What do we mean by ‘coping’? The term ‘coping’ gets bad press from people with chronic health problems. ‘Coping’ can sound like ‘just dragging my way through every day…’ I truly hope we are offering people more than this!
The term probably draws most of its current use from Folkman & Lazarus’ (1984) work on responses to stress. Coping in this sense refers to ‘purposeful efforts to manage the negative impact of stress’. We could argue that not all efforts to manage stress are purposeful, but for today let’s hold with this definition.
Most of the literature on living with chronic pain indicates that active coping skills are more helpful than passive. Active skills are those that help people maintain activity despite pain (or limitations), while passive skills reduce activity level.
Our problems come when we try to define which skills belong in which category!
Some good examples are:
- relaxation training – passive? or active?
- ‘pacing’ or working to a quota – passive? or active?
- asking for help – passive? or active?
I can bet most of us would say ‘it depends’!
My approach to helping people develop coping skills is to provide them with a broad range of different ways of coping, and encourage them to identify for themselves the ‘good things’ and ‘not so good things’ about each one. Truth to tell, everything a person does to cope with a situation has worked in some way at some time – but may have unintended consequences that become problematic over time. I find it helpful to remember that each of us makes the best choices we can given the information we have at that time.
It is up to the person we are working with to thoughtfully (make that ‘deliberately’) choose the right skill at the right time in line with the importance they place on an activity – and their confidence to use each skill. As therapists, our job is to provide them with clear, unambiguous information on their choices, the consequences of those choices, and our support to help them develop confidence when learning new skills.
What coping skills are out there? Short answer – lots!
I’ll be reviewing a range of them progressively in these pages – along with resources for you to use.
First up is my friend ‘pacing’ – read on and get ready to think…!
Meaning-focused coping – looking for the good things in dark times
Positive statements – a simple way to help people use their own positive thinking to help themselves become more confident when facing challenges.
Checking thoughts during activity – eliciting automatic thoughts during activities can be a great way to identify barriers to using skills
Hypnosis is often used in pain management, but meets with some suspicion from people unfamiliar with its use in health.
Do you have a pain management skill you want to know more about? Leave a comment and I’ll see what I can do!
Date last modified: 1 March 2008