Hurt Feelings
Fear Itself
I’m scared to imagine aging in chronic pain.
Late at night, after watching Stephen Colbert, I lie in bed trying to fall asleep while my mind drifts to terrifying thoughts.
Despite trying to fend them off by mentally singing the chorus to “Let It Go,” the hit song from Frozen, disturbing notions float through my brain. The worst isn’t the Big D, though. It is the reverse: worry about living into old age with my severe chronic pain — mostly from degenerative osteoarthritis due to a rare genetic disease.
What, I ask myself, will life be like the next day, the day after, and so on throughout the years as my body continues to decay? There, in the dark, my fear of future pain is overwhelming.
Unfortunately, pain comes for most of us oldsters. According to the National Institutes of Health (NIH):
— An estimated 65 percent of U.S. adults over the age of 65 report suffering from pain and up to 30 percent of older adults report suffering from chronic pain.
— 48 percent of older adults suffer from arthritis.
— 55 percent of older adults in long-term-care facilities say chronic pain impacts their daily function.
That’s scary. It turns out there is a name for what I feel: algophobia. Explains the Cleveland Clinic:
“[It is] an extreme fear of physical pain. While nobody wants to experience pain, people with this phobia have intense feelings of worry, panic, or depression at the thought of pain. … It’s most common in people with chronic pain syndromes. Other names for this condition include ‘pain-related fear’ and ‘pain anxiety.’ … One study suggests that half of people with low back pain have an elevated sense of fear about their pain.”
Makes sense. When pain is a constant in your life as a senior, you’re on alert all the time. Anxiety builds as you anticipate the next ache, stab, or burn. In the worst cases, the phobia can bring out-of-control panic attacks. (I am fortunate not to have experienced that yet.)
Fear is part of the fight, flight, freeze mechanism we all have. Our bodily sensors — touch, sight, sound, taste, and smell — are constantly arrayed against harm. They gather data about what’s going on inside and outside our bodies, ready to react if pain threatens. We are sensing machines — feeling, yes, but more so thinking, analyzing, imagining, anticipating, fearing.
Normally, sudden hurt is a screeching alarm that something is wrong. What doctors call “acute pain” zaps you, activating the instinct to do something to stop it: clench your muscles against it, scream to blow off the feeling, or break out in sweat. If you’re lucky, eventually whatever caused the acute pain heals and the problem goes away.
With chronic pain, however, the hurt endures. It persists and resists treatment for three months or more. Worse, high-impact chronic pain (HICP), defined as also affecting daily lives and activities, leaves those of us who have it in a constant state of dread.
The mind girds itself against further hurt. Imagination anticipates the pain to come. Fear distorts thinking.
Ironically, also according to the Cleveland Clinic:
“Unfortunately, exaggerating the threat of pain can actually make the pain worse. … The same chemicals in your brain that regulate fear and anxiety also regulate how you perceive pain. So chemical imbalances can trigger both problems.”
So, Catch 22: Trying to avoid pain causes more of it.
In my body, fear and pain have a weird relationship. I’ve noticed that my mind doesn’t remember pain well. Once the hurt is eased, the memory fades. My wife tells me that’s why women choose to have more children after their first; the agony of childbirth recedes with time.
The trauma remains, though. When it comes to hurt, the body keeps score. For me, the problem isn’t so much the pain itself; it’s the anticipation of pain that hurts the most.
My dread of more pain as I age is both short-term and long-term.
In the short term, each moment may bring another hurt. It’s like a scary movie: The buildup, accompanied by spooky music, is more stressful than the actual monster, no matter how gross, gooey, or gory.
Fear of painful shocks makes me consider my movements carefully. I stress at the thought of getting up from my La-Z-Boy and doing something as simple as walking into the kitchen for a handful of Wheat Thins and a Propel. Every move is a wary calculation about whether the result is worth the pain I’ll feel. Mostly, I prefer to sit still.
Over the long term, fear grabs me on an even deeper level. Because of my anxiety about more pain, I feel an existential dread of the future. I envision how my life will be at age 70, 75, or 80 if I live that long. I imagine myself decayed and suffering. At worst, I wonder whether I can survive all the pain to come as I get older.
The battle is to not let panic, either short-term or long-term, ruin my life. Yes, objectively I’ll have pain as long as I live. Dealing with the emotional fear of pain, though, is often as much hard work as physically coping with it. It’s tough to keep fear — something so basic to being human, something so instinctive, something so irrational — from getting the better of me.
Remember the momentous words of President Franklin Roosevelt:
“The only thing we have to fear is fear itself.”
He meant that anxiety is often worse than the problem at hand — in this case, the Great Depression of the 1930s.
When you have chronic pain, particularly my kind that becomes worse with time, fear can be all-consuming. The thing to do, though, is not panic. I’ve come to realize that my fear of chronic pain as I age is theoretical — a mere imagining of a future that may never come. So many other things could happen instead, including the Big D, that it’s wasted emotion to worry about one particular possibility. As Roosevelt pointed out, anxiety is the real enemy.
In the end, more than the pain itself, I fear the fear.
Randall H. Duckett is writing a book about the emotions of chronic pain and invites fellow sufferers to share their stories in it. He is also the author of Seven Cs: The Elements of Effective Writing (available on Amazon). He can be reached at randall@hurtfeelings.life.
