Pain can pose a challenge to friendship. You may feel that your pain is a drain on your friends, that they find you dull or tiresome. You may be disappointed in your friends' reaction to your pain, feeling they don't understand or care. You may worry that you won't be able to do what you used to do together or you may be unable to keep up. You may fear that your friends will be angry or annoyed if you have to reschedule a get together or leave early. You may not even want your friends to know about your pain. You may feel that you can't be the kind of friend you used to be, so you avoid your friends altogether.
These are common concerns. Sometimes they may even be valid with some friends some of the time. But friendship is such an important part of our lives, that it may be helpful to think about ways to preserve them even though you have pain. There are at least three important factors in maintaining your friendships: commitment, communication, and flexibility.
Commitment
One of the biggest barriers to maintaining friendship is when you drop out of your network of friends. If your commitment to having and nurturing friends has faltered, you may want to give some thought to which of your friendships matter and what you can do to renew your commitment to those friends. As you think about this issue, try not to worry for the moment about how you will continue your friendships, focus instead on which friendships are truly meaningful. (We will talk about how in a moment.)
Communication
Once you have decided who matters, open the door for communication. An important step in honoring your commitment is to talk with your friends about your pain and how you feel it has impacted your relationship. Start by talking with those friends who mean the most to you. Think about the assumptions that you have about your pain and how it might impact your friendship with that person. Then take the time to sit down and talk with your friend. You can talk about some of the fears you may have and ask your friend about his or her concerns. You may be surprised that your friend welcomes a frank discussion. Direc
t communication will be most effective.
Be Flexible
It is very possible to maintain a close circle of friends even though you have chronic pain. The key is to recognize that how you spend time with your friends may change. There is no need to isolate yourself. Flexibility is the key.
Maintaining contact is important. Be flexible in how you reach out. Try varied ways of staying in touch, using less taxing methods when you aren't feeling well enough for face-to-face contact:
- text
- voicemail
- online chat
- phone
- an old fashioned card or letter
Examine your views on what it means to “get together”. If you used to do very structured or elaborate things with your friends (e.g., dinner parties or nights on the town), it may feel odd at first to take a more relaxed approach. To ease the transition to a simpler way of being together, try giving a short explanation to your friends as in the examples below. Over time, such explanations won't be necessary.
- “I feel bad that I can't invite you over for dinner like I used to. But, it would be great to meet for lunch.”
- “I am sad that we can't play softball together anymore. My knees are just shot and running doesn't work out too well. I can still hit though and would love to go to the batting cage with you.”
- “I miss our long afternoons of shopping. Walking around for a long time is hard for me. How about if we meet up for coffee?”
I hope that some of these ideas will help you to restore and nurture your friendships. It means so much to be connected to others. Don't let pain take that away from you.
About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and Director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives.
DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.
The limits I have are often unpredictible and I gene to shy away from planning things ahead of time. One of the most helpful things I have learned to say to my friends when they invite me to do things is, “I really WANT to do that.” I have found that starting my response this way opens the door to being able to share my concerns and hesitations. They are then more able to really hear what my limitations or fears are and feel less like I am brushing them off. Often this will opens the door to a kind of team problem solving that makes it so I can participate. It helps my friends understand that I DO want to spend time with them and that of is the proposed activity that is the challenge and not their company.
Very helpful ideas. I like that your response lets your friends know first and foremost that you care about them and want to participate… and opens the door to find a solution. Thanks for sharing.
Very frank, kind and to the point. I truly appreciate and agree with most that is stated here by you. One point to consider though is that with some chronic ailments the physical problem itself may limit your ability to get to those friends. I agree wholeheartely that having that frank discussion is key and can testify that it works. You find out real fast who is a friend and who perhaps who would like to be a friend but has fears of their own. Many seem to have fears of asking you to do to much so they won’t ask you to do anything. But that frank discussion … yes that has proven to be key even with close family members.
However, my friend Dr. Ruehlaman, there are conditons that prevent one from being mobile dispite their wishes. Conditions that profoundly effect/affect what a person can ‘safely’ do that have nothing to do with pain. I would love to see a similar article that deals with some of these conditions. Or if you’d like to know specifics we can do that but preferably not on a blog.
At any rate, nice job I enjoyed this article. Thank You!
Hi Michael,
Thanks for your thoughts. My hope is that even those with the most limited mobility will be able to connect a bit more. I think that technology can be a great help. Staying in touch via text or email can make a difference when one is really isolated. Thanks again for your response.
Thank you for this blog topic. It really helps to hear and see this in print- that others are feeling the same thing or have the same fears or feelings that I do. It is very sad when we realize that our friends do not suport us in our disease .I have spent so many years trying to justify myself to people who just do not understand chronic pain , I realize that if someone cannot support me then chances are they really do not have my best interests at heart . We are better off without them and better to put our energy into more supportive friends and family. I think that people with chronic pain carry enough guilt already ,without the stress and guilt others can inflict.
I agree, guilt is generally not productive. I am happy you have a group of family and friends that understand and support you.
Clear, concise and simple. Thank you again for helping me to see that overthinking isn’t terribly helpful. A bonus challenge is managing dynamic boundaries, well i make this assumption, i am still giddy about almost mastering pacing in my personal life…..sort of.
I am glad it was helpful and that pacing is working for you!
Excellent article.
I would like to know how to make new friends within the limits of a disability. I moved to a new town soon after becoming disabled. While the change has been good physically for many reasons, I haven’t been able to easily meet new people and grown new friendships. I can’t volunteer because my condition makes it difficult for me to fulfill commitments. I can’t regularly attend scheduled activities for the same reason. Any suggestions?
Hi Judy,
A move is hard for anyone and pain can present additional challenges. While I am no expert on making new friends, I can think of a few things that might be helpful. One concern that many people with pain share is that you don’t want to make a commitment that you may not be able to meet. It sounds like that is a significant barrier for you. You may want evaluate the details of that idea. For example, would you be able to meet a commitment half of the time? Might you be able to attend if it was understood that you could only stay for part of the time? Would it be possible to take part in activities that were in the afternoon (or whatever time feels best to you)? I guess I am thinking that if you challenge that basic idea a bit, you may see some options that would work for you. The second hurdle is that of meeting new people. The more you can get yourself out of the house the more likely you will meet others. Routines often facilitate meeting others – going to the same coffee shop on Tuesday afternoons, attending a water aerobics class on Friday morning, sitting on the front porch in the evenings, joining a church. When you are out, talk to people as much as possible and take risks. Invite a neighbor over for coffee. Offer to help with a church activity with the understanding that you have limitations. Go to something even if you know you will leave early. A third thought I had is that when you are home, use technology to stay in touch. Meet others on facebook or other online sites. Send emails, text, or call friends and family from your old town. Don’t give up! Good luck.
This is a well thought-out and written piece. I have been a chronic intractable pain patient for 25 years and an activist, speaker, and advocate for 12 years. A danger of chronic pain is the withdrawal from past friends, lack of activity, isolation, depression, and becoming stuck in that rut. Once in this vicious downward cycle it is very difficult to escape, and it grow more difficult as time goes on. This syndrome will only be recognized and changed when a family member, caretaker, close friend, or the patient themselves are aware of the complexity of the problem, and “get after it.”. Some people in chronic pain feel that isolation, as life passes them by, is a normal response to chronic pain. It’s vital that people in pain follow the advice/recommendations of a professional like Dr. Linda Ruehlman, not only does it help cope with pain, but isolation offers no means for the person in pain to gain some of their life back.
Hello Robert,
Yes, the downward spiral into isolation can be so dangerous and hard to escape. But, as you say, isolation need not be a feature of chronic pain. Thanks so much for your comments.
I recently went to brunch with some friends who know I suffer from chronic migraines. Despite their assurances that we would go to a restaurant without a long wait for a table — because I needed to eat soon so as to not trigger a migraine — after 45 minutes and 4 table changes, which they insisted on, I left without having lunch. They all acted as if I had a problem . We had a big argument and I left. This happened 3 weeks ago snd we haven’t spoken since. Also they teased me about not going out much. This is why. I welcome the oportunity to discuss this with people who understand, and are supportive of, people who deal with chronic pain. Thanks fir providing this forum.
Hi Susan,
What a hurtful experience. I am sorry you had to go through that. It can be very difficult for people who don’t have pain to understand the mechanisms of pain. Depending on the nature of the friendship, I have found it is worth working to help them to “get it”. I am so glad this is a helpful place for you! Thanks for sharing.
Linda
P.S. I always take a protein bar in my purse for circumstances where I feel there may be a risk of a hunger-induced migraine.
This has been a tough area for me – I blogged about it a few months ago:
http://laborpain.wordpress.com/2011/06/14/spooning/
Hi Malia. I agree, it is a tough area, but well worth working on. Thanks for sharing your blog link.