We are the story we tell ourselves.

I’m not sure where I heard that but it really rung true for me. We are the story we tell ourselves, we are the words we use to describe ourselves, our lives. So why is it that so many of us tell ourselves a negative story? Or a sad story? Or an angry story?

Language is a powerful thing. The way we talk to ourselves, and the way we talk to others about ourselves, has a profound impact on the way we feel, emotionally and physically. Our words have an affect on how healthy we are in mind and body, on how we’re able to cope with difficult situations, on our chances for success in our endeavors, and in our ability to be happy and present and enjoy life.

I’ve been thinking about this a lot lately because the story I’ve been telling myself has changed significantly over the past few years. I went from being a firefighter, wholly identifying myself as a firefighter, to being an injured firefighter to being a medically retired firefighter who was in pain all the time. This story line made it difficult for me heal and move forward because I was so stuck in what I did as a profession before my injury rather than who I was as a person.

Who I was didn’t change, only my job title did

Along the way I’ve also described myself as injured, recovering from injury, having chronic pain, battling pain, struggling with pain, suffering…describing myself solely in terms of my pain and my hip.

Boy did I beat myself down with negative words, all the while wishing for the days before my injury and longing for the days to come when I could get back to where I was. I was mad and sad and frustrated. And I was worried. Worried about the pain, worried about my life, worried about the future: what would I do for a career? for financial security? for exercise? for fun?

Everything seemed so out of reach because all I saw was what I didn’t have and all I felt was pain.

When we focus solely on the struggle, the struggle is all there is

It wasn’t all doom and gloom, there were days where the light shined through, days I was happy. Days I laughed. My husband and my dog were my happiness, my backyard my oasis. There were good moments. Good moments I relished and cherished.

Those moments were easy to live through, easy to write about. It’s much harder for me to talk about the bad stuff because I worry about what people will think. I worry that I’m not conveying the message in a way people will relate to and gain from, I worry that people will see the good and think the bad can’t be all that bad, I worry that I’m a terrible writer, I worry that I have no business writing about any of this stuff at all.

I worry, worry, worry….more negative words and thoughts piled on top all the others. I’m a worrier by nature.

In addition to being a worrier I was a medically retired firefighter battling chronic pain. I felt weak, small, frail, defeated. I was unable to engage in the activities I enjoyed before. I saw myself as broken, unworthy, damaged goods. I was ashamed, isolated, withdrawn.

And I was also unable to return to the job I loved and had wholly identified myself by. I was declared PERMANENT and STATIONARY in the vernacular of Worker’s Comp. My condition had reached a plateau: I wasn’t going to get any better.

I’d had surgery for femoroacetabular impingement that included a femoroplasty, cartilage debridement, and labral tear fixation. I was diagnosed with post-surgical persistent pain, SI dysfunction, discogenic bulging with radiculopathy, and annular tears. All this added up to a whole person impairment and a disability rating.  

All this sounds dangerous and awful and worrisome, doesn’t it?

Words are powerful, and they can do harm. Especially the language of health ‘care’. It can make one feel more like damaged goods, labeled and put in a box, dehumanized, rather than make one feel like a valued and worthy person.

The words used in all my work comp paperwork led me to worry. I worried a lot. Not that it wasn’t a worrisome ordeal, it was, but my worry was outsized. HUGE. More than I could handle.

Those words that led to the constant worry led to fear that led me to alter the way I moved because I was way over-concerned with my body position at every waking moment.

I had also been told that I was asymmetrical, crooked, imbalanced, unstable, out of alignment, and counter-rotated. That my hip was just weak. That I needed to stabilize my core and work on my gait. So I constantly tried to maintain perfect alignment, concentrating so damn hard on things that shouldn’t be concentrated on, like sitting and walking, so as not make any of the damage (the tears, the bulges, the radiculopathy) worse or fuck up my surgery (a constant fear).

I was tense all the time, my movement unnatural, as I guarded my hip, trying to protect it, to protect me, from more damage, more pain.

Even though I knew better.

Even though I knew that guarding behaviors and fear of movement actually exacerbate and prolong pain.

But I had all those words in my head that worried me, you see.

Is it just me?

How many times have you heard someone say (or have you said to someone else) they have a ‘bad back’ or ‘bum knee’? a slipped, bulging, or herniated disc? shot nerves? that they’re ‘bone on bone‘? arthritic or ‘just old’? that they ‘threw out‘ their back? their knee? that they’re core is weak? unstable? that they’re out of alignment? that this or that is popped out or out of place? that their movement is dysfunctional and in need of correcting?

These words affect the way we experience pain. They can paint a fairly scary picture for us, a picture that is a pretty inaccurate representation of what is actually going on.

This type of language, words used by doctors and therapists as well as people in pain, does more harm than good. If a person is worried that they can make another disc slip out or that at any given moment their back (or knee or shoulder or whatever) will “go out”, they begin to restrict or alter their movement, which actually ends up exacerbating their pain rather than alleviating it.

Their “bad back” gets worse, not because they have a bad back but because they believe they do and that belief changed their behavior and their biology. Their “bad back” gets worse not because of some movement they made that “threw it out” but because of all the movements they didn’t make out of fear of hurting their back more.

The “Unknown Cause” diagnosis and the damage it can do

While some with back pain have an identifiable physiological cause, for many the cause is unknown and it’s told to them as such. For folks with back pain it’s called non-specific or simple low back pain, the cause idiopathic or unknown. That can be tough to hear, especially if you don’t know what those words are meant to convey. You’re in excruciating pain and you’re told it’s simple or non-specific, cause unknown.

Think those words matter?

Being told our pain has no identifiable cause can lead us to feel like we’re being dismissed or that we’re being told the pain is all in our head. I’m fairly certain it doesn’t promote healing and recovery, especially if other, more helpful, words aren’t added to the mix. And even more especially if it’s accompanied by ‘there’s nothing we can do’.

That one really gets me. Because that particular healthcare professional doesn’t have the answer, they make it seem as though nothing can be done. That’s simply not true. There’s much we can do.

It’s important that folks know that even when there’s no physical damage found, that doesn’t mean their pain has no cause or that it’s not real. The pain is not imagined, the pain is not less because there is no lesion.

This is important to recognize because having an unclear diagnosis can be much more difficult to bear than having an awful diagnosis. At least with an awful diagnosis you know what what you’re in for. You have some expectations of what will happen. When your answer is no answer it’s natural to feel lost and confused.

And feeling lost and confused can be quite scary.

All pain is real

Pain is lived, conscious experience. It involves all of the sociological, psychological, and biological factors and influences that ALL human experiences entail. That means everything from the sensitivity of our nervous system to the functioning of our immune system (all related, by the way). The state of our tissues to the state of our mind. From our sensations to our perceptions to our endocrine function to how much sleep we’ve been getting. From our previous experiences and memories to our current beliefs and expectations. Our work and home environments to our personal relationships, to our culture, to our society and our place within it.

By no means is that list exhaustive.

The way the brain brings together and interprets all of this information (and a million things more) can lead to the very real, very lived experience of pain.

So pain is not merely an indicator of tissue damage, that’s just one bit amongst many other bits, but rather the result of all a whole lotta information, perceptions, sensations and predictions indicating there is some sort of threat to our human self and there’s a need for protection.

Pain is there to get our attention and it does a really good job, a necessary job. It’s just that sometimes it’s an unnecessary job, sounding the alarm for protection when it needn’t, when there’s no real threat and we’re perfectly safe.

The point is that no matter the reason for it, no matter how manifested, all pain is real. It’s is not easy to measure, it’s not even easy to define, and it’s different for everyone. But it is ALWAYS very, very real.

The power of words in understanding pain

There’s obviously a lot that goes into the experience of pain that we used to think. Some of it we can control, some of it we can’t. But we do have some control.

We certainly have the power to choose the words we’re using to tell the story of our current experience. We may even have some influence over the words our doctors, our friends, our coworkers, and our loved ones are use when we are discussing pain with them. And that can be pretty damn powerful.

The words are important because the first step to living well with pain, or overcoming it, is making sense of it. To make sense of it, we must choose wisely the words and language used to describe it, whether we’re learning about pain from a healthcare professional or we’re exploring our own thoughts and experiences of pain.

Making sense of pain

If we don’t understand, if we can’t make sense of it, if we can’t gain from it, we need to ask more questions or seek better resources, better words, better depictions (which sometimes aren’t words at all).

If our words are understandable, accurate, and helpful, both the words we use with others and, perhaps most importantly, the words we use with ourselves, we can do much good. When we use language that promotes healing, learning, recovery, growth, confidence, competence, and health; words of empowerment, strength, love, kindness and compassion, we can change our experience.

We can change our story.

In future posts I’ll talk about the story I’m telling myself now and talk much more about the power of words in our health and happiness. I hope you’ll join me in the discussion.

Thanks for taking the time to read this long post! I’d love to hear from you.

If you would like some more resources on pain, you may want to check out bodyinmind.org and painHEALTH.

We believe the story we tell ourselves; the words we use are powerful

 

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10 Responses to "How the words we use can limit our ability to heal"

  1. WOW !!! If you wrote this all yourself, including all the medical terms, I’m totally WOWED and impressed. But, if you pasted it in from a medical journal, I’m still impressed, because you combined it with your personsal experience. You should go to a publisher and present it in the form of a small book to appear on the shelves of bookstores worldwide, in all languages, and it would sell like hot cakes!! Treat yourself with all the extra money it would bring and the gratification you would feel in helping others manage their physical pain. I”M SERIOUS. IT’S A GREAT TESTAMENT !!

    I’ll be anxious to hear what you think of the idea.

    • Thank you, Nell! It’s all mine, no cutting and pasting. And I love that you suggested I write a book! That’s my plan once I’m through with school. I’ve started compiling some research and making some connections in the field of pain science while I’m still taking classes but once I graduate in December I hope to start working on a book in earnest.

      Thank you for your ongoing support and encouragement!

  2. Hello from Norway!

    Great post and your reflections are truly thoughtful and fantastic. Lately I have referred many of my patients to your site. The response is that your stories have great impact and gives a lot of hope for others in pain :)

    Kind regards
    Kjartan

    • Hello, Kjartan! What a wonderful message to receive. I am honored that you share my stories with your patients and humbled that they find them a source of hope. Thank you for taking the time to let me know and for your support and encouragement, they’re truly appreciated beyond measure!

      Sincerely,
      Jo

  3. YES, yes, YES. keep on keeping on. this message needs to be heard more frequently and loudly in the world. I”m sending this link out to my email list for my Body Mind PT business. Well done, Joletta!

  4. Thank you so very much for your thoughtful insight! If words really mean something, then a mere thanks may not be enough! Jeanne Lerner

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