Living with chronic pain can be very frustrating. Not surprisingly, people with chronic pain tend to report greater levels of anger than those without pain. Expressions of anger differ, with some people being more likely to suppress and hide it, turning it inward on themselves, and others turning it outward, letting it explode. Still others struggle to be someplace in-between – hoping for “healthy expression” of anger that allows the angry person to express his/her feelings without being aggressive.
How you express your anger can make a difference – the in-between approach may be best over the long-run. I have written before about anger management. Today I want to talk a bit about the consequences of anger and how to prevent anger from starting in the first place. In general, high levels of anger have been found to increase both acute and chronic pain, reason enough to try to prevent it! Besides making pain worse, anger can also take a toll on your relationships, especially with family. For example, recently, a reader wrote to me:
“Sometimes when I have a migraine, I lose my temper and treat my husband badly. I realize that this has hurt our relationship. How can I undo the damage and prevent myself from snapping at him in the future?”
We all lose our temper sometimes. Apologies are very important. We tend to underestimate the importance and power of a simple apology. An apology should be a straightforward expression of the fact that you lashed out and you feel sorry about it. You do not need to include an excuse or an explanation or a reminder of what the other person may have done before you lost your temper. Here are some examples:
- I’m sorry I snapped at you.
- I am really sorry that I was nasty.
- I feel bad that I lost my temper and yelled at you.
- I’m sorry that I sounded so mean.
- I feel bad that I was so crabby this morning.
- I am sorry about the things I said when I lost my temper.
- I am so sorry for screaming at you.
Talk to your family about the plans you have for anger prevention (see below). You may invite them to read this blog. Finding ways to prevent anger will help you manage your pain and reduce angry blow-ups at loved ones. A couple of ideas include: keeping a journal to express your feelings of frustration, using relaxation techniques, and improving your communication with family.
Keeping a Journal
In an interesting study by Dr. Jennifer Graham and her colleagues, pain patients who kept a journal over 9 weeks in which they wrote about their anger reported significantly greater control over pain and depression (as compared to a control group). The authors noted that the mood benefits were greatest when the writers were able to think about and gain insight into the causes and implications of the situation that had triggered their anger. If notice you are starting to feel angry or after an angry exchange, try to write about it. You may gain some insight, feel better, and be less likely to take it out on your family later.
It is difficult to be both angry and relaxed at the same time. If you can learn some relaxation techniques, you can use them when you notice that you are starting to feel frustrated. Relaxing may help you to prevent feelings of frustration from exploding into anger. In my blog last week, I talked about mindfulness meditation for chronic pain. There are other techniques as well designed such progressive muscle relaxation, use of breathing techniques, guided imagery. If you are a subscribed member of the Chronic Pain Management Program, I hope you have already found our suite of relaxation tools in the Feeling Better Learning Center. If you are not a member, there are many relaxation tools for sale online through iTunes or on Amazon.
Every family has areas where better communication will decrease opportunities for anger. Spend some time talking with your family about the “hot button” areas (e.g., household chores, conflicting goals, differences of opinion about how things should be done).
Choose one area to work on – maybe start with one that is less of a problem area and work your way up to the hottest issues. Come to an agreement on how you will communicate about the issue. Dr. John Gottman, a leading researcher on relationships, has discovered four ways of communicating that tend to erode a relationship: criticism, contempt, defensiveness, and stonewalling (tuning out, leaving the room, refusing to interact). Talking with respect, trying to see the other person’s perspective, and making an effort to show that you care about the other person’s rights and feelings, always go a long way toward healthy communication.
About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives as well as Think Clearly about Depression, a self-management program for depression.
DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.
PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.
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