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.
Sleep Assessment and management i
Sleep Assessment and management ii
Do you have a pain management skill you want to know more about? Leave a comment and I’ll see what I can do!
Lazarus, R., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer
Date last modified: 1 March 2008
Although the intent of your sight is great I don’t see where it is I can find the solutions you speak of. You might make it easier for those of us with limited concentration, because we’re in such pain, to find the suggestions you elude to in your articles. Just a thought, and thank you for the contribution to those of us who suffer.
I’m not entirely sure of what you’re asking for… there is a search function on here, and some simple strategies listed in a separate section of the blog (the
Coping Strategies section). It’s great that people who have chronic pain come across my blog, but please do remember that I write the blog primarily for clinicians working with people who have chronic pain. It’s important to have a good relationship with a clinician who can work with you to develop and integrate the strategies I discuss, because this blog isn’t intended to be a replacement for specific clinical input.
“Hypnosis is often used in pain management, but meets with some suspicion from people unfamiliar with its use in health.”
this comment caught my attention because I had just had this conversation with a client of mine about hypnosis because he uses it. He suggested using, ‘motivational training’ or ‘brain food’ instead of ‘hypnosis’ because there seems to be a lot of negative opinions about hypnosis
Great idea! It is funny how hypnosis has so many connotations while ‘brain training’ does not, yet that is really what we are doing all the time!
Hey, I noticed you contributed to the “save yourself website” Do you know any good people in Wellington, NZ, for Myofacial Pain Syndrome treatment?
It depends a little – mainly whether your diagnosis has been confirmed, what outcome you’re looking for (pain reduction or pain management), and whether you’re wanting private or public treatment. Two pain management centres exist in Wellington: Hutt Hospital Pain Service and Wellington Pain Clinic. Both are public, but I’m not sure of the referral and acceptance criteria, but both provide medical management as well as self management.
I don’t know any private clinics in Wellington, nor individual practitioners, but you can always begin with these two.
Thanks, Wellington’s pain clinic suggested I had Myofacial Pain. I’m considering a variety of options at the moment (Tigger Points, Alexander Technique, and the Feldenkrais Method).
Additionally, I found a specialist Dr Jonathan Kuttner in Auckland who may be able to help.