4/9/2019 0 Comments chronic pain is like an abuserI have experienced both chronic pain and childhood abuse (verbal and emotional). When I think about the ways that my C-PTSD affects me, I find that there are a lot of similarities between living with chronic pain and living with an abuser. This observation is not originally mine, but from u/Ineedathrowaway34634 on r/chronic pain.
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2/21/2019 0 Comments The Intersection of Agoraphobia and Chronic Illness, or: How I Learned to Live in my CarAgoraphobia is typically defined as the fear of open spaces or crowds. It comes from the Greek "agora," which was the term used for the expansive outdoor markets held in the center of towns. If a person were afraid to go to the market, whether it was because of all the people, the noise, the lack of safe nooks and crannies to hide, or simply the fact that it wasn't home, they would be referred to as "agoraphobic." In Ye Olden times, it made sense to have this label, since the only places people really went were the market or places of worship. But in a modern world, with modern technology that connects us across the globe, the phrase is a bit antiquated.
Modern psychology narrows the definition to a fear of unfamiliar places, especially ones which provoke a feeling of anxiety or fear of embarrassment. The parameters are highly social--at times, it appears to be a form of social anxiety, as the person is assumed to have ruminant worries about being around people, embarrassing oneself, and feeling helpless. I find this definition to be a bit lacking, at least where chronic illness is considered. I'm not afraid of the Big Wide World. I'm not afraid of situations where I might be embarrassed or socially awkward (though this could be a product of years of therapy). But I do find myself paralyzed with fear at times, stuck in my bedroom or in my house or, in the most frustrating times, in my car. Sometimes getting out of the house isn’t even the concern, but once I get to my destination I just cannot will myself to leave my car. Is this truly agoraphobia, or is it a function of my CPTSD? In my teenage years, my car was the one safe place where I could reliably hide from my abusive parents. In an attempt to forestall coming home, I'd often drive around town after school, piling fast-food wrappers higher and higher onto the passenger-side floor. It's a habit I've unfortunately maintained through college, and one that drives my husband absolutely crazy. So here I am, typing this post rather than going to class, hiding in a completely different building on campus to avoid being seen. I hid in my car for a solid half-hour before finally deciding to come inside, but the whole time I was shaking and on the verge of tears. Why am I afraid to go to class? It's not a bad class at all--I usually really enjoy it! There's no test coming up, no pop quizzes, no difficult classmates or any possible stressors. And yet today I found myself paralyzed at the wheel of my car, unable to push myself to go in. This is where chronic illness intersects. Why am I anxious about today? I have a lot to do, lots of places on campus to visit in order to get graduation paperwork done and to meet with an advisor. That should be an incentive to get going and make the most of my time. But when I factor in my pain and fatigue, it suddenly feels insurmountable. The relatively short walk between buildings is compounded multiple times when I remember I have to get there and come back. The mental energy required to plan the shortest, most accessible route and to remember all I need to do is sometimes more spoons than I'll have for the whole day. It's never easy. Even if I didn't have to spend the energy to plan out the day, I still wipe myself out getting back and forth. I still end up with horrible pain which could lay me out for the rest of the afternoon when I get home. I still have to stay on top of my hydration and sugar to make sure I don't get sick from exerting that much energy. What should be a couple of simple errands that take maybe 30 minutes becomes an all-day affair for a person with chronic illnesses. I am anxious about pain. I am afraid of the helplessness that comes from being exhausted and still far from my car. I fear the embarrassment of missing appointments, missing class, missing everything--simply because I was too tired or in too much pain to get it all done on time. On the days I can't leave my bed or my house, I am afraid that leaving will cause more pain and fatigue than it's worth. I am terrified of getting lost because of my cognitive fog, and even more so of being stranded somewhere, unable to get home because of my pain and fatigue. I rarely go anywhere alone nowadays, which I'm sure isn't the best thing for me, but at least I can get out from time to time. But because my husband is my primary caregiver and accompanies me almost everywhere, my paranoia and fear extends to him too. I am terrified of something happening to him when he leaves for work. He works third shift, so he drives there at night and comes back in the early morning after a 12-hour shift. I'm terrified that he'll be too tired coming home and get into an accident. Sometimes it's not even any concrete fear, I'm just scared of being alone and I'm scared for him to leave the safety of the house. I can count on very little in my life because of my illnesses. I can never trust that I'll wake up with any amount of energy and limited pain. I can't trust that anything I eat won't destroy my stomach. I can't trust that I can get anything done I need to on any given day. The presence and safety of my home, my bed, my car, and my husband are the only constants I can rely on. (Well, the dog as well to some extent, but she usually likes him more than me.) Logically, it makes sense for me to be afraid of the outside world and to seek the comfort of my safety zone--and that's the problem. I have legitimate reasons to be fearful. But treating agoraphobia and addressing the irrationality of your anxieties is much harder when those fears are based on reasonable expectations that consistently happen. (For the record, I am seeking treatment for this, and I am always an advocate to seek professional help whenever possible.) For that reason, I'm not sure that CBT and talk therapy are really appropriate for people with both chronic illnesses and agoraphobic tendencies. Our fears are founded in fact, so logic-ing away those fears by demonstrating how irrational they are just doesn't make sense. For people like us, all sides of the issue have to be addressed. Maybe we need stronger treatment for a particular symptom which is causing us stress. Or maybe we need a change in mobility aid to support our confidence in our ability to navigate the world. If all else fails, we at least need treatment to manage the anxiety through improved coping mechanisms and possibly medication. As much as I hate to say it, and as much as it sucks in the moment, bad things are bound to happen. We have to be okay with the idea that we will sometimes get stuck in a bad situation, and we have to learn to manage the panic that comes with it. A life stuck in bed, at home, in your car because of fear…it's a life half-lived. P.S. If you made it this far into the post, I'll reward you with a joke. My husband calls it "Al Gore-aphobia" because it's a fear of the outside...y'know, the climate. |
AuthorApollo ArchivesCategoriesAll Chronic Pain College CPTSD Gastro Life Update SPD Vision Work |