12 steps for chronic pain, looking at harms – step 4

Step 4 is about looking deep into ourselves – our fears, how we were harmed, how we harmed others, our struggles and our strengths. It isn’t meant to be a point of condemnation – a list of how awful we are, but of confirmation of what has made us who we are. Without looking truth in the face, it is hard to break out of patterns and behaviors. The truth also allows us to see what works for us, and when we are most how we dream to be.  Since there are a lot of complexities in step 4, I will start with harms done to me.

In the Big Book, step 4 is “We made a searching and moral inventory of ourselves”. I find this step life changing when I am able to dig deeper into my own responses to situations and how this also impacts my current behaviors. For example: One of my friends, “Cailyn”, reacted to my physical symptoms with a lot of questions and assumptions about my psychological state. We had been close at one time, but less connected prior to my illness. I felt hurt by her comments and questions. What she said to me and her lack of support effected our relationship (social) and how I viewed myself (security). I however reacted by being angry, criticizing her, felt doubt, self-pride, rationalized, resentful, suspicious and self focused. Though many of these reactions were internal, I reacted to this hurt by causing additional harm. I am not responsible for her actions, but I am responsible for mine. As time went by, I allowed the relationship to fade, which was a good thing at the time as we were going different directions. However, I continued to resent her and her reaction to me when I was sharing my physical struggles.

Such as with Cailyn, there are many people who caused me harm when I became ill. The list includes family members who weren’t able to recognize my pain, other people who thought I was seeking pain medication for an escape, doctors who were unkind and unhelpful. Some of these harms may have been more about my own assumptions of why I felt they did what they did. In general, most of us are fairly self-absorbed, and on a given day are unable to give everyone the support they need or desire. When I am listing my harms, I found it was helpful not to analyze too much about what I didn’t know, and reflect more on what I felt was a harm, because this is what I react too. Later I can look and pray for clarity on whether my perception could have been off (many times it is) or whether my perception is only slightly true, such as I may think someone is overreacting, yet still might agree mostly with what they say.

Much of my reactions to harms done to me are similar to reactions I have had since I was a young child. I believe many of my reactions are almost automatic especially when the situation brings up old feelings of abandonment, criticism, abuse and/or neglect. If I feel shame, I tend to look for ways of self-preservation. Often this is done by accusing other people, in order to feel ok about myself. When I recognize what I am doing, I can look more clearly at what is being done or said to me, and process whether this is something that is true, where I need to make a correction, or something that isn’t, where I may need to move away from the person or situation. If I am wrong, my guilt can move me to make changes while holding onto who I want to be. If I can’t see clearly something I did, I can ask questions for clarification, and try to understand where they are coming from (which may not be related to me). Though doing the right thing doesn’t necessarily keep me from being resentful, it does give me space to make the choices I want to make, and lessen the impact.

In my world of chronic pain, I hope to find grace and forgiveness for this journey. May I be free of shame, and have a heart that seeks to understand.

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4 Responses to 12 steps for chronic pain, looking at harms – step 4

  1. Lola says:

    Your journey and experiences sound so similar to mine. However, I am lost regarding the way my psych team is reacting to my pain and meds. I desperately need a goog therapy team to stand behind me but they are the one pushing for rehab. I cut them off until I figure out what it is I need around me to thrive . Any thoughts?

    • It is always challenging to find the right support, especially since it can change with time. There is a lot of fear because of the risk of pain medication and sometimes it makes it hard for the support network to know how to respond. Though we are all different in what works for us, I can give some general thoughts to what has helped me in the journey. Some big areas for me are wholistic care, research and knowledge, finding the expertise in the individual even though not all their input is correct and my own self care and spirituality. I have also been reflecting on how I have missed some potential great support in the past, while being drawn to individuals who were less helpful. It doesn’t always come in the way I think so being open is important. As far as rehab goes, I honestly never had this option presented to me. It is hard to say whether this would be helpful in your situation. I think in my early days I probably wouldn’t have wanted this option, but I can see how this might have been helpful if they really understood pain and didn’t make assumptions about those who take medications. Not sure if that is helpful to you. You are welcome to send me a private message and share more. I wish you well as you navigate.

  2. There’s some fantastic advice in this post. Extremely useful for anyone who’s suffering from issues with chronic pain.

    Keep up the good work.

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