I just finished reading Lost Souls, by Niles Elliot Goldstein (author of God at the Edge). In Lost Souls, Goldstein looks at what happens when people are faced with big challenges. I believe having chronic pain is one such BIG challenge!

Goldstein introduces several phases we might go through (though not necessarily in this specific order):

1. Disorientation
In this stage, a challenge throws you off course. You become “confused, disoriented. A jumble of questions crammed my brain… Who am I? What am I doing? Where am I going?”

2. Panic
Difficult situations can lead to “fear… where confusion and the loss of confidence and stability overwhelm, even cripple, the human soul.” He describes panic as one of the most alarming and uncomfortable stages. “We are starting to recognize the depth and scope of our confusion.”

“While plunging us into a world of ambiguity and pain, panic teaches us that as human beings we have no alternative but to live.” This reminds me of the work I do with patients, finding ways to live fully despite pain.

3. Loneliness
Pain is a feeling only you can feel. No one else can feel the pain you feel. This can lead to a sense that no one understands. Solitude, however, can play a “powerful role… in our inner development.”

4. Yearning
I’d guess almost all of us have yearned – really, really hoped for – an end to the pain. We want to go back to “before.” Before the pain started, before it changed our lives.

5. Anger
“When we have grown weary of our journey and frustrated with the [negative] possibilities that are before us, the result can be anger.”

“Anger, even when appropriate, should never be more than a middle step, a way station on our pilgrimage. When it becomes an end in itself [when you become stuck in anger]… you remain lost. Those who refuse to give in to it, who resolve with all their hearts and souls to move forward despite their own difficulties, are the courageous ones who gain a glimpse of the horizon ahead.”

And this decision to move ahead creates possibilities:

6. Determination
“After having confronted (and hopefully worked through) our feelings of loneliness, pain, and rage at being lost, we can arrive at a point where we resolve to break free of the forces that are holding us back.” I think determination to live fully is a better approach than a determination to be pain-free. It allows us to move on and live, rather than become more and more focused on pain.

7. Surrender
“When something bad occurs in life that you can’t do anything about, you are given a choice – you can react angrily, or you can accept it and keep your eyes on your goals and on what is really important to you.”

“More important than self-reliance is a capacity for hope, as well as the ability not to give up but to give over.”

8. Emergence
“Accepting our limitations and giving ourselves over to uncertainty seem to be the last steps in our attempts to make it out of the wilderness. But what happens when we do? Where do we emerge?” First, it doesn’t happen once and end. Goldstein believes these stages continue to occur over and over, that working towards acceptance is an ongoing journey. “Human life is punctuated by semicolons, not periods; it is an ongoing, staggered process of fits and starts.” Goldstein quotes from T. S. Eliot:

What we call the beginning is often the end
And to make an end is to make a beginning.
The end is where we start from.

What suggestions for coping does Goldstein offer?

1. Staying in the present
“The way we stay rooted in the present, the way we keep from losing ourselves in the gravity of awareness, is to simply let it all go.”

2. An end result of inner transformation and spiritual growth
Difficult experiences don’t have to be damaging, but can lead to person growth.

3. Focus on what is important
In times of distress, everything but the most essential can fall away. Being focused on what is most important to us can be a blessing.

4. Reliance on others
Pain can be humbling in that you may need to rely on others as never before. Being the person helped, rather than the helper, can be humbling. Many with pain also note they feel more compassion towards others.

5. Accept the struggle
“We can progress from being lost at one stage in our lives to finding hope and renewal at another. We can evolve – though that evolution involves struggle.”

“There is a lot we can learn from our bewilderment, but in order to learn from it we must first acknowledge it, even embrace it.”