Chronic Pain and the Power of Perception: First in a Series

Many individuals who suffer from chronic pain often experience low moods, ranging from depression to outbursts of anger. They find it difficult to maintain physical activity or manage daily life, which in turn can deepen their depressive tendencies.

Low mood not only brings its own challenges, but it also intensifies the experience of pain because it breeds hopelessness, isolation, and obsessive thinking about the pain. Such thinking is like placing a magnifying glass over the pain.

A key difficulty with chronic pain is the constant focus on it. The pain becomes the center of a person's life: either in trying to find a cure or in questioning "Why do bad things happen to good people?" Of course, introspection is important- Jewish tradition values self-reflection and the idea of measure-for-measure as a tool for growth. However, that reflection should happen occasionally, not as a continuous loop whenever the pain flares up. Obsessing over suffering usually leads to frustration and despair, because it stems from a place of hopelessness.

This constant negative thinking also prevents the person from engaging with other aspects of life such as learning, work, hobbies, and interests that can actually help reduce their suffering.

It also damages relationships, cutting off healthy communication with family and friends. The person becomes consumed by a narrow world defined entirely by pain.

Measuring Pain

We must recognize that a hopeless person eventually gives up on trying to improve their condition, which can make the situation feel irreversible. Even worse, despair is contagious, so that when the person in pain gives up, their loved ones often give up too, ceasing their efforts to support and help.

What can be done?

One powerful tool is keeping a pain journal: record every instance the pain occurs and note its intensity on a scale of 1 to 10, where 1 is minimal pain and 10 is the most severe.

This is helpful because most people with chronic pain don’t actually experience the same level of pain all day long. However, in their minds, they perceive the pain as constant and severe, basing that perception on the worst moments that stick in their memory.

When someone believes their pain is consistently intense, they give up before even trying. They assume they are incapable of functioning at all and identify themselves as “a person in constant suffering.” Their self-image becomes one of limitation and agony, and they stop trying to function because they mistakenly believe that someone in their condition simply can’t.

A detailed journal can demonstrate that pain fluctuates throughout the day. There may be long stretches where the pain is low or even absent which are windows of opportunity for productivity, joy, or connection.

For example, a person may experience pain at a level 4 in the morning and a level 8 in the evening. Without tracking it, they may conclude that their pain is always at level 8- because the high points are the most emotionally memorable. They conflate the feeling of pain with an untested assumption that they are completely incapacitated. They assume that if they are in pain, they can’t function- althought this is often not true.

Someone who believes their pain is always at level 8 will tailor their day accordingly, essentially surrendering to non-function. After all, pain at level 8 truly does make life difficult: it’s hard to speak, laugh, or care about anything outside the suffering.

However, the truth is that pain levels vary and do not remain fixed at all hours of the day. There are indeed many opportunities for a person to do something meaningful to lift their mood and improve their mental state.

Even someone suffering from chronic pain can create meaningful change in their life if they learn to identify fluctuations in pain and adjust their activity levels accordingly. Rather than surrendering to a false narrative of constant suffering, they can reclaim parts of their day, rediscover hope, and bring back a sense of purpose.