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Pain Management: Cognitive Therapy for Chronic Pain & Fibromyalgia-Abb10
On the last track, we discussed three concepts related to redefining self-worth in chronic pain clients. These three concepts related to redefining self-worth included: poor self-image; grieving; and building the new identity.
On this track, we will examine three manifestations of anger commonly found in chronic pain clients. These three manifestations of anger commonly found in chronic pain clients include: anger arising from limitations; outbursts; and inbursts.
3 Manifestations of Anger
#1 Anger Arising from Limitations
Carol, age 31, had an enflamed disc in her spine that caused her constant pain. One day, a new manager at her office asked her to carry a box down to the warehouse. Unable to carry the box, but also equally unable to explain her weakness to her manager, Carol instead asked one of her friends to do the task for her, but still complained about the ignorance of her new employer. Carol stated, "He didn't even ask me if I could carry that box, he just ordered me to! He's such an inconsiderate ass! I bet if he expressed one ounce of concern for his employees, his head might implode."
Carol's unwarranted anger was quick in passing, but I still asked her to explain her condition to the manager the next day. I stated, "I know that you know people cannot read minds. If you do not explain to the people around you about your back pain, you will only find yourself becoming more and more angry at your situation." I asked Carol to make a list of people that should know about her condition to reduce the frequency of her angry outbursts.
Think of your Carol? Is he or she angry about his or her limitations?
Outbursts, however, often have more than one source. Clients with chronic pain tend to be easily frustrated due to the anguish that their condition causes them. Because of this, many clients build up quite a bit of small grievances that can erupt in an inundation of vehemence. Most of the time, the victim of these onslaughts are undeserving loved ones and family members. As a result, relationships become strained to the breaking point, all because the client cannot control or express his or her anger in a productive manner.
Hal, age 41, became easily annoyed at his inability to perform the slightest house work due to the fibromyalgia. In addition, his constant pain continually affected his ability to keep track of menial tasks and conversations. Hal stated, "I always have to ask people to repeat themselves, and I can't keep track of anything! I don't get mad that easily, but when the little things start to build up, it can really hurt my mood! Sometimes I'll just blow up at my wife Tiffany, and she doesn't even know what she did wrong!"
To help clients like Hal who are prone to sporadic outbursts at loved ones, I suggest simple anger control techniques such as counting to ten. Another technique is just going out for a walk. For fibromyalgia clients, this exercise is threefolds helpful: relieves the pain in their joints and leaves them a clearer head; it gives them time to cool off from their potential outburst; and it gives them the satisfaction of completing a task.
Think of your Hal. What other activities could he or she try to quell his or her anger?
Martha, age 47, suffered from lupus and in addition to the pain she experienced, the disease also exhibited itself in red rashes. Martha stated, "I hate my body! I hate it! Why is it doing this to me? I'm in pain and I'm hideous! My husband probably can't even stand to look at me. He thinks I'm a mess and not worth his trouble. He's so superficial!" Martha's dissatisfaction with her appearance created an acute self-hatred.
She had internalized her anger, directing her fury at herself which came out in a direct attack on her husband. Like Julia in the previous track, I asked Martha to create a list of positive character attributes that she could use to boost her self-esteem. Like redefining identity, this exercise forces the negative-thinking to pull out the positive and thus begin them on a path to self-satisfaction.
Think of your Martha. How is she internalizing her anger? What does this arise from?
On this track, we discussed three manifestations of anger commonly found in chronic pain clients. These three manifestations of anger commonly found in chronic pain clients included: anger arising from limitations; outbursts; and inbursts.
On the next track, we will examine three concepts related to helplessness. These three concepts related to helplessness include: humility vs. humiliation; catastrophizing; and asserting independence.
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