I am a huge fan of cups, mugs specifically. I have far too many all around my house. All different sizes and shapes, but I love them all. I think that may be part of the reason I really love the cup analogy in helping to understand how chronic pain works and all the factors that contribute to our individual pain pictures. Pain is like an overflowing cup. When our cup is too full, we end up with pain and other symptoms like headaches, irritable bowel syndrome, and chronic pain. In this blog post, we are going to touch on the categories of things that can fill our cups. To rehab our pain, we have to know what is contributing to it. Let’s get started.
Understanding Chronic Pain
You and I both know chronic pain sucks, it hurts, it steals life from us, it is confusing and it often really doesn’t make sense. So let’s get on the same page here. I am only going to touch on this briefly right now, you can read more here.
To understand chronic pain, it is essential to recognize that it is not solely a physical sensation. It involves a complex interaction between physical, emotional, and social factors. While there may be an initial injury or condition that triggers the pain, the persistence and severity of the pain are often influenced by various other factors.
One important aspect of chronic pain is the concept of central sensitization. This occurs when the nervous system becomes hypersensitive, amplifying pain signals and making them feel more intense. This means that even small things can elicit significant pain responses. Understanding this central sensitization is crucial because it helps explain why seemingly minor activities or movements can trigger intense pain for individuals with chronic pain.
Chronic pain is influenced by more than just tissue. Stress, anxiety, depression, and negative thoughts can all contribute to the experience of pain. The brain and the body are interconnected, and emotional distress can heighten pain perception. Supportive relationships and a sense of belonging can provide comfort and emotional relief, while social isolation and lack of understanding from others can exacerbate pain. As can lack of sleep, certain foods, lack of movement, and on and on. These are all things that can be “in” your cup.
By understanding that chronic pain is not solely a physical sensation but rather a complex interplay of physical, emotional, and social factors, we can begin to approach its management more holistically. This understanding opens up possibilities for almost endless treatment approaches which can return you to the life you want back!
The Cup Analogy Explained
Chronic pain can feel overwhelming and never-ending. It can seem like there’s just no relief in sight. But what if we could find a way to understand and manage our chronic pain better? That’s where the cup analogy comes in. Pick up a nearby cup. (bonus points from me if you share your cup in the Facebook group!) This cup represents you, all of you, and everything you can contain. If there’s too much in the cup it begins to overflow. That really shouldn’t be a huge surprise to any of us, right? We know when we become overwhelmed or overburdened, something overflows, pain or no pain.
This idea is described by many in the field in different ways. Greg Lehman uses the cup, Lorimer Moseley and David Butler talk about “SIMs” safety in me in the self-help book The Protectometer. Great book btw. Kieran O’Sullivan asks “What is good for you?”. While I tend to ask, what makes you feel safe? They are all ways of acknowledging how the nervous system plays a huge role in pain.
In short, your cup is you and what’s in it are all the different factors that contribute to pain. WHen the cup overflows, we experience pain. The goal is to decrease the amount of things in the cup AND build a bigger cup, so that pain isn’t triggered as easily!
What’s in Your Cup: Physical Factors
I tend to put physical factors at the bottom of the cup, they are usually things we can’t really change, but we can be aware of and modify the way we move, use aids, and take meds for. In this section you would list things like your diangosis, autoimmune conditions, medications. overall physical health. Pretty much all the stuff your medical team has told you about and you are focused on as the sigular reason for your pain.
Medical management for this portion of your cup is completely reasonable and frankly, smart. It’s when you have exhausted those routes and the pain remains a barrier to a well lived life. That is what usually brimngs people to me. If that’s you, keep reading the other catagories and see what resonates.
What’s in Your Cup: Thoughts/Beliefs
Our thoughts play a significant role in our experience of chronic pain. It’s essential to recognize and address the thoughts and beliefs we have about our pain because they can either intensify or alleviate our suffering. Read that again.
The things you believe about your body, your diangosis. your prognoisis ( ability to get better), your self, your abilities and about 4,000 other things all really have a huge effect on your pain experience.
It’s not just about thinking ‘good thoughts” or staying positive. If that were the key to being pain free, none of us would be in pain. Think about it. You’ve wished your pain away, pretended like you were ok, and done mental gymnastics a thousand times to try to improve your situation, haven’t you? Bet it didnt’ work.
The brain is pretty amazing. It’s job is to protect the meat sack, teh body. And OHHHHH Boy will it protect you against thoughts it knows (unconciously) are bull pucky! So skip the fake positive thougths and try for realistic ones. What I mean by that is get accurate information. Learn what is real and what isn’t when it comes to pain. There are a lot of real crap narratives out there that keep us super trapped protecting ourselves from more injury that are wildly unessecary!
The way we think…
Negative thoughts and beliefs about our pain can keep us trapped in a cycle of despair and hopelessness. When we constantly tell ourselves that the pain will never go away or that we are helpless, it becomes a self-fulfilling prophecy. Remember, thoughts are not facts. These negative thoughts can lead to increased stress, anxiety, and depression, which in turn can heighten our pain perception. Part of the reason for that is because those emotions produce chemcials, those chemcials heighten our neroust system awareness. You can learn more about htat in depth with my free course, Chronic Pain Explained.
On the other hand, positive thoughts and beliefs about our pain can provide a glimmer of hope and help us cope better. It’s important to challenge and reframe negative thoughts and replace them with more realistic and empowering ones. For example, instead of thinking, “I will never find relief from this pain,” we can reframe it as, “I am actively seeking solutions and taking steps towards managing my pain.” Anything that is true, and provides the brain with saftey helps empty the cup.
Mindfulness
Mindfulness practices can also be helpful when it comes to thoughts and chronic pain. It teaches us to observe our thoughts without judgment and to let go of any negative or unhelpful thinking patterns. By cultivating a mindful awareness of our thoughts, we can develop a greater sense of control over them and reduce their impact on our pain experience. I know it sounds a bit unbelievable, but it is very real. This idea was huge in my own recovery and in the way I am dealing with my long covid issues. Our thoughts are quiet powerful and are usually a large part of our pain prisions.
For more on the “thinking” part of our pain pictures, I encourage you to check out Dr. Rachel Zoftness, she has written a workbook to help people in pain work through some of these things and I give it 5 stars. Follow her on social media for more.
What’s in Your Cup: Feelings
Believe it or not, these are quiet seperate from thoughts. They are not they same!
Chronic pain doesn’t just affect us physically – it also takes a toll on our emotional well-being. Our feelings can contribute to what’s in our cup and influence the intensity of our pain. Understanding and addressing these emotional factors is an essential step towards finding relief.
Living with chronic pain can be a rollercoaster of emotions. It’s normal to feel frustrated, angry, sad, or even hopeless at times. But these emotional experiences can actually intensify our pain and make it harder to manage. When we’re feeling overwhelmed or stressed, our nervous systems become more sensitive to information, often leading to heightened discomfort. It’s more stuff in our cup, making it more likely to overflow.
On the other hand, positive emotions can help lighten our cup and provide some relief. Feeling calm, hopeful, and optimistic can reduce stress levels and improve our ability to cope with pain. These positive emotions create a buffer that helps us better navigate the challenges of living with chronic pain. It’s not always easy to cultivate things like gratitude in the midst of challenges like pain, but it is an essential skill for living well.
To address the emotional factors in our cup, it’s important to practice self-care and prioritize our mental well-being. Exploring and processing our emotions, developing healthy coping mechanisms, and creating a plan to manage the emotional aspects of chronic pain and any trauma or hardships we have experienced is part of the recovery process. A part the majority of people miss.
Engaging in stress-reducing activities can also make a significant difference. Mindfulness practices, such as meditation or deep breathing exercises, can help calm our minds and alleviate emotional distress. Engaging in hobbies or activities that bring us joy and relaxation can also be beneficial.
Your feelings matter, and addressing them is crucial for managing chronic pain. By acknowledging and addressing the emotional factors in your cup, you can create more space for relief and find greater peace amidst the challenges of chronic pain. Remember, this isnt’ about things being stuck in your body, it’s about creating a safe place for your brain to be so that your nervous system can step back from high alert!
What’s in Your Cup: Social Factors
THe world around us from systems to indivdualscan play a role in our experience of chronic pain, both positively and negatively.
Supportive relationships and a sense of belonging can provide comfort and emotional relief, which can help lighten the load in your cup. Having loved ones who understand and empathize with your pain can make a world of difference. They can provide a listening ear, offer practical support, and validate your experiences, which can help reduce feelings of isolation and make your pain more manageable.
On the flip side, social isolation and lack of understanding from others can add to your cup. Feeling misunderstood or invalidated by friends, family, or colleagues can be incredibly disheartening. It can make you question your own experiences and increase feelings of frustration and helplessness. Not only that, isolation creates an enviornment in the body that is more friendly adn apt towards inflammation! We know inflammation isn’t helpful for pain. (See how these things seem unrelated, but really aren’t!)
That’s why building a support network of people who truly understand and support you is crucial. Connecting with others who are also living with chronic pain can provide a unique sense of understanding and camaraderie. Joining support groups, whether online or in-person, can offer a safe space to share your experiences, gain insights, and learn coping strategies from others who are walking a similar path. ( Feel free to join mine on Facebook!)
The other aspect of our social factors are the larger systems at work in our lives. Insurance, workmans comp, roles at work, social satatus, financial stability,political religious systems…. all the hard facts of life that can make life easier or harder. These societal factors take up room in our cups and can make life harder.
If you have identified some of these systems as part of what is in your cup, I encourage you to seek support and ask for help where you can.
What’s in Your Cup: LifeStyle
No one likes this part and I get it, but let’s look at items in teh cup that are often within our control.
Diet. Certain foods can either fuel inflammation and or histamine response or reduce it. Incorporating an anti-inflammatory diet rich in fruits, vegetables, whole grains, and healthy fats can help decrease inflammation in your body, potentially reducing pain levels. On the other hand, processed foods, sugary drinks, and excessive alcohol consumption can contribute to inflammation and exacerbate your pain.
Regular exercise/ movement is another lifestyle choice that can help. Engaging in physical activity releases endorphins, which are natural pain-relieving chemicals in the body. Our bodies were created to move. We simoly have to move them to use them correctly. Modifying movement and activity is often necessary for a time, but at the end of the day, we have to move if we want to feel well. Lack of movement adds to the cup.
Managing stress is essential for managing chronic pain. High levels of stress can exacerbate pain and make it more challenging to cope. Finding healthy stress management techniques, such as mindfulness meditation, deep breathing exercises, or engaging in hobbies you enjoy, can help reduce stress levels and provide relief from chronic pain.
Getting enough restorative sleep is also crucial. Poor sleep quality can intensify our pain experience and make it more difficult to cope. Establishing a consistent sleep routine, creating a calming sleep environment, and practicing good sleep hygiene can all contribute to better sleep and, ultimately, reduced pain levels. Fun fact: 4 nights in a row of less than 6 hours of sleep can increase our pain intensity by 25%!
Finally, managing your time and energy effectively is essential for living well with chronic pain. It’s important to prioritize self-care, listen to your body, and pace yourself. Learning to say no and setting boundaries can help prevent overload and minimize pain flare-ups.
By making conscious lifestyle choices, you can decrease what’s in your cup and set yourself up for healing. Remember, every decision you make about your diet, exercise, stress management, sleep, and time management can have a significant impact on your pain levels and overall well-being. Choose a lifestyle that supports your healing journey and empowers you to live your best life, even with chronic pain.
The routes to healing
We’ve covered a number of catagories that contribute to pain and I’ve written on many of them, but there is always more to share and uncover. I strongly enourage my clients to figure out the biggest chuncks in there cup and then find the ones that can make change too. That is the best way to start to empty your cup so that pain isn’t as quick to fire off. The major skills you will need are acceptance, hope, accurate facts, and a plan to heal, address, or adjust the mental and emotional aspects of life. This may mean adding a coach, a psychologist, a personal trainer or dietician to your medical team. You may also consider speaking ro your MD about issues you have newly identified and may want to see if medication or other treatment might help manage.
Building a Bigger Cup
Emptying our cup and developing new skills is one way to address chronic pain, the other is building greater capacity, a bigger cup to hold what you already have in it. This is often done through utilizing tools like pacing, graded exposure, graded exercise, and learning to end the boom – bust cycle. Other means to build a bigger cup are addressing old pains, hurts, traumas and or stressors. They play into our pain pictures far more than we realize. Once you realize it, building a bigger and better life gets easier and easier.
I hope that this post has given you some things to consider about your pain picture, and if you are new here, I encourage you to click on the links provided within this post, and to wander my blog. There are many posts that will help you with almost every topic listed within this post.
Have questions or thoughts? Join me on Facebook and continue the conversation!
