Living Successfully with Chronic Pain

by Ruth Stella MacLean

How writing in your journal can change your perspective

One of the techniques I advocate in my book Living Successfully with Chronic Pain is keeping a journal in which you record your levels of pain, your activities and your thoughts and feelings.

It has been a big help to me when I am talking to health professional about the best way to proceed with my treatment, and especially the management of my pain.

I was also able to chart patterns, to see which activities seemed to lessen my pain and which ones seemed to increase it. With a little help from my journal I could figure out what was happening to me and more importantly, what was likely to happen to me when I did certain things.

The most amazing result was that my journal allowed me to see how big a role my emotional state played in the level and duration of my pain.

I came across the scientific studies of James Pennebaker, a University of Texas at Austin psychologist and researcher. He determined through his work that when we write about stressful events, it helps us to come to terms with them, and that in turn reduces the impact of mental stress on our physical health.

Other studies into why journaling works indicated it helps us remove mental blocks and in the process, helps us to better understand ourselves.

Many journal writers are concerned that if they just let themselves go without restraint when they write about their pain that it would be unbearable if their spouse or someone close to them ended up reading it.

My advice is to write without restraint for the full benefit to you, but be judicious about the parts of your journal that you share. Keep your journal in a safe and private place, or get one of the many books with a lock, and then use it to unburden yourself and tell it like it really is.

In this way you will get a better understanding of your feelings in relation to your life with pain—a huge benefit in the long term.

To me, the additional benefits of keeping a pain journal are that it helped me to clarify my thoughts. I noticed my pattern of behavior changing. When I began the journal, I started each entry with a lament for the past; later I moved to talking about the problems of dealing with the present, and ultimately, it led me to a new place where I began to make plans to restructure my life with chronic pain.

For the first time since my pain started, I began to concentrate on what was possible, as opposed to what wasn’t. Keeping a journal helped me to begin my search for a new life, a life that made room for my pain.

Ruth Stella MacLean, author of Living Successfully with Chronic Pain, is a former nurse and hospital administrator turned bestselling novelist. Her chronic pain, which forced her to give up her career as a health professional, opened a new door for her to become a successful romantic suspense writer. To order her book on chronic pain, click on the title below.

Living Successfully With Chronic Pain

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Ruth Stella MacLean, author of Living Successfully with Chronic Pain, welcomes your stories and inquiries.

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One Part Science, Three Parts Heart

  • More tips on how to live with chronic pain

By Ruth Stella MacLean

Author of Living Successfully with Chronic Pain

Article at a glance: If you live with chronic pain, you may often feel slightly alienated from the 24/7 constantly moving world around you. It is packed with people who move effortlessly without hurting, who have a seemingly endless reserve of energy, and who make plans with a reasonable certainty that when the day dawns they will feel like fulfilling their scheduled activities. You have none of those luxuries. How can you find your place in that world, accomplish your own purposeful work, and still deal with your chronic pain issues? In this special report, you will find lots of tips from the chronic pain community shared with love and a smattering of science thrown in to signal hope for our future.

Sharing ideas to cope with chronic pain

If you are reading this special report, chances are that the last few months or years of your life have been blurred by pain. You have sought help from many levels of the health profession but you still find your quality of life changed with the enduring pain.

Your doctor and your physical therapist and many others you encountered in your search to alleviate your pain have cast some light on your situation, but you couldn’t escape the feeling that you were being talked down to. Your family stepped up to the plate with kindness and well-meaning advice, but your altered role is nonetheless taking its toll on the household dynamics.

Most friends watch helplessly and voice their support, while others cannot cope with the changed you and call less frequently now. You read the statistic that one of every five people on this planet endures chronic pain for periods of their lives, but right now, you feel very alone.

I understand all of these thoughts and feelings because I live in chronic pain. In my book, Living Successfully With Chronic Pain, I chronicle my journey to managing my pain and recreating my life. I had to give up my career as a hospital administrator and reinvent myself as a romance/suspense writer. Pain has become my lifetime companion and I work hard to find ways to cope with it.

After my book was published, I received many letters and emails from readers who shared with me some of their techniques for coping with their chronic pain. I was intrigued by all of their suggestions and tried many of them. Most of all, my spirits were lifted when I suddenly realized that I was part of a whole special community: the people who live with pain successfully.

This special report contains some of those tips that I learned after I finished working on my book coupled with some of the latest scientific reports on successful pain strategies.

Defining chronic pain

One of the first things that I realized recently was this. Doctors and other health care workers ask us to describe and define our pain based on a numbering system from one to ten. This is not a system that works for me. Putting a number on the pain level doesn’t describe it in a meaningful way, nor does it describe how the pain behaves.

I define my pain by asking myself these questions.

Whether it is an episode of pain, or the regular day-to-day pain, how intense is it?

How long does it take me to recover?

Was this pain different from the last bout of pain?

If so, how was it different?

Subtle distinctions when talking about pain were noted by one of my readers as well. She only began to put her life back together when she realized there was a difference between living with pain and masking pain. She decided it was sometimes okay to acknowledge her pain, both to herself and others, and then direct her thoughts to positive things in her life. She engaged in laughter as therapy and stopped using superlative adjectives to describe her pain.

She would respond merely “I have pain,” when asked how she felt, if she felt absolutely awful, instead of saying things like “the pain is killing me” or other “I can hardly stand this pain.” If she was going through a time when the pain was being managed, she would respond “fine.”

Those close to her appreciated her truthfulness without drama and responded calmly and kindly to the times they realized her pain was intense. They learned not to encourage her to go beyond her activity limit. Overall, everyone seemed more comfortable without the superlatives, she explained.

Another thing readers shared is that while sources of their pain can be grouped together, as in pain resulting from an injury, surgery, or medical condition such as cancer, shingles, diabetes, arthritis and others, no one thing creates the same kind of pain for each person. Each person’s pain is unique in some way. Just as blue is a color but there are many shades of it, from sky blue to royal blue to baby blue; so too are their varying shades of pain.

Keeping pain from taking over your life and identity

Pain may be unique, but our response to chronic pain has some great similarities. An overriding concern of many people is fear of losing their entire identity to their pain.

Instead of being known as Mary the accountant or Sam the gardener, they become known merely as “poor Mary,” or “poor Sam” who is always in pain.

Their talents, their abilities and their personalities live in the shadow while their pain takes over the terms in which others view them. Fighting back from this edge of non-existence is a major issue for most of us.

The problem is intensified by the fact that so many people with chronic pain have to re-establish a new identity. Mary the accountant, for example, has to come to terms that she can’t sit at her desk for 12 straight hours a day during tax time and get everything done. Sam can’t climb the stairs to his top-floor studio anymore and has to find a new way to paint his murals in keeping with his new life with pain.

The recurring theme in all the messages is that the faster people let go of the idea that they will find a magic pill they can take to get their life back to normal, and instead focus on the adjustments that need to be made to re-establish their identity in a new way, the better.

Of course that is so much easier said than done. When the pain begins we all believe that it is just temporary, that time and the miracles of modern medicine will soon have it under control and no longer a dominant force in our lives.

It is depressing when we discover that such is not the case. In our struggle, we start to talk more about our pain, because in the aftermath of its arrival, it takes over our minds as well as our bodies.

It is the subject that leads every conversational exchange with friends and family; it is the elephant in the room even when you go out for a night and try to live normally. It is a means for people see you only as someone they feel sorry for or to dismiss you as no longer be involved the way you once did.

Proven Techniques for relief of chronic pain

The medical profession is focused on finding new research to solve pain issues, so in my work of helping people to live with chronic pain, I have focused more on seeing if certain coping skills I try or my readers mention seem to work for more than one or two people.

Three scientific studies into how people cope with chronic pain in the last 10 years support what many readers are saying works for them.

The three techniques include laughing, listening to music and changing your attitude.

In 2013 at a meeting of The European Pain Federation (EFIC) Congress in Florence, Italy, a group of Swiss researchers led by Thomas Benz suggested that based on their research, humor interventions should be considered effective pain therapy.

A group of study subjects were shown hilarious films as they sat in a theatre with their hands in ice water. They were asked to keep their hands in the freezing cold water for as long as they could bear it while they watched the films.

Those who laughed at the films and were able to really enjoy the comedy of the moment were capable of keeping their hands in the ice water longer than those who did not laugh. In fact, follow-up tests showed that their pain tolerance remained for 20 minutes after their laughing stopped. (I’ve no idea why the researches chose ice water. Could they not have come up with a more real life type of pain?)

The researchers postulated that the results might be attributed to the laughter activating endorphins release and relieving muscle tension.

Interestingly enough, the subjects could not get relief from faked laughter. They had to be giving genuine belly laughs to get the full benefit of the pain relief.

In another study, researchers at the Cleveland Clinic Foundation in 2006 studied the impact of listening to music on 60 patients who had been enduring chronic pain for half a dozen years.

The patients were randomly divided into two groups. One group listened to music for one hour a day on headsets. Half of that group could select their own music while the others could only pick one of five pre-selected relaxation recordings. The other group had no music at all.

According to the study results published in the Journal of Advanced Nursing, the people who listened to the music charted a 21 percent reduction in their level of pain and a 25 percent drop in their depression caused by their pain compared to those who had no music. It did not seem to matter whether they selected their own music or had it provided to them.

The attitude and chronic pain study took place in 2012 and was published in the journal Pain.

In this instance, researchers at the Johns Hopkins University School of Medicine discovered that people who constantly talk about pain and have negative feelings about it, and can’t sleep because of pain, have more negative thoughts about pain than those who talk less about their pain. The researchers used the term “pain catastrophizing” to describe this experience.

Research team leader Dr. Luis F. Buenaver concluded that while it may sound simple, the reality is that you can change the way you feel by changing the way you think.

A total of 214 people were involved in this study, and all suffered from myofascial temporomandibular disorder (serious facial and jaw pain).

What else can science suggest to ease your pain?

Wrapping up this report on some of the latest scientific studies into chronic pain, there are three more methods that people who live with chronic pain may find helpful as coping strategies.

First, stop watching the news or reading reports of bad things happening in our world.

Researchers at Ben-Gurion University of the Negev discovered that the intensity of chronic pain increased in study subjects when they viewed terrorist attacks in the media.

Secondly, talk to your spouse and solicit their respect for and acceptance of your pain.

Researchers from Wayne State University and the Norwegian Center for Addiction Research recruited 78 adults with chronic pain and their spouses for the experiment. The results, published in The Journal of Pain in 2011, showed that if a spouse validates the behavior of the person in chronic pain, they cope better. If their pain is greeted with hostility or ignorance by their spouse, the patient becomes more distressed and is prone to depression. Men in particularly responded poorly if their partner did not validate their pain.

The third and final study examined showed that meditation helped chronic pain patients experience a 20 percent reduction in pain intensity.

This study, published in 2016 in Military Behavioral Health, was conducted at the Washington, D.C. Veterans Affairs Medical Centre and involved veterans.

Dr. Thomas Nassif, who headed the study, concluded that the patients who meditated seemed more able to accept pain and respond to it with less stress than those who did not meditate.

Conclusion: You are not alone: we can help each other

Between my book and your responses, coupled with what researchers are discovering, one conclusion is clear:

If you suffer with chronic pain, you are not alone. There is a caring community out there who has great ideas and wants to hear your suggestions. While we wait for medical interventions to be discovered to make our pain more manageable or eliminate it entirely, we can be bolstered by finding new strategies to live with our pain and still have meaningful lives.

We are learning that we often do better with a combination of different coping mechanisms to get back on our feet.

I remain a big believer in keeping a daily journal in which I chronicle new strategies I try and the results not just for that day, but for the week that follows. What my journal keeps telling me is that successfully copying with chronic pain at this point appears to be about one part science, and three parts heart.

Please keep sharing and keeping this discussion going. In the near future I hope to bring out a companion workbook to support my original book that will help you work through your journey back to purposeful living.

About The Author

Ruth Stella MacLean, author of Living Successfully with Chronic Pain, is a former nurse and hospital administrator turned bestselling novelist. Her chronic pain, which forced her to give up her career as a health professional, opened a new door for her to become a successful romantic suspense writer. To order her book on chronic pain, Living Successfully with Chronic pain click on this hyperlink:  If you prefer an ereader version go to Kindle, Kobo, or iTunes for a digital version of Living Successfully with Chronic Pain.


Turk, D.C. (2011) Interdisciplinary Management of Adult Patients with Chronic Pain – When Pills, Potions and Procedures Are Inadequate.

Siedlecki, S. (2006) Effect of Music on Power, Depression and Disability. Journal of Advanced Nursing. June 54 (5): 553-62

Buenaver, L.F. (2012) Change in Attitude May Ease Chronic Pain By Aiding Sleep, Study Suggests. John Hopkins Medicine.

Shahar, G. and Lerman, S.F. (2012) Viewing terrorist attacks on TV increases pain intensity.

Lumley, M.A., Cohen, J.L. et al. (2011) Pain and Emotion: A Biopsychosocial Review of Recent Research.

Nassif, T. (2016) Meditation may ease TBI pain.



Welcome Back and Updates

Welcome to my blog on living successfully with chronic pain. It’s been awhile since I posted here, but my life has been pretty awful these past three years. My husband of 47 years died of ALS July 6th 2013, and my daughter was diagnosed with ovarian cancer and has gone through several rounds of treatment since the fall of 2013.

To say that life is unfair at the moment is a gross understatement, but as my sister Elizabeth Secord Calder was fond of saying, “This too shall pass.” But it will only pass with time, and then very slowly. Time is only antidote to grief, sorrow and emotional pain. We need time to recover from whatever event has impacted our lives, threatened our happiness, or made us reconsider who we are and what life is really all about.

As you can imagine when my husband received the dreaded diagnosis, one of my major concerns, besides the horror of his diagnosis and the devastation it was causing him, was whether or not my chronic pain could be managed around all the worry, exhaustion and of course all extra things I had to do every day to maintain my husband at home as long as possible.

At first all I could do was try to get enough rest and use all my normal pain management techniques to ward off a major pain episode, something I feared very much. Not only would it be painful for me, it would add to my husband’s worries. The last thing he needed was to be worried about me.

At night, after I’d gotten him settled in his hospital bed, I would go to what had become my room to rest. In order to relax I would close my eyes and begin ‘seeing’ my body from my toes to the top of my head. This idea of ‘seeing’ was to try and visualize and relax all the areas of my body. I focused on seeing it on what I call the screen created by the inside of my eyelids. It acted as a distraction I suppose, something to free up my mind from all the worry and allow me to fall asleep. As you can imagine I couldn’t take any type of sleep aid that might mean I wouldn’t hear my husband should he need me during the night.

Then one night after an exhausting day during which I realized that my husband’s symptoms were progressing much more rapidly than the doctors had anticipated, I felt completely lost and afraid. What would my pain mean for him and for me? I was lying in bed in pain and desperately worried about what would happen next. Then something truly unusual happened.

I was going through my closed eye routine, my worry chasing after every thought in my mind. My pain seemed to be worse than usual, but when I came to the area of pain in my right leg I stopped. Placing my hand over the area I ‘saw’ the spot in my mind’s eye. As I worked slowly on the spot, visualizing it, feeling the pain in all its intensity rather than backing away from it, letting my mind ‘go’ to the spot in a soothing, caring way, the pain began to ease. At first I thought it was all in my mind.

A few days later I experienced pain in the same area, and this time I intentionally focused my attention on my hand that rested over the spot, visualizing the spot beneath my fingers.

After that, each time I felt the pain begin, I grabbed the first opportunity to ‘go in my mind’ to where the pain was. Placing my hand on the area I ‘looked’ it over carefully, giving it shape and sometimes pressing on the area in an attempt to get closer to the pain. The difference here is that before I found this technique I would be more removed from the pain, looking outside my body for the relief, not inside.

So for the remainder of my husband’s life I worked on this technique, finding it easier each time I did it, making it possible for me to keep him at home until the final three days of his life.

Then when my daughter became ill and I moved to be near her during her treatment, I used the ‘mind’ technique to manage my pain. It worked. I was able to focus on ‘seeing’ my pain sometimes simply by sitting in a chair and closing my eyes. This manner of managing chronic pain kept me going through the worst two and a half years of my life. I’m thankful that I was able to find such an easy and doable technique for my pain.

This new-to-me pain management technique still works, not only with my chronic pain but also for any episode of acute pain from other causes.

I’m giving several workshops this fall on how to practice a different approach to chronic pain. The first one will be in held in Hammond River, Saturday October 31st at the Holy Trinity Anglican Church.

If you can’t be there, please email me about the basics of this technique. Simply hit the contact button on the top of the page and send me an email.

All the best,