Chronic Pain Quotes

Sometimes I think illness sits inside every woman, waiting for the right moment to bloom. I have known so many sick women all my life. Women with chronic pain, with ever-gestating diseases. Women with conditions. Men, sure, they have bone snaps, they have backaches, they have a surgery or two, yank out a tonsil, insert a shiny plastic hip. Women get consumed.

Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.

And we're such language-based creatures that to some extent we cannot know what we cannot name. And so we assume it isn't real. We refer to it with catch-all terms, like crazy or chronic pain, terms that both ostracise and minimise. The term chronic pain captures nothing of the grinding, constant, ceaseless, inescapable hurt. And the term crazy arrives at us with none of the terror and worry you live with.

What I mean is sometimes, for an artist, chronic pain can be a gift.

If I only could explain How much I miss that precious moment when I was free from the shackles of chronic pain.

Mental illness People assume you aren’t sick unless they see the sickness on your skin like scars forming a map of all the ways you’re hurting. My heart is a prison of Have you tried?s Have you tried exercising? Have you tried eating better? Have you tried not being sad, not being sick? Have you tried being more like me? Have you tried shutting up? Yes, I have tried. Yes, I am still trying, and yes, I am still sick. Sometimes monsters are invisible, and sometimes demons attack you from the inside. Just because you cannot see the claws and the teeth does not mean they aren’t ripping through me. Pain does not need to be seen to be felt. Telling me there is no problem won’t solve the problem. This is not how miracles are born. This is not how sickness works.

In fact, I do not think laziness exists. You know what does exist? Executive dysfunction, procrastination, feeling overwhelmed, perfectionism, trauma, amotivation, chronic pain, energy fatigue, depression, lack of skills, lack of support, and differing priorities.

God uses chronic pain and weakness, along with other afflictions, as his chisel for sculpting our lives. Felt weakness deepens dependence on Christ for strength each day. The weaker we feel, the harder we lean. And the harder we lean, the stronger we grow spiritually, even while our bodies waste away. To live with your ‘thorn’ uncomplainingly — that is, sweet, patient, and free in heart to love and help others, even though every day you feel weak — is true sanctification. It is true healing for the spirit. It is a supreme victory of grace.

I often wished that more people understood the invisible side of things. Even the people who seemed to understand, didn't really.

Pain is always emotional. Fear and depression keep constant company with chronic hurting.

People who don't see you every day have a hard time understanding how on some days--good days--you can run three miles, but can barely walk across the parking lot on other days,' [my mom] said quietly.

The erosion of an effective patient-physician relationship has no place when dealing with chronic pain. Worst of all, dismissing the patient's pain is as devastating as crushing a patient's hope.

Few things a doctor does are more important than relieving pain. . . pain is soul destroying. No patient should have to endure intense pain unnecessarily. The quality of mercy is essential to the practice of medicine; here, of all places, it should not be strained.

I started feeling afraid of my own body, like it was a torture chamber I’d been trapped inside.

The trouble with chronic pain is that it is so easy to become accustomed to it, both mentally and physically. At first it's absolutely agonizing; it's the only thing you think about, like a rock in your shoe that rubs your foot raw with every step. Then the constant rubbing, the pain and the limp all become part of the status quo, the occasional stabbing pain just a reminder. You are so set to endure, hunched against it - and when it starts to ease, you don't really notice, until the absence washes over you like a balm.

Surrender is an incredibly difficult topic in light of chronic illness, because loss is often continued and sustained.

Believing you have chronic pain or illness can cause it to be so. So too, believing you are healing can cure you.

I'm used to functioning in pain, asshole. Are you?

Somewhere inside that hurting body, there is something better, something stronger, something real.

Because we’ve been lied to and lied to, and it hurts to be lied to. It’s ultimately just about that complicated: it hurts. It denies you respect for yourself, for the liar, for the world. Especially if the lies are chronic, systemic, if hard experience seems to teach that everything you’re supposed to believe in’s really a game based on lies. Young Voters have been taught well and thoroughly. You may not personally remember Vietnam or Watergate, but it’s a good bet you remember ‘No new taxes’ and ‘Out of the loop’ and ‘No direct knowledge of any impropriety at this time’ and Did not inhale’ and ‘Did not have sex with that woman’ and etc. etc. It’s depressing and painful to believe that the would-be ‘public servants’ you’re forced to choose between are all phonies whose only real concern is their own care and feeding and who will lie so outrageously with such a straight face that you just know they have to believe you’re an idiot. So who wouldn’t fall all over themselves for a top politician who actually seemed to talk to you like you were a person, an intelligent adult worthy of respect?

She's terrified that all these sensations and images are coming out of her — but I think she's even more terrified to find out why." Carla's description was typical of survivors of chronic childhood abuse. Almost always, they deny or minimize the abusive memories. They have to: it's too painful to believe that their parents would do such a thing.

sufferers of depression, who can elect to keep their feelings private, experience chronic, unremitting emotional alienation. Each moment spent “passing” as normal deepens the sense of disconnection generated by depression in the first instance. In this regard, depression stands as a nearly pure case of impression-management. For depressed individuals, the social requirement to “put on a happy face” requires subjugation of an especially intense inner experience. Yet, nearly unbelievably, many severely depressed people “pull off the act” for long periods of time. The price of the performance is to further exacerbate a life condition that already seems impossibly painful

If your body is screaming in pain, whether the pain is muscular contractions, anxiety, depression, asthma or arthritis, a first step in releasing the pain may be making the connection between your body pain and the cause. “Beliefs are physical. A thought held long enough and repeated enough becomes a belief. The belief then becomes biology.

I want to share something Virginia Woolf wrote: 'English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache...The merest schoolgirl when she falls in love, has Shakespeare or Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.' And we're such language-based creatures that to some extent we cannot know what we cannot name. And so we assume it isn't real. We refer to it with catch-all terms, like crazy or chronic pain, terms that both ostracize and minimize. The term chronic pain captures nothing of the grinding, constant, ceaseless,inescapable hurt. And the term crazy arrives at us with none of the terror and worry you live with. Nor do either of those terms connote the courage people in such pains exemplify, which is why I'd ask you to frame your mental health around a word other than crazy.

I am not hurt,” she said, “I am in pain.

I'm in pain all the time,' I said, 'and if I gave into it then I'd do nothing.

If I only could explain how much I miss that precious moment when I was free from the shackles of chronic pain.

In the debate over opioid addiction, there’s one group we aren’t hearing from: chronic pain patients, many of whom need to use the drugs on a long-term basis.

All parents set out with expectations, hopes and dreams for their child. When a child is diagnosed with a health problem, these aspirations are altered. While one parent is hoping to see their child graduate from university, another is praying that they can live pain free

But I had to think to myself that this was normal, because that was the attitude. I was 19 when I went to see my doctor and I was told it was all in the mind.

Do you know about the spoons? Because you should. The Spoon Theory was created by a friend of mine, Christine Miserandino, to explain the limits you have when you live with chronic illness. Most healthy people have a seemingly infinite number of spoons at their disposal, each one representing the energy needed to do a task. You get up in the morning. That’s a spoon. You take a shower. That’s a spoon. You work, and play, and clean, and love, and hate, and that’s lots of damn spoons … but if you are young and healthy you still have spoons left over as you fall asleep and wait for the new supply of spoons to be delivered in the morning. But if you are sick or in pain, your exhaustion changes you and the number of spoons you have. Autoimmune disease or chronic pain like I have with my arthritis cuts down on your spoons. Depression or anxiety takes away even more. Maybe you only have six spoons to use that day. Sometimes you have even fewer. And you look at the things you need to do and realize that you don’t have enough spoons to do them all. If you clean the house you won’t have any spoons left to exercise. You can visit a friend but you won’t have enough spoons to drive yourself back home. You can accomplish everything a normal person does for hours but then you hit a wall and fall into bed thinking, “I wish I could stop breathing for an hour because it’s exhausting, all this inhaling and exhaling.” And then your husband sees you lying on the bed and raises his eyebrow seductively and you say, “No. I can’t have sex with you today because there aren’t enough spoons,” and he looks at you strangely because that sounds kinky, and not in a good way. And you know you should explain the Spoon Theory so he won’t get mad but you don’t have the energy to explain properly because you used your last spoon of the morning picking up his dry cleaning so instead you just defensively yell: “I SPENT ALL MY SPOONS ON YOUR LAUNDRY,” and he says, “What the … You can’t pay for dry cleaning with spoons. What is wrong with you?” Now you’re mad because this is his fault too but you’re too tired to fight out loud and so you have the argument in your mind, but it doesn’t go well because you’re too tired to defend yourself even in your head, and the critical internal voices take over and you’re too tired not to believe them. Then you get more depressed and the next day you wake up with even fewer spoons and so you try to make spoons out of caffeine and willpower but that never really works. The only thing that does work is realizing that your lack of spoons is not your fault, and to remind yourself of that fact over and over as you compare your fucked-up life to everyone else’s just-as-fucked-up-but-not-as-noticeably-to-outsiders lives. Really, the only people you should be comparing yourself to would be people who make you feel better by comparison. For instance, people who are in comas, because those people have no spoons at all and you don’t see anyone judging them. Personally, I always compare myself to Galileo because everyone knows he’s fantastic, but he has no spoons at all because he’s dead. So technically I’m better than Galileo because all I’ve done is take a shower and already I’ve accomplished more than him today. If we were having a competition I’d have beaten him in daily accomplishments every damn day of my life. But I’m not gloating because Galileo can’t control his current spoon supply any more than I can, and if Galileo couldn’t figure out how to keep his dwindling spoon supply I think it’s pretty unfair of me to judge myself for mine. I’ve learned to use my spoons wisely. To say no. To push myself, but not too hard. To try to enjoy the amazingness of life while teetering at the edge of terror and fatigue.

What a person did when they were in pain said a lot about them.

And so it is a truth universally acknowledged that a young woman in possession of vague symptoms like fatigue and pain will be in search of a doctor who believes she is actually sick.

Healing severe or chronic pain, I believe, includes transforming our relationship to the pain, and, ultimately, it is about transforming our relationship to who we are and to life.

It is like walking down a street and every so often someone beats the shit out of you. You mostly heal, but some injuries just don’t, and then you go out and walk some more, and someone comes by and beats the shit out of you again.

Sometimes, this disapproval of how you are managing your pain crosses over to disbelief that you are in as much pain as you say you are. They don’t believe that your pain is a legitimate enough reason to rest or nap or cry or take narcotic medications or not go to work or to go to the doctor. They might think that you are making too big of a deal out of it. They doubt the legitimacy of the pain itself. This kind of stigma is the source of the dreaded accusation that chronic pain is “all in your head.” It’s as if to say that you are making a mountain out of a molehill.

Anyone who takes opioids on a regular basis will become dependent upon them, meaning they will have to taper off gradually to avoid withdrawal symptoms. But very few chronic pain patients exhibit the compulsive drug-seeking behaviors of someone who is addicted.

After more than a decade in which chronic pain was treated with highly addictive medicine, there still was no attempt to bring the studies of pain and addiction together. Specialists in pain and in addiction operated in different worlds.

Pain is a portal to transformation, It does not knock politely.

Often the pain that makes us feel most stuck is not our suffering; it is experiencing distress in the presence of people who expect us to get better faster than we can.

Having a chronic illness, Molly thought, was like being invaded. Her grandmother back in Michigan used to tell about the day one of their cows got loose and wandered into the parlor, and the awful time they had getting her out. That was exactly what Molly's arthritis was like: as if some big old cow had got into her house and wouldn't go away. It just sat there, taking up space in her life and making everything more difficult, mooing loudly from time to time and making cow pies, and all she could do really was edge around it and put up with it. When other people first became aware of the cow, they expressed concern and anxiety. They suggested strategies for getting the animal out of Molly's parlor: remedies and doctors and procedures, some mainstream and some New Age. They related anecdotes of friends who had removed their own cows in one way or another. But after a while they had exhausted their suggestions. Then they usually began to pretend that the cow wasn't there, and they preferred for Molly to go along with the pretense.

And I didn't know how to say the future was like a language I couldn't speak anymore.

I had learned quickly that life doesn't always go the way I want it to, and that's okay. I still plod on.

Chronic illness is hard. Pain is hard. Isolation is hard. The financial cost is hard. Grieving is hard and necessary and sometimes takes far longer than we ever imagined.

Living with long-term suffering in American culture feels like being off-key. Suffering quiets and slows, but our culture prefers a crescendo.

When all you know is pain you don’t know that that is not normal. It is not a woman’s lot to suffer, even if we’ve been raised that way. It is not OK to miss a part of your life because of pain and excessive bleeding. It is not OK to be bed-ridden for two-to-three days a month. It is not OK to pain during sex. It is not OK to have major bloating or nausea." (Address, 2011 Endometriosis Foundation of America Blossom Ball)

A common misconception is that some people are only in pain because they are weak, anxious, depressed, or do not deal well with stress. This is not correct. Every experience you have — touch, warmth, itch, pain — is created by the brain and thus is all in your head, but it does not mean they are not real. Things like fear, anxiety, or depression can increase pain levels and can increase the chance of persistent pain. But often, these feelings only develop after a person already has chronic pain.

Despite what appears to be a low risk of addiction in naïve, chronic pain patients, it is reasonable to ask how much harm is actually done to patients with chronic pain by withholding opiate analgesics.

I love the days when my body cooperates.

Pain diminishes us, and it is so important to remember, in the midst of pain and everything that pain takes from you, that still ... you are enough. You are enough just as you are. You are worthy of love and kindness. You are enough. And you have enough.

Moskowitz defined chronic pain as “learned pain.” Chronic pain not only indicates illness; it is itself an illness. The body’s alarm system is stuck in the “on” position, because the person has been unable to remedy the cause of an acute pain, and the central nervous system has become damaged.

Even the littlest things were now a challenge, one I didn't understand.

Many empaths are diagnosed with chronic illnesses such as fibromyalgia, CFS, lupus, and various autoimmune diseases, as well as psychological disorders such as agoraphobia, social anxiety, ADHD, depression, sensory processing disorder, among many others.

It's not easy to diagnose because depending where the endometrial deposits are, the symptoms can be quite different. It's an unrecognized problem among teenage girls, and it's something that every young woman who has painful menstruation should be aware of ... it's a condition that is curable if it's caught early. If not, if it's allowed to run on, it can cause infertility, and it can really mess up your life. [Author Hilary Mantel on being asked about being a writer with endometriosis, Nov 2012 NPR interview]

To many people, I am no longer just myself. I am a reminder of a thought that is difficult for the rational brain to accept: our bodies might fail at any moment.

I’m tired of things I love being gone forever. I didn’t think there was room in me for any more holes, but that’s all I am now, a collection of empty spaces where things were ripped away.

For some reason the word “chronic” often has to be explained. It does not mean severe, though many chronic conditions can be exceptionally serious and indeed life-threatening. No, “chronic” means persistent over time, enduring, constant. Diabetes is a chronic condition, but measles is not. With measles, you contract it and then it is gone. It can sometimes be fatal, but is never chronic. Manic depression, in other words, is something you have to learn to live with. There are therapies which may help some people to function and function for the most part happily and well. Sometimes a talking therapy, sometimes pharmaceutical intervention helps.

Your arm is shot, Sorrengail,” Tynan hisses, his face pale and sweaty. “I’m used to functioning in pain, asshole. Are you?

Shared joy is increased; Shared pain is lessened.

We may deny that an event occurred, or we may act as though it was unimportant. For instance, when someone we love dies, or when we are injured or violated, we may act as though nothing has happened, because the emotions that come with truly acknowledging the situation are too painful. In addition, dissociation may be experienced as part of the body being disconnected or almost absent. Frequently, chronic pain represents a part of the body that has been dissociated.

I guess it's human nature to question yourself, to question why all the pain has had to happen? sometimes there isn't any answers it just is what it is and how we make ourselves feel and see through that, is what will determine how we move forward.

One thing I hate about being ill is that no one believes it unless I share it all with them, and even then they don’t act on it.

Nothing worked. This blazing pain seemed only to be getting worse.

Recently God asked me the same question in a new way, "And if I don't allow you to heal, if I never remove the pain, will you still trust Me?

That pain moves when you move; it mutters between every breath; it spikes your ears; it rips. You think pain can’t be any more horrible than that. Until you discover that the well is bottomless. There’s always more.

Carla's description was typical of survivors of chronic childhood abuse. Almost always, they deny or minimize the abusive memories. They have to: it's too painful to believe that their parents would do such a thing. So they fragment the memories into hundreds of shards, leaving only acceptable traces in their conscious minds. Rationalizations like "my childhood was rough," "he only did it to me once or twice," and "it wasn't so bad" are common, masking the fact that the abuse was devastating and chronic. But while the knowledge, body sensations, and feelings are shattered, they are not forgotten. They intrude in unexpected ways: through panic attacks and insomnia, through dreams and artwork, through seemingly inexplicable compulsions, and through the shadowy dread of the abusive parent. They live just outside of consciousness like noisy neighbors who bang on the pipes and occasionally show up at the door.

Every EDS patient knows that one of the hardest parts of our day is the moment we open our eyes and waken into the reality of our bodies, stirred from dreams of ourselves as we used to be, and the futures we imagined we’d have.

The agony of this chronic stage of being cannot be endured for long. At the deepest level, toxic shame triggers our basic automatic defensive cover-ups. Freud called these automatic cover-ups our primary ego defenses. Once these defenses are in place they function automatically and unconsciously, sending our true and authentic selves into hiding. We develop a false identity out of this basic core. We become master impersonators. We avoid our core agony and pain and over a period of years, we avoid our avoidance.

We set limits for ourselves all the time. This imaginary line that you're positive you won't ever cross. An action that you are positive you would never do, no matter what. But what we don't consider when we draw our line is a change in our situation. An action that you were sure last week you wouldn't do suddenly becomes a viable option this week because the situation has drive you to it. Then you move your limit line and talk yourself into believing this new line will never be crossed. A man will take a stand and proclaim "I would never lie to my wife." But what if he maxes out their credit card because of his internet porn addiction? The line gets moved. I'm sure if you ask any mother or father they would not hesitate in harming or even killing someone who was about to do the same to their child. The line gets moved. A girl who is so consumed by the pain and empty ache of loneliness will be drive to do anything, no matter how degrading she thinks it is, because she wants to numb the chronic pain. The line gets moved. The line keeps moving and moving until one day you realize you're limitless. If you are being completely honest with yourself, there is absolutely nothing you wouldn't do if the situation required you to cross another line.

Lily had lived with the same pain for so long it felt like a part of her. The worst days, though, were when the pain was different. When it came faster, or harsher, or fiercer than she was used to. When it prickled instead of throbbed. When it attacked her right ankle instead of her left knee. When it woke her up at night instead of aching dully first thing in the morning. On those days, her standard-issue pain was replaced by something different and frightening, something that took over her body and left her without the slightest clue of when, or even if, it would release her. Those times, her pain wasn’t a part of her anymore. Those times, she was a part of it.

You see, it is so hard for these creatures to persevere. The routine of adversity, the gradual decay of youthful loves and youthful hopes, the quiet despair (hardly felt as pain) of ever overcoming the chronic temptations with which we have again and again defeated them, the drabness which we create in their lives and the inarticulate resentment with which we teach them to respond to it--all this provides admirable opportunities of wearing out a soul by attrition.

None of my doctors told me about how pain wears you down until you sometimes don't know where physical pain stops and mental pain begins. They didn't tell me about the anger and the fear and the helplessness. Finn told me and then, when I finally let him, held me while I let it all sink in.

When we tell those stories to people in chronic pain, or those living with incurable illness, we often end up minimizing their experience. We end up expressing our doubt in the face of their certainty, which only compounds the extent to which pain separates the person experiencing it from the wider social order. The challenge and responsibility of per- sonhood, it seems to me, is to recognize personhood in others-to listen to others' pain and take it seriously, even when you yourself cannot feel it. That capacity for listening, I think, really does separate human life from the quasi-life of an enterovirus.

Government agencies are trying to get doctors to cut back on prescribing opioids. I understand that they need to do something about the epidemic of overdoses. However, labeling everyone as addicts, including those who responsibly take opioids for chronic pain, is not the answer. If the proposed changes take effect, they would force physicians to neglect their patients. Moreover, legitimate pain patients, like myself, would be left in agony on a daily basis.

Yes, I thought. That is how life feels too often. Like you're doing everything you can to survive only to be sabotaged by something beyond your control, maybe even some darker part of yourself. Sometimes, it was your body. Your cells turning into poison and fighting against you. Or chronic pain sprouting up your neck and wrapping around the outsides of your scalp until it felt like fingernails sinking into your brain. Sometimes, it was lust or heartbreak or loneliness or fear driving you off the road toward something you'd spent months of years avoiding. Actively fighting against. At least the last thing they'd seen, the meteor streaming toward Earth, had distracted them because of its beauty. They hadn't been afraid. They'd been mesmerised. Maybe that was all you could hope for in life.

My mom’s in jail right now for assault with a deadly weapon, which was pretty stupid of her, I admit. But she took good care of us growing up. She worked her ass off before she blew out her back and started drinking. Chronic pain, you know? But she never would have tried to run over that cop if she’d stuck it out in the anger management program. I’m still not sure why she went after that second guy, he’s not the one who wrote the parking ticket….” Horse burst out laughing, biting it back quick.

Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say 'My tooth is aching' than to say 'My heart is broken'. Yet if the cause is accepted and faced, the conflict will strengthen and purify the character and in time the pain will usually pass. Sometimes, however, it persists and the effect is devastating; if the cause is not faced or not recognised, it produces the dreary state of the chronic neurotic. But some by heroism overcome even chronic mental pain. They often produce brilliant work and strengthen, harden, and sharpen their characters till they become like tempered steel.

Sometimes I think illness sits inside every woman, waiting for the right moment to bloom. I have known so many sick women all my life. Women with chronic pain, with ever-gestating diseases. Women with conditions. Men, sure, they have bone snaps, they have backaches, they have a surgery or two, yank out a tonsil, insert a shiny plastic hip. Women get consumed. Not surprising, considering the sheer amount of traffic a woman’s body experiences. Tampons and speculums. Cocks, fingers, vibrators and more, between the legs, from behind, in the mouth. Men love to put things inside women, don’t they?

What, am I supposed to feel guilty?" I say. He looks confused. "Guilty?" "That I feel fine for once? That I'm not limping and moaning around? Dragging my leg like Briana? Lying on the floor, crying into my ears when everyone else around me rolls their eyes? I'm supposed to feel bad that I'm better now? I'm supposed to cry over a little cut. To what? To make you feel like I'm not a monster. I need to perform my little bit of pain for you so you'll know I'm human?" "Miranda, I didn't mean—" "But not too much pain, am I right? Not too much, never too much. If it was too much, you wouldn't know what to do with me, would you? Too much would make you uncomfortable. Bored. My crying would leave a bad taste. That would just be bad theater, wouldn't it? A bad show. You want a good show. They all do. A few pretty tears on my cheeks that you can brush away. Just a delicate little bit of ouch so you know there's someone in there. So you don't get too scared of me, am I right? So you know I'm still a vulnerable thing. That I can be brought down if need be.

One crucial distinction between major depression and chronic depression is that, in the latter, one largely ceases to howl in protest that the world is hard or painful. Rather, one becomes accustomed to it, expecting such hardship and greeting it with, at best, a stoic determination.

We have a genuine and devastating epidemic of opiate abuse in this country, and it is of critical importance that this problem be addressed. But we must do so in a way that doesn’t cut off an effective (and often the only) treatment for the chronically ill, many of whom are able to function in this world at all only because of the small respite that responsible opiate use provides.

The addiction crisis is terrifying, and many people don’t comprehend appropriate opioid use. When I first started taking pain medication, I remember a family member saying, “Dianne, you’re going to become an addict!” We need to help people understand that taking pain medicine to maximize one’s ability to be productive and to sustain enriching relationships is very different than the disease of addiction, which limits one’s ability to contribute to society and maintain healthy habits.

You stop noticing pain, is the thing. You notice it when it’s really bad, or when it’s different, but… on the rare occasion someone asks me what it’s like to live with RA, I don’t ever know what to say. They ask me if its painful, and I say yes because I know intellectually it must be, because the idea of doing some of the things that other people do without thinking fills me with dread and panic, but I always think about it mechanically. I can’t do x. I don’t want to do y. I don’t continue the thought into I can’t do that because it would hurt. I don’t want to do that because then I would be in pain. You can’t live like that. There’s only so much you can carry quietly by yourself, so you turn an illness into a list of rules instead of a list of symptoms, and you take pills that don’t help, and you do stretches, and you think instead of feeling. You think.

Somatic Symptoms: People with Complex PTSD often have medical unexplained physical symptoms such as abdominal pains, headaches, joint and muscle pain, stomach problems, and elimination problems. These people are sometimes most unfortunately mislabeled as hypochondriacs or as exaggerating their physical problems. But these problems are real, even though they may not be related to a specific physical diagnosis. Some dissociative parts are stuck in the past experiences that involved pain may intrude such that a person experiences unexplained pain or other physical symptoms. And more generally, chronic stress affects the body in all kinds of ways, just as it does the mind. In fact, the mind and body cannot be separated. Unfortunately, the connection between current physical symptoms and past traumatizing events is not always so clear to either the individual or the physician, at least for a while. At the same time we know that people who have suffered from serious medical, problems. It is therefore very important that you have physical problems checked out, to make sure you do not have a problem from which you need medical help.

The depressed person’s therapist was always extremely careful to avoid appearing to judge or blame the depressed person for clinging to her defenses, or to suggest that the depressed person had in any way consciously chosen or chosen to cling to a chronic depression whose agony made her (i.e., the depressed person’s) every waking hour feel like more than any person could possibly endure. This renunciation of judgment or imposed value was held by the therapeutic school in which the therapist’s philosophy of healing had evolved over almost fifteen years of clinical experience to be integral to the combination of unconditional support and complete honesty about feelings which composed the nurturing professionalism required for a productive therapeutic journey toward authenticity and intrapersonal wholeness. Defenses against intimacy, the depressed person’s therapist’s experiential theory held, were nearly always arrested or vestigial survival-mechanisms; i.e., they had, at one time, been environmentally appropriate and necessary and had very probably served to shield a defenseless childhood psyche against potentially unbearable trauma, but in nearly all cases they (i.e., the defense-mechanisms) had become inappropriately imprinted and arrested and were now, in adulthood, no longer environmentally appropriate and in fact now, paradoxically, actually caused a great deal more trauma and pain than they prevented. Nevertheless, the therapist had made it clear from the outset that she was in no way going to pressure, hector, cajole, argue, persuade, flummox, trick, harangue, shame, or manipulate the depressed person into letting go of her arrested or vestigial defenses before she (i.e., the depressed person) felt ready and able to risk taking the leap of faith in her own internal resources and self-esteem and personal growth and healing to do so (i.e., to leave the nest of her defenses and freely and joyfully fly).

My doctors, who are not cavalier with prescriptions, give me this medication because I have earned their trust. And yet, with mounting government and public pressure, my doctors’ hands are becoming increasingly tied. They apologetically explain to me why they are required to make the medication even harder for me to get, against their own medical judgment. If the day ever comes when they aren’t allowed to prescribe Percocet to me at all, it may well be the end of the minimal quality of life I fight so hard to achieve.

Not every day is awful. Not every day is good. Despite the way the hours pass, I’m living like I should. Not every day is all wrong. Not every day is right. At least I’m not a spider trying to scamper out of sight. Not every day is ideal. Not every day is bad. At any rate I have my senses, even if they’re mad. Not every day is happy. Not every day is glum. When melancholy drags me down, a simple tune I hum. Not every day I smile. Not every day I frown. With effort, I can take a scowl and turn it upside down. Not every day is crazy. Not every day is sane. If consequence nips at my heels I don’t pass on the blame. Not every day is giddy. Not every day is blah. Yet I can still appreciate a giggle and guffaw. Not every day is timid. Not every day is proud. I may not be a dragon, but I roar about as loud. Not every day has rainbows. Not every day has rain. Despite the fact I’m stiff and sore, I’m not in chronic pain. On every day the sun shines, so every night I pray that I might see the morning light and live another day.

Highly traumatized and chronically neglected or abused individuals are dominated by the immobilization/shutdown system. On the other hand, acutely traumatized people (often by a single recent event and without a history of repeated trauma, neglect or abuse) are generally dominated by the sympathetic fight/flight system. They tend to suffer from flashbacks and racing hearts, while the chronically traumatized individuals generally show no change or even a decrease in heart rate. These sufferers tend to be plagued with dissociative symptoms, including frequent spacyness, unreality, depersonalization, and various somatic and health complaints. Somatic symptoms include gastrointestinal problems, migraines, some forms of asthma, persistent pain, chronic fatigue, and general disengagement from life.

If your problem is being chronically starved of social bonds, then part of the solution is to bond with the heroin itself and the relief it gives you. But a bigger part is to bond with the subculture that comes with taking heroin—the tribe of fellow users all embarked on the same mission and facing the same threats and risking death every day with you. It gives you an identity. It gives you a life of highs and lows, instead of relentless monotony. The world stops being indifferent to you, and starts being hostile—which is at least proof that you exist, that you aren’t dead already. The heroin helps users deal with the pain of being unable to form normal bonds with other humans. The heroin subculture gives them bonds with other human beings.

People with chronic illness, pain, and fatigue have been among the most critical of this aspect of the social model, rightly noting that social and structural changes will do little to make one's joints stop aching or to alleviate back pain. Nor will changes in architecture and attitude heal diabetes or cancer or fatigue. Focusing exclusively on disabling barriers, as a strict social model seems to do, renders pain and fatigue irrelevant to the project of disability politics.

Some people (like singularly unhelpful and clearly underqualified physical therapists, unsympathetic GPs, and that supremely irritating second cousin who ate all the stuffing at Christmas) assumed that a lack of feeling in certain body parts shouldn’t affect sleep at all. Her insomnia in such situations, they said, was something she could easily overcome. Chloe liked to remind those people that the human brain tended to keep track of all body parts, and was prone to panic when one of those parts went offline. Actually, what Chloe liked to do was imagine hitting those people with a brick.

Somatic symptoms for which no clear physical basis can be found are ubiquitous in traumatized children and adults. They can include chronic back and neck pain, fibromyalgia, migraines, digestive problems, spastic colon/irritable bowel syndrome, chronic fatigue, and some forms of asthma.16 Traumatized children have fifty times the rate of asthma as their nontraumatized peers.17 Studies have shown that many children and adults with fatal asthma attacks were not aware of having breathing problems before the attacks.

In his books, Dr. Alexander Lowen put into words the anguish I could not describe. He explained how a repressed experience was converted into a physical symptom. Intense sexual energy that had not been resolved or discharged would be forced into muscles, causing chronic muscular tensions. Finally, someone understood my pain…at least that one. Chronic muscular tension may not sound like a big deal but I have lived in a body primed for lifting a car. The muscles never let go. Even when I awaken, they are flexed to the max. It’s called “muscular armoring.

Since my symptoms began 13 years ago, I’ve tried every form of pain management I could access — NSAIDS, nonopioid analgesics, neurologic medications, acupuncture, laser therapy, physical therapy, prolotherapy, massage, and trigger-point injections. Most of these have been unhelpful; others provide temporary relief, often at great expense. At the end of the day, when my body is fully depleted of its resources and in the most pain, a single dose of Percocet is the only tool that silences the pain enough for me to fall asleep. I honestly don’t know what I’d do if Percocet became unavailable to me, and the very thought scares me. I’ve been taking it for five years. To avoid any chance of addiction, I only take it at night and have stayed on a consistently low dose.

So many modern diseases, including heart disease, depression, cancer, Alzheimer’s, and all the autoimmune diseases (such as rheumatoid arthritis and lupus), occur in part because our body’s immune systems produce excess chronic inflammation. In chronic inflammation, the immune system stays on too long and may even begin to attack the body’s own tissues, as though they were outside invaders. The causes of chronic inflammation are many, including diet and, of course, the countless chemical toxins that become embedded in the body. Chronically inflamed bodies produce chemicals, called pro-inflammatory cytokines, which contribute to pain and inflammation.

It’s like I have this demon inside of me, and I want it gone, but the idea of removing it via pill is . . . I don’t know . . . weird. But a lot of days I get over that, because I do really hate the demon.” “You often try to understand your experience through metaphor, Aza: It’s like a demon inside of you; you’ll call your consciousness a bus, or a prison cell, or a spiral, or a whirlpool, or a loop, or a—I think you once called it a scribbled circle, which I found interesting.” “Yeah,” I said. “One of the challenges with pain—physical or psychic—is that we can really only approach it through metaphor. It can’t be represented the way a table or a body can. In some ways, pain is the opposite of language.” She turned to her computer, shook her mouse to wake it up, and then clicked an image on her desktop. “I want to share something Virginia Woolf wrote: ‘English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache. . . . The merest schoolgirl, when she falls in love, has Shakespeare or Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.’ And we’re such language-based creatures that to some extent we cannot know what we cannot name. And so we assume it isn’t real. We refer to it with catch-all terms, like crazy or chronic pain, terms that both ostracize and minimize. The term chronic pain captures nothing of the grinding, constant, ceaseless, inescapable hurt. And the term crazy arrives at us with none of the terror and worry you live with. Nor do either of those terms connote the courage people in such pains exemplify, which is why I’d ask you to frame your mental health around a word other than crazy.

In the car inching its way down Fifth Avenue, toward Bergdorf Goodman and this glamorous party, I looked back on my past with a new understanding. This sickness, the “endo-whatever,” had stained so much—my sense of self, my womanhood, my marriage, my ability to be present. I had effectively missed one week of each month every year of my life since I was thirteen, because of the chronic pain and hormonal fluctuations I suffered during my period. I had lain in bed, with heating pads and hot-water bottles, using acupuncture, drinking teas, taking various pain medications and suffering the collateral effects of them. I thought of all the many tests I missed in various classes throughout my education, the school dances, the jobs I knew I couldn’t take as a model, because of the bleeding and bloating as well as the pain (especially the bathing suit and lingerie shoots, which paid the most). How many family occasions was I absent from? How many second or third dates did I not go on? How many times had I not been able to be there for others or for myself? How many of my reactions to stress or emotional strife had been colored through the lens of chronic pain? My sense of self was defined by this handicap. The impediment of expected pain would shackle my days and any plans I made. I did not see my own womanhood as something positive or to be celebrated, but as a curse that I had to constantly make room for and muddle through. Like the scar on my arm, my reproductive system was a liability. The disease, developing part and parcel with my womanhood starting at puberty with my menses, affected my own self-esteem and the way I felt about my body. No one likes to get her period, but when your femininity carries with it such pain and consistent physical and emotional strife, it’s hard not to feel that your body is betraying you. The very relationship you have with yourself and your person is tainted by these ever-present problems. I now finally knew my struggles were due to this condition. I wasn’t high-strung or fickle and I wasn’t overreacting.

My name is CRPS, or so they say But I actually go by; a few different names. I was once called causalgia, nearly 150 years ago And then I had a new name It was RSD, apparently so. I went by that name because the burn lived inside of me. Now I am called CRPS, because I have so much to say I struggle to be free. I don't have one symptom and this is where I change, I attack the home of where I live; with shooting/burning pains. Depression fills the mind of the body I belong, it starts to speak harsh to self, negativity growing strong. Then I start to annoy them; with the issues with sensitivity, You'd think the pain enough; but no, it wants to make you aware of its trembling disability. I silently make my move; but the screams are loud and clear, Because I enter your physical reality and you can't disappear. I confuse your thoughts; I contain apart of your memory, I cover your perspective, the fog makes it sometimes unbearable to see. I play with your temperature levels, I make you nervous all the time - I take away your independance and take away your pride. I stay with you by the day & I remind you by the night, I am an awful journey and you will struggle with this fight. Then there's a side to me; not many understand, I have the ability to heal and you can be my friend. Help yourself find the strength to fight me with all you have, because eventually I'll get tired of making you grow mad. It will take some time; remember I mainly live inside your brain, Curing me is hard work but I promise you, You can beat me if you feed love to my pain. Find the strength to carry on and feed the fears with light; hold on to the seat because, like I said, it's going to be a fight. But I hope to meet you, when your healthy and healed, & you will silenty say to me - I did this, I am cured is this real? That day could possibly come; closer than I want- After all I am a disease and im fighting for my spot. I won't deny from my medical angle, I am close to losing the " incurable " battle.

For a person with ADD, tuning out is an automatic brain activity that originated during the period of rapid brain development in infancy when there was emotional hurt combined with helplessness. At one time or another, every infant or young child feels frustration and psychological pain. Episodic experiences of a distressing nature do not induce dissociation, but chronic distress does—the distress of the sensitive infant with unsatisfied attunement needs, for example. The infant has to dissociate chronic emotional pain from consciousness for two reasons. First, it is too overwhelming for his fragile nervous system. He simply cannot exist in what we might call a state of chronic negative arousal, with adrenaline and other stress hormones pumping through his veins all the time. It is physiologically too toxic. He has to block it out. Second, if the parent’s anxiety is the source of the infant’s distress, the infant unconsciously senses that fully expressing his own emotional turmoil will only heighten that anxiety. His distress would then be aggravated—a vicious cycle he can escape by tuning out.

In 1994, Friedman wrote a memo marked “Very Confidential” to Raymond, Mortimer, and Richard Sackler. The market for cancer pain was significant, Friedman pointed out: four million prescriptions a year. In fact, there were three-quarters of a million prescriptions just for MS Contin. “We believe that the FDA will restrict our initial launch of OxyContin to the Cancer pain market,” Friedman wrote. But what if, over time, the drug extended beyond that? There was a much greater market for other types of pain: back pain, neck pain, arthritis, fibromyalgia. According to the wrestler turned pain doctor John Bonica, one in three Americans was suffering from untreated chronic pain. If that was even somewhat true, it represented an enormous untapped market. What if you could figure out a way to market this new drug, OxyContin, to all those patients? The plan would have to remain secret for the time being, but in his memo to the Sacklers, Friedman confirmed that the intention was “to expand the use of OxyContin beyond Cancer patients to chronic non-malignant pain.” This was a hugely audacious scheme. In the 1940s, Arthur Sackler had watched the introduction of Thorazine. It was a “major” tranquilizer that worked wonders on patients who were psychotic. But the way the Sackler family made its first great fortune was with Arthur’s involvement in marketing the “minor” tranquilizers Librium and Valium. Thorazine was perceived as a heavy-duty solution for a heavy-duty problem, but the market for the drug was naturally limited to people suffering from severe enough conditions to warrant a major tranquilizer. The beauty of the minor tranquilizers was that they were for everyone. The reason those drugs were such a success was that they were pills that you could pop to relieve an extraordinary range of common psychological and emotional ailments. Now Arthur’s brothers and his nephew Richard would make the same pivot with a painkiller: they had enjoyed great success with MS Contin, but it was perceived as a heavy-duty drug for cancer. And cancer was a limited market. If you could figure out a way to market OxyContin not just for cancer but for any sort of pain, the profits would be astronomical. It was “imperative,” Friedman told the Sacklers, “that we establish a literature” to support this kind of positioning. They would suggest OxyContin for “the broadest range of use.” Still, they faced one significant hurdle. Oxycodone is roughly twice as potent as morphine, and as a consequence OxyContin would be a much stronger drug than MS Contin. American doctors still tended to take great care in administering strong opioids because of long-established concerns about the addictiveness of these drugs. For years, proponents of MS Contin had argued that in an end-of-life situation, when someone is in a mortal fight with cancer, it was a bit silly to worry about the patient’s getting hooked on morphine. But if Purdue wanted to market a powerful opioid like OxyContin for less acute, more persistent types of pain, one challenge would be the perception, among physicians, that opioids could be very addictive. If OxyContin was going to achieve its full commercial potential, the Sacklers and Purdue would have to undo that perception.