Pain and the Practitioner

Before I crushed a nerve in my leg, my career plan had been to become an attorney. However, I found that the fatigue and pain worsened by activity did not lend itself to actively practicing law. Instead, I found that Psychotherapy, was a great field for people with chronic illnesses because it does not require much physical activity. For people with chronic illnesses, or who are getting older, the flexibility of being a therapist provides options that allow for fulfilling employment that would otherwise be impossible.

However, for therapists like me, who are dealing with chronic illness, it is important to set yourself up for success through pragmatic planning. It is important to know your medical condition, what increases pain, and what makes it better. For example, if changes in weather exasperate pain, it is important as the therapist to inform clients that there may come a time when sessions need to be rescheduled. Hopefully, that happens rarely. The most important thing is to be honest with yourself about the severity and implications of your illness. How many hours can you realistically work in a day, and in a week? What is a sustainable pace? If you take on more than what you realistically can, your coping mechanisms will diminish. By not taking on too much, and engaging in restorative rituals, you can maximize your capabilities.

Chronic pain and illness cause changes to the mind and body. Fatigue is a common obstacle for people dealing with chronic illness. It is important to be aware of how fatigue impacts your personality and psyche. It requires extra focus to remain patient and present with your clients. Mindfulness is one technique that can help build the capacity of selective attention. Through practice, you can build the capacity to focus your attention away from your symptoms and towards your clients. Utilizing meditation or mindfulness before each session can help center yourself and prepare for the task at hand.

Dealing with chronic illness is frustrating and challenging. For this reason, as well as many others, it is even more important for the clinician in pain to use psychotherapy themselves. Understanding the interaction of activity and the perception of pain is critical in being effective in any work environment. Scheduling clients in manageable chunks that are broken up by periods of rest is critical for many people dealing with pain. It is important to be honest with yourself and pragmatic in figuring out solutions that decrease the impact of chronic illness.

Many pain conditions include unexpected spikes of pain. It is important to practice dealing with this pain without others noticing any effect. Practicing talking to people in very cold weather or other adverse conditions can help develop the ability to tune out the physiological sensations, in favor of the interaction with others. Decreasing personal stress whenever possible, adhering to a good sleep schedule, utilizing medications, mind-body techniques, nutrition, physical therapy, alternative medicine are all pieces of the puzzle of remaining active, even when dealing with chronic illness or disability.

Chronic pain and chronic illness affect all aspects of life. Therefore, an effective strategy for dealing with pain must chip away at it from all sides. When illness cannot be cured, the focus must turn to maximizing quality of life. By minimizing the distress that the chronic illness causes, and maximizing the quality of life, it is possible to continue to work. Therapy is a great field, because the focus is not on physical effort. However, it is critical to take a realistic assessment of your medical condition and its impact on your life. If you’re able to minimize the amount of time that you could potentially miss, and are able to pay attention to your clients and to be present with them in the moment, it’s possible to be effective and help people. It’s critical to take a pragmatic view of your medical condition and your life to devise strategies to minimize the effect of the illness. This often includes a holistic strategy that includes good sleep hygiene, nutrition, exercise, stress reduction, medication, and therapy to minimize the distracting effects of the illness. Sometimes, the practitioner’s illness can have a therapeutic effect on the client. Illness touches everyone’s life in some way or another.

Matthew Purinton, MSW, LSW is a Staff Therapist in Council for Relationships’ University City office and can be reached at 215-382-6680 ext. 3135.