Do You Push Your “Comfort Zone” When You’re in Pain?
Recently I pushed my own comfort zone massively — not with pain but instead by applying, preparing and delivering my first TEDx talk. It’s a talk called “Transform your relationship to pain for a better future” and in it, pushing through pain is one of the important ideas that I challenge.
To prepare for the talk, I was only pushing through emotional and logistical discomfort. And yes once the pandemic hit, and it became clear that I would not be standing on that notorious “red dot”, on a stage in front of a live audience — I had to suddenly also become my own camera-person, sound-technician and set director.
BUT none of that compares to what people are faced with when navigating pain on a daily basis and trying to figure out how to move forward. Many find themselves pushing past the pain and leaving comfort zones behind.
Ironically, I was pushing my comfort zone to prepare for this talk, and yet the idea that I was preparing to share from the TEDx “stage”, includes questioning the value of pushing past comfort zones when it comes to pain.
Pushing through my emotional discomfort for this talk — and then having my effort heralded and praised as a “win”, made me realize this is part of why it can seem like pushing through minor pain would also be considered a “win”.
Pushing through pain is not the same as pushing through irrational fear. However, because pain can bring up fear — it can feel the same. When we push aside pain, it may feel like we’re overcoming irrational fear but the consequences of ignoring pain — no matter how small — is much more dire.
For the answer to why that is, you’ll have to watch the talk.
How Much Pain Should You Push Through?
I’m constantly navigating this question with my patients. By the time they show up in my office, I have to wonder: how much pain are they actually pushing through? In other words, to what degree are they inadvertently under-representing the severity of their situation?
Health care professionals too often assume that patients are over-reporting their pain — “catastrophizing” or exaggerating. That is exactly the opposite of what I’ve observed in practice.
We all wear a façade of some sort when we’re in pain. This pain-mask distorts the true degree of injury and dysfunction. Before I can effectively help anyone, I have to find ways to peek behind the mask.
I need to know: should I encourage them to push through more or less? How far past their comfort zone can I or should I take them during treatment? These questions are impossible to answer without first better understanding the human in front of me.
There are 3 basic pain-masks that we learn to wear in early childhood during our first experiences with pain — big and small. Which mask do you wear?
1. “You’re fine — walk it off”
2. “You poor thing — quick, make that bad pain go away!”
3. “Pull yourself together — what will people think?! “
We carry these reactions with us through life. Whichever one you learned, is the one that most often informs your experience of pain. If you’re wondering which one is the “right” reaction — spoiler alert: none of them.
Is Your Pain-Mask Making You Exaggerate Your Pain?
Probably not.
These learned reactions from childhood, shape our adult pain-masks and each one of them teaches us that pain is a negative thing that needs to be stopped or ignored.
If you deal with daily pain and you’ve come to see it as a bad thing, your only option is to not let the pain “win”. You have to push past it somehow but how much is too much?
Every practitioner who treats pain should have this patient struggle on their radar.
Instead, most of us pain-care providers want to quantify pain so that we can implement the techniques and tools that we learned in school. We’re trained to “fix” the “problem”. We like to check the boxes and wash our hands of the matter without ever giving credence to the patient’s pain-experience which is woefully not quantifiable. But science is showing us that the pain-experience is everything.
By focusing on the “fix” the healthcare profession satisfies patients’ craving for a clear-cut answer. Us providers get to validate our professional training and reassure ourselves that we “know what we’re doing” or at least appear as if. Then if the patient doesn’t respond to our care — it’s easy to say that they are “non-compliant” or they must be “catastrophizing”.
Even though catastrophizing is a common phenomenon that has real neurological roots, it is in my opinion a highly destructive term. It suggests to patients that their experience of pain is somehow invalid.
I have yet to see a patient who doesn’t have a good reason for feeling the way they do about their pain. It’s simply not possible to exaggerate an experience that’s true for you.
What I’ve observed in practice is that people are much more often worried about being seen as “weak”, “whiners”, “complainers”, “babies”. This makes them try to ignore pain and push through it until it’s unbearable. THAT is the problem.
Would we really have as many people with persistent and complex pain if we fostered a caring attention early on — when pain first happens?
Does Paying Attention to Your Pain Mean That You Are Weak?
Listening to pain goes against much of the conventional advice. Even some of the cutting-edge evidence-based advice is to not dwell on it.
The thinking is that if we dwell on pain, we risk spiraling into chronic and limiting avoidance behavior which keeps us from engaging fully in life.
Treatments like Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT) are being used to address pain more commonly these days. While these approaches acknowledge important psycho-social aspects of pain, they also advocate for not dwelling unduly on it.
It’s true that the more we focus on something, the more we amplify the experience of it.
But first of all how we pay attention to pain makes all the difference, but secondly — even though the advice to not dwell is well-intentioned and has clear scientific merit, I believe it feeds into a deeply problematic narrative about pain.
When we accept pain as chronic and as something we have to learn to live with, our only choice is to learn to live with the pain — which these aforementioned therapies are wonderful for.
But there is a very important distinction to make here, and that is that “daily” pain is not the same thing as “chronic” pain.
I believe advocating for “pushing through” pain, even in a smart and therapeutic setting, is actually leading to more complex and persistent pain across the board. The message is getting distorted and misunderstood by people who do not yet have true chronic pain.
Chronic disregard for pain is the real culprit behind this modern pain epidemic. If you don’t even give yourself a chance to stop and look at the pain, you’ll never see the opportunities for understanding, creating healthy context and better coping.
Are You Expecting Yourself to Be Someone You’re Not?
We’ve embraced an unrealistic ideal in our society.
We hold ourselves up to the gold standard of revered athletes or performers or emergency professionals. These people are hailed for the feats they accomplish when pushing the limits of their physiology for the sake of the show, the game, or the rescue mission.
And that is admirable. They should be held up and recognized for these incredible feats.
But everyday people like you and me are not putting on a show, saving lives or being paid millions to play the game. And yet, we have taken on this same high-performing mentality and applied it to ourselves.
“Why pay attention to early signs of pain or discomfort when they are so insignificant compared to the awesome tasks of performing, competing or saving lives?! In fact, any pain that doesn’t completely incapacitate you can’t possibly be important. You can’t let pain win! That makes you the loser!”
If this sounds like your narrative, then I’m urgently telling you: first signs of pain — and what many people might just call “discomfort”- are very important signals. Paying attention so that we can learn from those signals is vital in order to break the cycle of assumed chronic pain.
Is the Chronic Pain Epidemic Actually an Epidemic of Ignored-Pain-Until-It’s-Too-Late?
How often is persistent pain (assumed to be chronic) actually just the result of years of unrecognized and unaddressed early aches and pains, that initially seemed too insignificant to acknowledge?
By the time someone finally presents in distress with severe chronic pain (that seems to have come out of nowhere), we’re no longer actually treating pain. At that point we’re treating the avoidance of pain.
The results of prolonged pain-avoidance include, complicated brain and nervous system changes that can perpetuate pain in a real biological way.
Then of course the only thing left to do at that point is to “kill” the pain in an attempt to salvage our sanity. But if that doesn’t work, then yes — we must find ways to live with it, enter treatments like CBT and ACT.
Listening to your pain starts with talking about it right away. Talk to yourself about it. Talk to a practitioner about it. Learn to talk about your pain without shame or disdain.
It’s up to practitioners and physicians to lead the way here and put aside our desire to “fix”. What patients need from us is permission and guidance to safely and appropriately listen and reflect on their unique experience of being in pain. Everyone deserves to determine for themselves what that experience is.
Pushing your comfort zone to experience new and exciting heights does not have to come at a biological cost.
Pain is a part of life. It’s a part of you. Let yourself experience before blindly pushing ahead. Turning your attention to pain-coping strategies can transform all future pain-experience.
It’s time to embrace pain-coping, not just pain-killing.
By exploring the pain-experience in practice, I now know that we can all learn to improve pain-coping and pave the way for a better future for ourselves and our loved ones.
