gabriola Island, which also hosts the general public for its personal growth workshops.
- PS Pain is Weird — Pain science reveals a volatile, misleading sensation that is often more than just a symptom, and sometimes worse than whatever started it. In particular, this article gets into some pretty specific details about mind-over-matter and just exactly how much mental states can or cannot effect pain.
- How chronic pain has made me happier. Rob Heaton does a great job of telling his story and describing the relationship between personal growth and chronic pain.
- All in My Head: An epic quest to cure an unrelenting, totally unreasonable, and only slightly enlightening headache (book), by Paula Kamen. amazon.com ❐ Like PainScience.com, this book offers an unusual combination of both humour and information about pain. Kamen is a completely engaging writer, and tells her story with both journalist rigour and personality.
- PS Why Do We Get Sick? — The curious and tangled connections between pain, poor health, and the lives we lead
- PS The Art of Bioenergetic Breathing — A potent tool for personal growth and transformation by breathing quickly and deeply
- PS The Anatomy of Vitality — What makes life tick? A poetic romp through the substance of vitality
- When the Body Says No: The Cost of Hidden Stress (book), by Gabor Maté. amazon.com ❐ With clarity and passion, Vancouver physician Gabor Maté tells the stories of people whose pain and illnesses emerged from lives filled with stress, anxiety and depression, illuminating the next frontier in medicine: the elusive mind-body connection.
- PS Anxiety & Chronic Pain — A self-help guide for people who worry and hurt
- PS An Open and Closed Case — An explanation for a strange duality of muscle sensation observed in massage therapy
- Smile or Die: How positive thinking fooled America and the world (book), by Barbara Ehrenreich (book review). Barbara Erenreich’s report on the cult of optimism that has sprung up around breast cancer. A substantial excerpt of the book is available, originally published as an article in Harper’s Magazine in 2001. The inferior US title is Bright-Sided: How Positive Thinking is Undermining America.
What’s new in this article?
2018 — New (short) section, “Pain management versus coping.”
2018 — New section: “Practical example #2: ditching toxic relationships.” Inspired by Wilson et al (spousal empathy, sympathy have an impact on chronic pain).
2016 — Significant revision. Migrated many points to footnotes for readability. Added several new links. Clarified the purpose of the article (what it is, and what it’s not). Added a fun featured image.
2006 — Publication.
- I won’t be citing science to support the claim that personal growth can treat some kinds pain, because there really is none, and there probably never can be: personal growth is impossible to measure. There is no way to quantify “wisdom,” and so there is no way to know if increased wisdom causes pain to resolve. This article isn’t really making that case: it’s making the case that it’s worth a shot, and inherently valuable in any case. BACK TO TEXT
- Because the brain’s notion of what is threatening (and therefore painful) is so lavishly multifactorial. So when Hency Rollins said “pain is personal,” he expresses something more beautifully science-based than he might have realized. Or, knowing Rollins, perhaps he knew it quite well. BACK TO TEXT
- And probably not just because problems often finally go away on their own, although they do. Regression to the mean — the tendency of conditions to drift back towards average — accounts for a lot of recovery. Personal growth may be one of the mechanisms by which that occurs. One of the reasons so many health problems gradually get better is because we adapt and change as people. A simplistic example: if someone has an overuse injury like plantar fasciitis that keeps her from doing a favourite activity like walking, it may take her quite a while to accept that she just can’t walk as much as she used to. She may go through complex phases of denial and frustration and resistance to alternatives before finally coming to grips emotionally with the idea that her life has to involve less walking, at least for a while. It’s not until her behaviour is changed by this acceptance that her feet finally get a chance to heal. Did she “regress to the mean”? Or did she grow as a person? It’s both. BACK TO TEXT
- Working as massage therapist (2000–2010), sometime it was really clear that my clients’ pain was bubbling up from a deep well inside of them, and it was going to keep coming no matter how much I tried to hold it back with my hands. That’s a poetic way of saying that sometimes the pain obviously had everything to do with the state of the patient’s nervous system (not necessarily their psychology, but that too), and little or nothing to do with the state of their tissues. BACK TO TEXT
- Alcohol abuse, of course, is a common problem, and often predates pain problems, starting out as a coping mechanism for something else entirely, quite possibly the lesser of evils in the beginning, and only later, slowly, insidiously becomes the greater evil: a driver of severe chronic pain. But by that time it is a habit and an addiction so entrenched that it seems like part of the fabric of life with no obvious connection to the pain! BACK TO TEXT
- Goldstein P, Weissman-Fogel I, Shamay-Tsoory SG. The role of touch in regulating inter-partner physiological coupling during empathy for pain. Sci Rep. 2017 Jun;7(1):3252. PubMed #28607375. ❐ PainSci #53159. ❐ A small test with straightforward results: acute pain was muted when romantic partners held hands, at its worst when separated. Chronic pain is a different beast, but the results probably apply to some degree. BACK TO TEXT
- Wilson SJ, Martire LM, Sliwinski MJ. Daily Spousal Responsiveness Predicts Longer-Term Trajectories of Patients' Physical Function. Psychol Sci. 2017 Jun;28(6):786–797. PubMed #28459650. ❐ PainSci #52829. ❐
Empathy and sympathy matter. Please, wives and husbands, don’t roll your eyes at your spouse’s symptom reports! In this study of 145 people with knee osteoarthritis, patients whose spouses were more openly sympathetic did better compared to those whose spouses were “punishing” or merely “solicitous.”BACK TO TEXT
- That’s personal praise: I’ve spent time with them. 😃 BACK TO TEXT
- They first got interested in group therapy when they famously noticed that people were doing better talking to each other in their waiting room than they were in individual therapy. So, to this day, workshops at Haven are all about doing and trying things with other people — tinkering with social context, and doing it with expert input from people who have spent decades carefully observing and participating in the human experience. BACK TO TEXT