Rebecca Campbell’s husband was recently laid off, she has four children to care for – in addition to her job as a caregiver – and the added stress was building to a painful attack of fibromyalgia in the middle of her back.
“The not knowing almost put me into a fibro-spin,” she said. “But I said no, I can’t do it.”
Across the conference room table, Lawonda Posey, who also suffers painful attacks from fibromyalgia, nodded in appreciation.
“For you to be able to talk yourself out of it shows such a strong will,” she said. “I don’t know if I could do it.”
“It took a lot of willpower,” Campbell said. “But it also took a lot of faith.”
The two women are part of the Chronic Pain Support Group that meets twice a month at Augusta Pain Center, where they can share their experiences and talk about techniques and strategies that have helped them .
Pain was once considered strictly a physical phenomenon directly related to tissue damage, but in the 1980s it was assessed more comprehensively to include emotional and behavioral elements, such as its impact on the patient’s life and family, according to the American Psychological Association.
Pain psychology is a relatively new field but is gaining a wider acceptance, said Dr. William S. Schiff, a clinical psychologist who specializes in pain at Augusta Pain Center.
“It’s become a lot more popular in the last couple of years, especially as some insurance companies or providers are being specifically taught that they should have an evaluation done in regard to pain psychology,” he said.
An evaluation can better assess the elements that could be contributing to the pain and help spot those who might misuse or abuse pain drugs. A negative emotional and behavioral response to pain can physically add to symptoms, Schiff said.
“It’s all based on biological responses,” he said. “I don’t want anyone to think that the negative downward spiral is psychological. It is a physiological response. Your body is tensing up, those nerve pathways are opening up.”
It can lead to what is called “pain catastrophizing,” a condition where patients have a “tendency to magnify the threat value of pain stimulus and to feel helpless in the context of pain,” according to a review article in the journal Expert Review of Neurotherapeutics.
Schiff said he sees it too often.
“It almost cripples their ability to function,” he said. “Sometimes it can create a situation where they become paralyzed by the fact that they have pain and they are unwilling to explore other options.”
Pain is different for different people. Campbell said hers “feels like somebody is taking my muscles and just wringing and twisting (them)” in the middle of her back. For Posey, “it is more the nerve endings all over my body make me just hurt at the surface,” she said. “I wake up in pain like there are needles all throughout my body.”
But they also share a common chronic fatigue.
“I get tired and I get that fog where you just can’t think of your words,” Posey said.
Over time, chronic pain can alter a patient’s sense of identity, particularly when it meant losing a job or having to give up certain responsibilities. After being laid off, Posey now has to consider how she might be able to re-enter the workforce.
“What can I do or can’t I do?” she pondered. “What do I need to do and how do I fit in?”
After her second back surgery three years ago, Campbell said she had to consider possibly having to give up being a caregiver.
“I’ve been a caregiver for so long that I don’t know who else to be,” she said.
While medications help, patients can also find relief through breathing and relaxation techniques, Schiff said.
“When you do the relaxation response it is also a physiological response, the body is loosening up, there is less pressure on those damaged areas,” Schiff said. “It is not just tricking yourself out of pain. There is very sound research behind it.”
Campbell said her breathing can take her “almost into a hypnotic state” and allows her to “go to a different place and helps calm me down.”
For Posey, focusing on the breathing helps keep out stray thoughts that can lead to anxiety.
“You feel more at ease and think, ‘OK, I can get up and do this now,’” she said.
Being able to come to the support group is also helpful, the women said.
“It helped me immensely being able to have somebody else to communicate with,” Campbell said.
“It kind of makes me feel like I’m not the only one,” Posey said.