If you recognize yourself in one (or more) of these five types, read on for advice on how to break unhelpful old habits and start healthier new ones.

Once upon a time, not so long ago, doctors thought there was one pain-prone personality, a bundle of characteristics that made it more likely you’d have pain, feel pain intensely and stay stuck longer in the cycle of suffering. Now, thank goodness, we know this isn’t true. There isn’t any pain-prone personality, confirms James Weisberg, Ph.D., co-editor of Personality Characteristics of People With Pain (American Psychological Association, 2000). But there are certain traits that correlate with pain. Pain, he adds, is physical sensation plus emotional reaction; we can certainly lower our emotional reaction to it, thus lowering our overall pain perception. Pain expert Christina Lasich, M.D., author of High Heels to Hormones: A Woman’s Guide to Spine Care (iUniverse, 2008), sees things similarly. Everyone comes into a painful experience with a certain set of personality traits. Some might have more resilience, for instance, or more anxiety when facing an accident or illness, and those traits can amplify or reduce the pain experience, she explains. Put another way, some emotional and thinking styles make pain worse, while others ease it.

The first step to turning down the volume on your pain is to become aware of what’s helping you and what’s not and that includes how you act, think and feel. In other words, the building blocks of who you are. Read on to see if you recognize yourself in any of the following five styles of coping with chronic pain all are pretty common, but not necessarily healthy. If one or more sound familiar, don’t worry; you’ll also find tips from healthcare providers and people living with pain to help you bring out your best self and feel better faster.

The Pleaser

Motto-Don’t mind me; I’m just here to make you happy.

Pleasers would be the ultimate yes-men, except that they are frequently female. They’re the folks who just can’t say no, says Christina Lasich. The inability to say no comes from deeply entrenched believes, namely that people won’t like you, that they’ll be disappointed in you and even that setting limits will lead to the loss of your friends, family or your job. The problem, of course, is that saying yes to everything can force pleasers into what Lasich describes as an unsustainable pace that pushes the body beyond what it can handle, leading to more pain. Pleasers may also hold out on their healthcare providers, says John P. Garofalo, Ph.D., an associate professor of psychology at Washington State University, in Vancouver, which can obviously hinder treatment. Like many women who become nurses, Sharon Puckett, 48, of Atlanta, is a natural nurturer. In fact, she’s so good at taking care of others that she overlooks her own needs. It’s not just hard for me to say no, it’s also hard for me to ask for help, she says. So I do too much, and that makes me hurt more. Pleasers like Puckett, who has chronic regional pain syndrome in her right upper body, are likely to take on too much, agreeing to things even when their plate is overfull. Spouses, friends and colleagues, meanwhile, may come to expect the pleaser to take care of everything.

How to Break the Cycle
Assertiveness training can teach pleasers to set limits and ask for help cornerstones of pain management, says James Weisberg. The key is to not make the pain the focus of your request for help, he says. So, when asking your teenager to take out the trash, explain that everyone in the household must take on responsibility, rather than emphasizing that lifting the garbage hurts your back. Leaning to take guilt-free time for yourself is also key. As Puckett puts it, the world is not going to fall apart if I take a nap and I’ll hurt more later if I don’t take it. She also allows herself to have my pity moments, limiting herself to no more than a half-hour. When the time is up, she moves on to visualizing mood-boosting images of the beach.

The Inflexible

Motto-It’s my way or the highway.

In the old days they were known as type A personalities rigid, hard-driving, competitive perfectionists who hold themselves and everyone else to exacting standards, believing there’s only one right way to do things (yep, their way). Inflexibles have an especially hard time accepting physical limitations, says Weisberg, and often insist on doing as much as they’ve always done; in short, they won’t change their routine even if it hurts them. For example: The house has to be cleaned from top to bottom every Sunday, just like before they had their pain, Weisberg says.

As with pleasers and others who push through and do too much, the inflexibles often end up exacerbating aches and pains when they don’t heed them. But there’s another element common to this style: anger. Inflexibles tend to get frustrated and mad when things don’t go according to plan, which increases their anxiety and, in turn, their hurt. The research is pretty clear: Anger has been linked to pain in many studies and is known to increase the sensitivity to painful stimuli,” says pain specialist Christina Lasich. Darby Long, 54, a nurse from Stockbridge, Georgia, is a classic inflexible. Her attitude toward her rotator cuff injury is, it should have been better yesterday, she says, and her impatience makes it a challenge for her to slow down when she knows she should. push through things, do more than I should and then I pay for it, says Longo plainly.

How to Break the Cycle
A little self-acceptance can go a long way toward breaking inflexible habits: I am learning to be more patient and kind with myself, says Longo, who does breathing exercises and progressive muscle relaxation (PMR) every morning and during the day when she feels her frustration mounting. PMR is a simple relaxation technique in which you gently tense and relax each body part, starting at your toes and moving up to your head, until you’ve scanned and relaxed your entire body. If you’re pressed for time, try doing a quick body scan to see where you’re holding tension and let it go. Both practices calm Longo down and release muscle tension and soreness, she says. One of her favorite breathing exercises is to count five slow beats per inhale, then five per exhale, for a total of five minutes.

It can also be especially important for inflexibles to focus on opening up to new ways of thinking and doing. Rather than cleaning the whole house on Sunday, for instance, how about doing a little bit every day, suggests Weisberg. And keep in mind that rigid thinking about how to treat your pain may be cutting you off from other therapies, medications, relaxation techniques and integrative approaches that could be useful, Garofalo stresses.

The Catastrophizer

Motto-It’s only going to get worse.

Catastrophizers dwell on pain, falling into a spiral of pessimistic thinking which, studies show, can lead to both increased pain and more sensitivity to it. Thoughts like My pain is killing me, and I can’t take it anymore are not only highly unlikely, they’re also disabling. It’s a short trip, after all, from expecting the worst to feeling like there’s nothing you can do about it. Ron Smith, a former corporate consultant who’s been living with HIV and depression for two decades, says his knee-jerk reaction to always assume the worst, can trigger serious anxiety. What’s worse, I’m less likely to take my medication or follow my pain-management strategy, including my exercise plan when the black cloud gets the best of him, says Smith.

How to Break the Cycle
Try short-circuiting a debilitation downward spiral by countering a negative thought with a more realistic one. Ask yourself, for example, Haven’t I been able to endure this pain before? or There are other jobs out there I’d be good at and enjoy, right? The goal is to reach more realistic conclusions and challenge blanket statements about your life and your ability to manage your pain what psychotherapists call reframing your thoughts. This is not necessarily taking a negative and turning it into a positive, but into a realistic conclusion, explains Weisberg. Can’t break the thought loop on your own? Consider finding a cognitive behavioral therapist (CBT) with experience treating those with chronic pain to guide you: this is their specialty. And if you just can’t stop the dark thoughts from coming, start by simply paying attention to the conversation in your head, so you can begin to realize when you are letting habitual catastrophic thoughts get out of control, suggests Lasich, who adds that distracting yourself with a relaxation technique or hobby works too. When Smith feels a bout of negative thinking coming on, he tries to interrupt it with logical thinking and breathing exercises. And if they don’t work, he goes for a walk to get his mind on something else.

The Extreme Optimist

Motto-It’s all good.

Don’t get us wrong: Optimism is definitely a positive train, and there’s plenty of research that optimistic thoughts can release dopamine, a mood-boosting and pain-mitigating neurotransmitter. But even optimism can be overdone if it leads to unrealistic or wishful thinking, especially when you believe that your discomfort will magically improve without any effort. Garofalo points out the difference between the active optimist and the extreme (or passive) optimist: Active optimists fare better not only because they keep hoping things will get better, but also because they take an active role in ensuring that they do get better, he says. Like stoics (see below) and pleasers, the extreme optimist may ignore pain or not bring it up with their healthcare providers or even their loved ones. They may also fail to follow through on their treatment plan because they feel their health will take care of itself. Terry Murphy, a youthful 59-year old who has recurring sports injuries, plays in baseball leagues with men in their 30s and 40s. He is, he says, a little naive and unrealistic about my age. While his upbeat, it’ll-go-away-on-its-own approach has served him well in the past, a recent serious bout with tennis elbow would have benefited from less wishful thinking. I could have saved myself more injury and pain had I addressed the first twinges of elbow pain right away, he admits.

How to Break the Cycle
See pain as a signal from the body, like thirst or hunger, and pay attention to what it’s trying to tell you, says Lasich. If the aches say it’s time to opt out of snowboarding black-diamond trails with 20-year olds, it might be worth facing that reality rather than deluding yourself into pain-inducing activities. If you’re feeling pain, you need to do something: see a doctor, improve your health, stop an age-inappropriate activity or change the way you do something, she adds. Progressive muscle relaxation (PMR) can improve body awareness and make it easier to identify where pain signals are coming from so you tune into them sooner, before pain worsens and becomes harder to treat.

The Stoic

Motto-Pain? What pain?

Simply put, stoics live like they aren’t hurting at all. In fact, they just may have a higher pain threshold than others. Carla Trotter, 63, a self-described high-achieving stoic type who typically wants to push through her pain as if it weren’t there, recently came to a profound conclusion about her personality, and its link to the fibromyalgia and acoustic neuroma that have led to her discomfort over the years: It’s not that my personality causes chronic pain, says the retired educator and school nurse from Healdsburg, California. But it makes it hard to adjust to pain, accept it and make the adjustments necessary to cope with it.

Trotter’s self-insight is backed up by research; when you push through to your breaking point it’s not useful and over time can even be harmful (tissues and muscles are stressed even more, for one thing). Soft tissue can only tolerate so much, says Lasich. Pain is a warning that can indicate damage is being done, she says, adding that stoics may not only push themselves too far, they also tend to not allow proper recovery and rest when their body needs it.

What’s more, stoics often have grown up in families where they weren’t allowed to give in to any kind of discomfort, as was the case in Trotter’s family. According to Garofalo, who has a private practice in pain management, this family dynamic is very common in stoics, adding that some will distance themselves from all intense physical or emotional sensation, while others may adopt a cold facade to mask their severe anxiety.

How to Break the Cycle
Trotter has it right when she says that self-awareness and self-acceptance are key to keeping her stoic tendencies in check. The biggest step and I’m still in the process has been accepting myself and my situation and learning to tell myself, you can’t tough this one out. For Trotter, this plays out in better budgeting of her time and energy. For instance, she now does the week’s ironing in two or three sessions, rather than pushing through in one go and paying for it later with a flare-up. In his practice, Garofalo encourages his stoic clients to notice and talk about all aspects of their treatment, both what they feel is easiest and what is more difficult, so that those who are unaccustomed to noticing varying feelings, moods and pain levels can begin to tune into them. The long-term goal? Understanding yourself better over time so you can find more effective and healthier ways to cope with your pain and even lessen it.


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