Pain Recovery for Families. Robert Hunter
Pain Management Experience _________________
List the medications that have been prescribed for _______________, as well as those he or she is using that are not prescribed (put a P next to those prescribed and an N next to those not prescribed). You can refer to the list in Tables 1.1(a) and 1.1(b).
Now list any substances _______________ has used in addition to medications.
Include alcohol, over-the-counter products, cigarettes, caffeine, and illegal drugs.
Finally, list any treatment modalities or procedures _______________ has used or undergone for pain management. Indicate “+” or “–” as to whether they were helpful or not.
As you read this chapter, your mind may be churning with frustration, fear, anger, and confusion. How did you get here, and what do you do now? Is there a way out? Indeed there is, so read on and get ready to work. In the next chapter, you will see more clearly how your life has become based on the well-being of your person with pain. And you will begin to see how you can move toward balancing your own life, regardless of how _______________ is doing.
2 How Families React to Chronic Pain
After Jim’s injury, he was laid up in the hospital for a while, then came home and hadn’t worked since—over four years ago. He couldn’t sit up or concentrate long enough even to do therapy. He was severely depressed and in pain twenty-four/seven. Two surgeries and countless epidural injections had left him no better, and, in fact, worse after the last surgery; now he had burning and tingling down his right leg that kept him from resting, so he was up and down all night. Mary nursed Jim in the hospital and at home for as long as she could, but finally money was running out and she was compelled to return to work. At the time, she still had one of her kids at home, whom she felt she was abandoning because she had to leave to work nights as a nurse at a local hospital. It was actually a relief to be out of the house (though she hated herself for feeling it). At least she could care for people who got better. And she didn’t have to live with them—with their pain, their complaining, their depression, and their anger. At home, that’s mostly what dominated her life and the life of her family. Jim tried his best, but it seemed like his best wasn’t nearly enough. The pain was getting the best of him, and driving them both, not to mention the kids, crazy!
Thankfully, Mandi was out of the house, recently graduating from college and going on to graduate school. She wanted to help, even offering to quit school and return home, but Mary categorically refused. The last thing she wanted was for her successful daughter to get sucked into the downward spiral that had become their life. Ross had become more sullen and withdrawn lately. Mary was sure he was missing his dad. They were both subject to Jim’s moodiness—one minute shouting, the next crying. Mary knew it was taking its toll on her teenaged son and didn’t know where to turn.
When chronic pain is introduced into the family, everything changes. Along with these changes, a variety of confusing and negative emotions often develop as the whole family is thrown off balance by role reversals, medical concerns, financial and legal worries, and other lifestyle shifts. It can be difficult for even a well-functioning family to adapt in a positive way; in fact, it is uncommon to see a healthy adjustment to such a trauma.
While every family’s experience is unique, there tends to be a pattern to how families respond to chronic pain, which may occur rapidly or over a long period of time. When a member of the family becomes disabled by chronic pain, the rest of the family steps up and takes on more responsibilities. These responsibilities can include earning money for the family, doing household chores, caring for children, and any other functions the person in pain fulfilled in the past but is now unable to fulfill. As family roles change, each person’s sense of self has to readjust. Mary had stopped working as a nurse to become a full-time mom, and all of a sudden she had to figure out how to earn a living for the family when Jim could no longer work. Jim’s pain changed his identity as the breadwinner, and also caused him to be absent from activities he enjoyed with the kids—soccer practice, helping them study, etc.
With the role shifts, everybody suffers an incremental loss as a little bit is chipped away from their sense of self and the part of them that was defined by their relationship with the person in pain.
A shift you may have experienced is that suddenly ______________ has become the central figure in your life, with everyone else revolving around him or her: running, getting, doing, trying to make things better, compensating for, and trying to fill the vacancies. This can leave you with little time to take care of or enjoy yourself. You may be feeling resentful or depressed, but you may believe that these feelings are inappropriate because you are not the one in pain. You have become less interested in your own needs, because _______________ is the one who needs attention.
Mary’s role as Jim’s caretaker eventually became her primary identity. This continuous sacrificing of her own needs to the needs of another led to her feeling overwhelmed by feelings of anger, sadness, and guilt, which began negatively affecting her own health.
Often with chronic pain, everyone in the family system feels like they’re carrying a burden. Everyone feels victimized by the pain, but may not be communicating their feelings to each other or seeking support to help them cope, at a time when they need support the most.
{exercise} 2.1
Am I Out of Balance? _________________________________________
Please answer “Yes” or “No” to the following questions. Fill in the blanks with the name of your family member who has chronic pain.
| Yes | No | Does your life revolve around _______________? |
| Yes | No | Is your well-being dependent on _______________’s well-being? |
| Yes | No | If _______________ hurts, do you hurt, or are you unable to have fun, concentrate on your work, or take proper care of yourself or others in your life? |
| Yes | No | Do you feel guilty when you are impatient, annoyed, or simply not there? |
| Yes | No | Is your life spinning out of control in your attempts to help? |
| Yes | No | Are you depressed, angry, fearful, anxious, irritable? |
| Yes | No | Are you unable to see any way out of these emotions? |
Taking a Family Systems Approach
Describing the family as a system helps us to better understand the effects of chronic pain on the family as a whole, rather than on each member individually. In a family systems approach, what is important is looking at the