Chronic Pain: The Facade of Wellbeing

Chronic pain takes a large toll on a person and their family. Pain cuts deep into a person’s life, slowly eroding all that they were, until at the core is just pain, tolerating, existing and nothing left of the person they had been. Is it better then to maintain a façade of well-being all the time around coworkers and family? Or do we need some alone time to not spend all that energy for the façade itself.

The façade gets us through a good portion of the day and some would say it is necessary to do so. We learn to dampen the behavioral indicators of our suffering, so that other people are not concerned, worried or bothered. It can be annoying to reflect on the need to do this, but seriously we believe no one wants to see our suffering and we seriously do not want to endure their real or false sympathy, their good or poor advice. It is a coping mechanism and not everyone likes it but most of us develop it. So that we can live what life we can without constantly needing to explain.

The façade is not only to hide our pain from others but to distance the pain from ourselves. There is a point where working is beneficial because it occupies us, distracts us and forces us to erect that facade. Without it we would be brooding at home with no separation between us and our pain. Thinking about pain makes it worse. So to a point it is a great coping mechanism. I often do not talk to people about the realities of my chronic pain because it often breaks down the facade and people get a glimpse of what is beneath it.

But the facade is a facade. It is a face we put to the world. When the pain goes beyond that point then the facade is stripped away and all that remains is raw pain. So raw you can't move, you can't think, you can't even scream... it just freezes you as you tremble with the overpowering need to do anything to end it and knowing nothing will. People will see that, most likely family will see that... it is inevitable. And that is fine. That sort of pain needs to be dealt with, or at the very least acknowledged. You can not and should not attempt to hide it. To try would lead to a desperate need to end it. In such cases the façade becomes detrimental, since extreme, acute pain should not be held to yourself.

With family we use the facade as well, for many reasons more important than we use it on others and co-workers. We may talk about the level of pain or a symptom that is bothering us, but that level of sharing does not cover the depth of what is felt, or the chronic everydayness of our usual pain... it just may acknowledge a bad day. So is having that facade 24/7 become detrimental? Is it more stressful and tiring than if we could just shed that facade with our work clothes at the end of the work day? Maybe, to some degree, it is a good thing for all people concerned. Frankly, no matter how great we think we are at pretending we are not suffering, we are not. People close to us know, by all the little signs we cannot mask behind a flippant joke and a smile. And those closest to us know because smiles become fixed, eyes glazed, personality flat.... we are not ourselves. Sometimes family members will say that they no longer recognize the person with chronic pain when the pain is bad, as though the pain leaches out everything, all their vibrancy and personality. Any facade takes effort and even that effort is noticeable. Often the facade is for their benefit, rather than our own (while at work or in social situations we use it to our benefit). It is terrifying to expose that raw pain to people that really care. Partly because of the emotional strain and frustrations we hold come out when the façade drops. Partly because we know revealing the full nature of our suffering would only worry those we love when they have no way to help us.

Whether we hide it or not our family knows and it affects them. So how does chronic pain affect your family, your spouse, your children? How does that decreasing lifestyle affect them and their desires? How does your lack of goals and future thinking affect their outlook? How does seeing you suffer in the severe pain moments and behind your facade, knowing they can do nothing for you affect them? It is not the same answer for everyone. Many single people, while they may be free of that facade off work hours, they also sometimes choose not to date, because they do not want to have someone else have to deal with their illness, do not think anyone would want to, do not want to pretend to be fine when they are not. Truth of the matter is that some people cannot handle a spouse with chronic pain. Sometimes they handle it by not handling it. And sometimes significant others are just what we need; a combination of sympathy and support. But that has to be stressful, hard and tiring for them. So it is not just you and your pain, it seeps into every aspect of your life and affects all those around you. It does not mean we have to pretend harder, as that will get us nowhere, but we should consider the affect on our loved ones. Acknowledge it, even if we do not know what to do about it.

The façade is extremely useful to get us through the work day. Just like we all play roles in different situations, the pain façade enables us to perform with some distancing from the pain while avoiding the complications that arise in a workplace for someone with chronic pain. No one wants others to think they are using their illness as an excuse or are chronic complainers. Just as we hardly need every random cure and lifestyle advice people feel the need to offer. That being said, using our façade of well-being can lead to a feeling of isolation. It can lead to others doubting the chronic nature of our illness, since it is only expressed when it is dire. It is best to leave the façade for the outside world and connect more with friends and family. Communicating about your pain level with loved ones on a regular basis with ease stress for everyone and let others know when a day is a good pain day and when it really is not.