Everyone suffers difficulties and adversity of some kind, examples of which are mental illness, disability, pain, illness and stress. Not everything is under our control and we have widely varying ways and success of dealing with these stresses. How content we are with our lives and how effective we are at life management depends on our ability to cope with these events. If we can be realistic and generate a plan for managing then success is the more likely outcome. What happens to us when we suffer setbacks is complex and we need to address several parts of the situation.
Loss figures in many of the challenges we face and this needs to be recognised as many consequences flow from this. We accept without question when we do not have any pain and feel a loss when our bodily comfort is removed. Simple activities are affected such as doing the gardening, getting the shopping and sitting in a restaurant or cinema. As we get older many changes creep up slowly upon us and we may not be happy with these and find them hard to accept. A sudden and dramatic change in our comfort or ability is much more difficult to accept, particularly if we are young or very active.
Other losses we can suffer are loss of a relationship, death of a loved one, loss of job, loss of role in life, loss of income, loss of a part of the body and so a loss of our sense of self and self-esteem. Loss of some kind which leads to the single most disabling condition in the world, depression. When we are depressed we undergo a change in our brain chemistry which causes us to think negatively and to apply a continual negative bias to all our thinking and conclusions. This is important for its own sake in terms of our mental state but also because a high proportion of depressed people suffer a pain condition of some kind.
As we struggle to come to terms with our losses we can fall into depression and become hopeless and be unable to take the actions which would help us out of our situation and thereby alleviate our depression. This position may need cognitive therapy and/or antidepressant medication to start the process of a more realistic interpretation of our position and so begin to lift the negativity we have fallen into. If we do not become depressed we may react in another typical and natural way to our losses by fighting against them.
I’m just not going to let the pain beat me is a very common sentence uttered by pain patients, turning their condition into a competition which pain is not going to win. This strategy is commonly pursued as people try to maintain control in bad circumstances, pushing themselves to keep going with their duties. There is a significant downside here though and that is the very high costs of holding a continuing battle with pain by pushing on, leading to a decline of ability, increasing pain and depression.
One of the key concepts here is conflict. Conflict between what we should be able to do and what we can actually do. Conflict leads to feelings of aggression towards the pain and towards the world which is making demands upon us which we cannot satisfy. This way we develop a conflictual relationship with others and with ourselves which leads us to become stuck in one particular approach This is mostly because we have not moved towards one of the most useful reactions to a problem we can’t do much about, acceptance.
Acceptance is an important concept and not to be confused with resignation. Resignation is where we give in to the things which have happened to us and feel whatever we do will be ineffective, nothing will achieve a positive change and we just have to put up with it no matter how bad the situation is. This is a negative interpretation of our situation will inevitably lead towards a depressive state and prevent the person from taking any steps to improve their situation. So resignation is an undesirable state and learning acceptance is likely to be more functional and have better consequences for our futures.