Rolling with the Punches

Suddenly, agony like Yana has never felt before. The excruciating pain feels like a powerful electric shock that starts in her lower back, moves through her hips, and ends all the way down in her right calf. The severe numbness and weakness it causes in her leg makes her stumble and fall out of the boxing ring. Tito, her coach, rushes to her aid, and within minutes, both of them are aboard an ambulance on their way to the hospital.

It all began three years ago, on the day Yana decided to celebrate her 30th birthday by joining a boxing gym in order to get in better shape. It was then that she first felt the tingling sensation in her body. She had just completed a full boxing workout for the first time in her life, so she dismissed the minor discomfort as nothing more than a nuisance. But the unwelcome visitor returned a year later, this time in the form of shooting pain. Yana ignored it once more, belittling it as nothing more than a side effect of her rigorous routine.

However, a few months ago, while doing squats, Yana felt an intense burning sensation in her lower limbs that lasted several days. "Don't worry, you probably pinched a nerve," Tito said at the time. "It's very common for boxers to go through this. Repetitive movements can cause swollen muscles and joints. This can translate into numbness, stiffness, and even the sensation of pins and needles in the body. We'll work on your posture and movements, and you'll notice that the whole thing will be over sooner rather than later," he added. But the former national heavyweight champion was dead wrong. Yana's condition deteriorated over time, to the point where the persistent ache not only interfered with her training but also began to affect her life outside the ring.

"Hi Yana," Tito says warmly as she opens her eyes. She's lying on a bed as a nurse makes sure her IV is delivering the right amount of sedatives into her bloodstream. "I just found out that you've been admitted to the emergency room three times this year for the same problem. Why didn't you tell me anything before?" Tito wonders. Yana responds slowly and sleepily, "I felt guilty, lost, and helpless. I reasoned that if I stopped thinking about the pain, it would go away. That was a stupid assumption on my part, I know. But you must understand that I am terrified at the prospect of one day being unable to live a normal life." As he listens to her, Tito takes her hands in his and says quietly, "Hold your horses. Let me tell you something that I hope will put your mind at ease."

Pain is undeniably a global health issue. According to the BMC Public Health Journal, one in every five adults worldwide suffers from physical pain, whether acute, chronic, or intermittent. Every year, an additional one in ten adults is diagnosed with chronic physical pain. Arthritis or joint pain, back and neck pain, headaches and migraines, muscle pain, and stomachache are all common types. Pain has a number of serious side effects on the body, including but not limited to fatigue, sleep disorders, appetite changes, high blood pressure, and muscle tension. It can also cause altered perceptions, mood swings, anger, anxiety, and depression, among other things.

According to new research published in the British Journal of Health Psychology, people who experience chronic physical pain also report feelings of deep guilt. This is due to three major factors. First, others believing that the pain is unjustified (e.g., people thinking that they are faking their symptoms). Second, others assuming that the individual is not properly managing the condition (e.g., criticism about not following a treatment). Finally, personal beliefs about how their pain affects others (e.g., inability to perform at work as expected). High levels of pain-related guilt are associated with a greater proclivity to catastrophize, ruminate, and isolate.

It goes without saying that the combination of ongoing pain and its physical and emotional consequences can lead to despair. Misery, discouragement, anguish, agony, and distress are all present when we lose all hope. Despair is also accompanied by frustration, helplessness, sadness, grief, and fear. In more extreme cases, it can be linked to suicidal thoughts because believing there’s no hope for a healthier and happier future can be interpreted as life itself being meaningless. In such circumstances, returning to a state of mind where people can live a full and happy life frequently requires the intervention of a mental health specialist.

Managing the many problems that come with living with constant pain takes a great deal of personal strength. This, according to Bruce Daisley’s book Fortitude, finds its origins in three cornerstones: control, identity, and community. A sense of control over our own destiny fosters self-esteem and a feeling of empowerment. It aids in the prevention of physical illness and protects us from stress and depression. Also, thinking we have control over our lives makes us want to find ways to deal with our problems or at least new ways to think about them. As for our identity, we need to set boundaries between ourselves and our problems. Once we understand why we feel the pain we do, where it comes from, and why it is not our fault – why, in other words, our pain is our experience, not who we are – we can start to turn away from the harmful story we have told ourselves. And a sense of community makes us feel like we're all in it together. When we believe that we belong to a group and are in sync with it, we feel safe. Anything that separates us from the group hurts our well-being and, by extension, our inner strength.

So, how does Daisley recommend we cultivate our sense of control, identity, and community? To increase our sense of control, it's worthwhile to reduce the uncertainty and lack of information that cause us stress, even if it means starting with the little things in our daily lives. The same can be said for looking for positives in our current situation; even if they are minor, they will help us feel more in control. In terms of identity, interacting with others who are going through the same things we are can help, because we will soon realize that they are much more than the burden they are carrying. As a result, spending time with people who share our feelings can be extremely beneficial. Finally, shared adversity results in shared emotions and synchrony. This is because human activities such as eating, laughing, and performing rituals together cause the release of endorphins. Taking advantage of opportunities for social bonding will allow us to strengthen our sense of community and combat the debilitating effects of loneliness.

Richard Templar, the author of The Rules of Thinking, agrees that resilience comes from believing in our power to control our own lives, from attaching our identity to who we really are, and from having help from a community of supportive people. But he also mentions three other sources of inner strength that can help us cope with incapacitating pain. First, acceptance. We can't deal with a problem unless we recognize it. If we try to change the inevitable, fight the unbeatable, or change the past in our minds, we will remain stuck in that place. Acceptance does not imply giving up; rather, it means recognizing what we cannot change and moving on as soon as possible. Second, liking ourselves. There is a strong link between resilience and self-esteem, or how much worth we believe we have as individuals. It’s not the same as confidence, which is more concerned with the skills and abilities we think we possess. This is about whether or not we believe we have intrinsic value. We will cope better with adversity if we like ourselves than if we don't. And third, cutting ourselves some slack. People who are resilient know how to be gentle with themselves. This isn't about absolving ourselves of responsibility; it's simply recognizing that self-criticism is counterproductive.

Templar observes that acceptance is accompanied by flexibility, a degree of elasticity that allows us to bounce back in the face of adversity. The more adaptable our thinking, the sooner we'll be out. This is a skill we can practice on smaller issues that are frustrating rather than disastrous. In terms of liking ourselves, he emphasizes the importance of not comparing ourselves to others and berating ourselves for not doing what they can. It also entails not comparing ourselves to some idealized image of what we should be like in our heads. Finally, self-kindness can be fostered by forgiving ourselves when things don't go as planned and recognizing that it has nothing to do with who we are. We should also surround ourselves with people who will encourage us to think positively and avoid anyone who will tell us we're not good enough. Their point of view isn't correct, and it's certainly not helpful.

A few weeks have passed. Yana listened intently to what Tito had to say and implemented all of the experts' recommendations. She worked on her sense of control, identity, and community to develop inner strength. She also paid attention to accepting her situation, liking herself, and being kind to herself. This, along with medical treatment and the assistance of a mental health specialist, is helping her better cope with her chronic pain. The days of fear, guilt, and helplessness are long gone. Anxiety, misery, and despair are now a thing of the past.

The sound of a loud “ding, ding, ding” comes out from the bell in the arena. "Let's get ready to rumbleeeee," yells the referee from inside the ring, and Yana smacks her opponent's gloves. To spectators, this means she’s ready to begin her battle. To her, this means she already won it.

Author: Esteban Polidura, CFA. November 19, 2022.

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