Emotional? Physical Feelings? Both? Confused!

"I am so angry! This person just irritates me so much. I don't know why! He just does."

"I feel so sad today. I think I'm unhappy with my job or maybe I am unhappy with myself...I am not really sure."

"I just feel so depressed and I don't know why."

It is not uncommon for people who live with chronic physical illness to at times experience unwanted emotions (e.g. anger, sadness, depression) and to be unsure about where these feelings came from. Sometimes the person is able to identify the cause of their emotion and other times the person may remain very confused about their experience. Oftentimes, one thing that people who live with chronic physical illness are not uncertain about is their physical pain or discomfort. For example, one can identify pain in the muscles, or a headache, or complete exhaustion. So how are these two things related? Emotional pain and physical pain...are they so seperate after all?

It takes up a lot of emotional energy when a person who lives with a chronic physical illness suffers or hurts physically. The pain may be felt in a physical body part such as a chest or a kidney but that physical body part is also a part of the entire human. There will certainly be some emotional reaction to the symptom even if the person has experienced the same symptoms thousands of times. A person can think to him or her self with ease, "I know what I am feeling right now. It is my ____ acting up." However, intellectual understanding does not necessarily negate emotional feeling. Even if a person has experienced this symptom numerous times it may make him or her furious that he or she needs to deal with this regularly or maybe very sad about the limitations it imposes on his or her life. It is easy to ignore these feelings in the service of a "I am used to this, life goes on" attitude, but these feelings will not just disappear; they will express themselves in one way or another. For example, one's anger about having to deal with the illness symptoms may be displaced onto a coworker who suddenly irritates the person to no degree for absolutely no reason, or a piece of constructive criticism at work causes one to break down in tears, masking the underlying sadness about the chronic illness. Displacement of the feelings of one's suffering onto something else in the person's life can leave the person feeling very confused and disillusioned.

It is sometimes not easy for a person to really admit to him or her self that the physical symptoms of his or her illness are causing emotional reactions. People may think "this darn illness is hurting my body and now its causing me emotional pain too!" Some people may feel that admitting to the emotional effects of the physical illness is letting the illness "get the best of them." However, in a way the opposite is true. If feelings are not acknowledged and directly and appropriately expressed, they will find a way to manifest...usually in a displaced way. It may be difficult but it is worth the struggle to get to the point where one is able to say, "I am angry because I hurt so much today" or "I am really sad that I can't run like I used to" or "I am depressed that I cannot be there for my kids in the way that I really want to be." Sometimes one may need to seek professional help, as this process of acknowledging how the physical and the emotional dance together as one can be very difficult.

People can ignore the holistic nature of being human...the interconnection of physical and emotional; however, pretending that a duality between body and mind exist does not in fact create such a duality. The feelings will still be there and if expressed inappropriately and in a displaced manner may cause more confusion and problems for people than would have resulted from the acknowledgment of the feelings stemming from the physical illness. Yes it is not always an easy task as these feelings may oftentimes not even be conscious as they can be so painful. It is important to seek professional help if you see that your emotions have been causing problems in your life, your social relationships, or your job since you have been diagnosed with your illness. Maybe you do not have to remain confused.

Pain's Life? No My Life!

Doctors can objectively measure blood pressure, heart rate, change in the number of antibodies or cells, and many other indicators of health and illness. How can pain be measured? Health professionals can ask people how much they hurt on a scale of 1 to 10 and monitor subjective changes in pain, or they can simply ask one to describe how he or she feels, but pain cannot be objectively rated. Sometimes when a person is in extreme pain, physical changes can occur, such as changes in heart rate; however, the level of pain that may lead to bodily changes in one person can be higher or lower than the level that will result in the same changes in another person. We all have different levels of pain tolerance.

Pain is a complicated phenomena; the experience varying from person to person and influenced by sociocultural norms, gender, age, mood, levels of stress, and one's ability to cope with the pain, as well as other factors. All people at some time in their lives experience pain, but many people who live with chronic physical illness have to manage pain much more often than those who do not. Having to manage pain on a daily, weekly, or even monthly basis can be frustrating, exhausting, and can take a huge toll on one's psychological well being. It is easy to feel depressed and defeated, and to sometimes become preoccupied with the pain as if it has taken over your life. Is it possible for you to take over the pain and to control your life?

When many moments are spent wondering when the pain will stop, little time remains for living and enjoying. Shifting focus from the pain to something interesting and pleasurable enough to make you want to be thankful for your life...even for a life with suffering is more than possible. Buddhist monk Pema Chodron writes, "If we're willing to give up hope that insecurity and pain can be exterminated, then we can have the courage to relax with the groundlessness of our situation" (Chodron, 2005, p. 46). Surprisingly, if one stops thinking about when the pain will end and allows space for thinking about something else, the pain will end for that time. This is how meditation works. People can train their mind to focus on whatever they want it to focus on, while relaxing in the experience that they are in in the moment--even a painful one. This is one of the reasons why pain tolerance varies from person to person. And if someone is paying attention to something that he or she enjoys it will likely affect his or her mood, and in effect mood also influences pain levels. When a person is happy at a given moment, he or she is likely to experience less pain than if the same person is unhappy in that same situation. It is a chain reaction.

All that said, this is not an easy process. Although it is difficult to measure pain objectively, physical pain is real and it hurts. It takes a lot of courage and strength to stand up to pain, and this process itself can be painful. Pain can be very powerful but do not forget that you are even more powerful. This is one of the reasons why pain tolerance varies between different people...because people can control the pain. You choose how to spend your time--your life. It is your life, not the pain's!

Chodron, P. (2005). When things fall apart: Heart advice for difficult times. Boston: Shambala.