Learning to cope with your pain can make a huge difference in your quality of life. Most anyone with pain can agree to that even if they haven’t yet found a good way to cope. I know that early on I alternated between active and passive coping as my attempts at acting coping failed I would return to a feeling of helplessness, only to grow exhausted with the pain and again willing to try something…anything! to help the pain.
- Active coping is making active (mental or physical) attempts to deal with the pain. Whether it’s just changing the way you think about pain (perhaps through cognitive behavioral therapy) or physically doing something (like changing your lifestyle).
- Passive coping is the feeling that you have no control over your pain and nothing you do matters. You feel helpless to improve your situation so you don’t bother trying.
Obviously, active coping is the better choice, but there are many methods to actively cope with your pain? Is one better than another? Does it matter so long as you are actively trying to improve your situation?
A 2016 Swedish study aimed to answer these questions. They evaluated Fibromyalgia patients and neuropathic pain patients (suffering from localized neuropathic pain). One noticable difference between these two groups is the increased risk of depression among those with Fibromyalgia that does not exist for those with neuropathic pain.
The researchers hypothesized that those with Fibromyalgia are more likely than those with neuropathic pain or healthy people to use passive coping techniques due to the generalized nature of their illness (it hurts all over) as well as because of the way that the illness affects serotonin and noradrenaline levels in the brain (both of which affect mood).
Chronic pain (Fibromyalgia and neuropathic pain) patients along with healthy controls were evaluated using the Coping Strategy Questionnaire. The questionnaire measures the patients likelihood of using the seven different coping strategies; five active strategies: “diverting attention,”“reinterpreting pain,”“coping self–statements,”“ignoring pain sensations,”“increasing activity level;” and two passive strategies:“catastrophizing” and “praying or hoping.”
Unsurprisingly, patients overall were more likely than the healthy controls to use coping strategies. Specifically, Fibromyalgia and neuropathic pain patients were significantly more likely than healthy controls to use “reinterpreting pain,” “coping self-statements,” “praying or hoping,” and “catastrophizing.” Fibromyalgia patients were more likely than controls to use “divering attention” as a coping strategy. All three groups were equally likely to use “ignoring pain sensations” and “increasing activity.”
Interestingly, Fibromyalgia patients significantly felt they had more control over their pain and more ability to decrease their pain than neuropathic pain patients. However, when compared to healthy controls both groups of pain patients felt they were less able to control their pain and they were less confident about their ability to decrease their pain.
While the study failed to find any difference in coping strategies between the two pain groups (Fibromyalgia and neuropathic pain), it did find that those with Fibromyalgia believed that their coping strategies actually affect their pain more than those with neuropathic pain do. The researchers found that Fibromyalgia patients are actually able to exercise control over their pain. This may be because of the generalized nature of our pain.
Unfortunately, the recruitment techniques for this study left things a bit imbalanced and makes it difficult to tell if they recruited high-functioning Fibromalgia patients are those who are worse off than normal. The neuropathic pain patients were recruited from a pain clinic, while the Fibromyalgia patients were recruited via advertisements because there is no Fibromyalgia clinic in the area where the study was held (therefore fewer treatment options for those with Fibromyalgia, possibly forcing those patients to take more control of their pain).
As expected those who use more active coping techniques tend to have lower ratings of pain than those who reported using passive coping techniques (hoping or praying or catastrophizing). Go figure, by definition someone who catastrophizes their pain is going to report higher levels of pain.
Overall, we don’t have an answer of which coping strategy is better, but active coping definitely wins over passive, which just leaves you feeling out of control and potentially adds depression on top of the pain. Take control and take action with active coping. It probably doesn’t matter which type of active coping you choose so long as you do something.
So, what’s your favorite way to cope with chronic pain? Do you just hope and pray? Do you catastrophize? Do you distract yourself from pain? Do you try to reinterpret the pain? Do you use coping self-statements? Do you increase your activity level? Or, Do you just ignore the pain?
Or, do you do something else entirely?
In my best Dr. Phil voice…How’s that working for ya?
Baastrup, S., Schultz, R., Brødsgaard, I., Moore, R., Jensen, T. S., Vase Toft, L., … & Gormsen, L. (2016). A comparison of coping strategies in patients with fibromyalgia, chronic neuropathic pain, and pain‐free controls.Scandinavian Journal of Psychology.