Body Talk: Listening To and Learning From Your Chronic Pain

My chronic illness has always been a moving target. Since my late teens, I’ve had an autoimmune disease that causes intense pain and stiffness in my spine and joints. It may last for minutes, for hours, or for days. While I can predict that some activities will cause a flare-up (like standing on hard floors, or sitting for long periods of time), sometimes it seems to come from nowhere.

Historically, I’ve considered my biggest relationship challenge to be communicating about my body.

Depending on the individual and the intensity of my pain, this process can be fun, or it can feel like trying to guide someone across an active minefield. (Scarleteen has a number of wonderful articles that would have helped me during this period⁠ !) Nevertheless, one day, I realized something: even as I tried to play descriptive whack-a-mole with my pain, it was getting harder for me to answer basic questions about what felt good to me.

For those of us with chronic pain, living our lives with other people can be tricky. If we admit that we’re hurting, this can mean having to manage other people’s emotions — even well-meaning concern or sadness can feel like a lot! As a result, many of us try to compartmentalize. We may put on a happy face to look professional at work or to keep from bringing down a friend’s party. Sometimes, we push our pain to the back burner for our own sake, because we’re exhausted by it or don’t want it to take over our day. In all these cases, however, we practice muting our physical feelings. And, though we may have good reasons for doing so, this can influence the ways we communicate with our own bodies long-term.

Why was I having such a hard time communicating such basic things? After some thought, I realized that some of the survival strategies I used to get through the day were coming back to bite me.

It was a big deal when I understood that my coping mechanisms were having side effects in my sexual⁠ life. By getting in the habit of “tuning out⁠ ” my pain, I’d also lost track of some neutral or positive sensations — even physical pleasure. This not only affected my experiences, but my ability to talk to my partner⁠ about my feelings: how could I give them a full picture, if I didn’t have all the relevant information?

It took practice, but, over time, I developed some strategies for re-learning how to listen to myself. I not only enjoy sex⁠ more now, but I’m more mindful of how I can care for my body during my everyday life.  I hope these suggestions can help you too.

If you're reading this during the COVID-19 pandemic, we strongly advise you keep in-person sex to only partners you are sheltering-in-place with. Otherwise, it's safest for everyone to keep sex with new partners or those you don't live with virtual, until we can all get well on the other side of this. We know that if you (we!) want sex with partners we don't live with, these limitations can be really hard.  For some support, click here or feel free to come grouse about it with us on our boards.

1.  Slow Down

It’s easy to feel pressure to be spontaneous. (From rom-coms to pornography⁠ , depictions of people having sex in the media often imply that “real passion” is always urgent and can’t wait.) Treating sex or desire⁠ like a race, however, doesn’t give you much processing time to consider, “What would feel good to me today? What might be getting in the way of my comfort and enjoyment?” 

Think about what kind of time or atmosphere you need to consider these questions, and bring your needs up with your partners. For example, you can identify forms of physical intimacy that feel lower-impact for your particular body. (Think about positions you find comfortable in your daily life. I, for example, need a chair-back or wall to support me while sitting.) Use this bodily knowledge as a foundation for exploring with your partner: “I want to be sexual with you, but I’m still figuring out what my body needs today. Can we start with [a kind of sex I generally find to be comfortable]?” Whether you’d like to stay in this comfort zone or try to branch out different kinds of sex based on how you feel is completely up to you (and your partner)!

Sometimes, it can be helpful to plan sex, so you have time to check in with your body before you’re dividing attention between yourself and your partner(s). You and your partner(s) can pick a particular time of day, or you can agree on how much notice you’d both like to have before sex. (For example, “I would love to have sex with you, if you’re also in the mood — does twenty minutes from now work for you?”) Planning sex in advance can be just as fun as being spontaneous, because of the anticipation it creates!

Once I created more time for myself to reflect on my needs, it became easier for me to re-connect with the physical feelings that I’d be suppressing. The next two strategies offer suggestions for how to approach this process.

2.  Breathe

I know; you’re already doing that. (Hopefully!) But taking a few deep breaths can help ground you in your body, making you more attuned to your physical self. Slowing and deepening your breathing has the added benefit of helping to relieve anxiety.

When you’re tense, you tend to take shallow breaths that only fill your upper lungs. (This is what causes the suffocating feeling that accompanies panic attacks.) By contrast, diaphragmatic breathing – or “belly breathing” – helps to slow your breaths and relax your body by using your entire lung capacity.

To start, sit or recline in a position you find comfortable.

Place one hand on your belly (just below your navel) and the other on your chest. Inhale through your nose. When you breathe in, let your belly expand so it presses into your lower hand. You will feel your ribcage expanding and, finally, the hand on your chest begin to rise. Hold the breath for a moment. Then exhale slowly through your nose. Listen to the air passing⁠ in and out of your body. Feel your heartbeat begin to slow.

You’re aware of your body now, and ready to have a conversation with it.

3.  Do a Body Inventory

Now that you’re tuned in to your body, it’s time to do a friendly check-in. I put emphasis on “friendly” because it’s easy to slip into an adversarial relationship⁠ with your body, because you’re weary of being in pain. This frustration is normal and valid, but, remember, your body generates all the positive sensations you enjoy as well. Try to engage it as your ally⁠ .

Especially if your pain is systemic and variable (like mine), you may not be keeping track of all the signals your body sends you throughout the day.

Get in the habit of doing a friendly check-in. You know what questions are most salient for your body, but here are some places to start: Physically and mentally, how are you feeling today? Are you anxious or distracted? Are there signs that you’re overlooking a source of discomfort? Where are you holding tension? Rather than trying to white-knuckle your way through these feelings, allow yourself to acknowledge them; they’re here to help you take care of yourself.

Checking for tension can be easier said than done. One of my favorite methods is progressive muscle relaxation (PMR), which involves tensing and relaxing the various muscle groups of your body. If you have muscular pain or immobility in any parts of your body, please feel free to modify the following instructions to fit your own abilities and comfort needs.

To try PMR: assume the same kind of comfortable position that you’d use for your breath exercises. Take a few deep breaths, following the directives in Step 2.

Now, focus on your feet. As you are able, tense the muscles in your feet by pulling in your toes and curling the arches. There should be a squeezing feeling without causing you additional pain or strain. Hold that tension for five seconds. Finally, release the tension and let the muscles of your feet go limp. You can repeat the process with each muscle group, moving up your body: calves, thighs, stomach, back and chest, arms and shoulders, and neck and head. (For your head, squeeze your eyes and mouth shut to create tension and allow them to fall open to release it.) When I use PMR, I find that squeezing and relaxing my muscles helps me to release sources of muscle tension that I didn’t even release I had.

Whether your body check-ins involve self-talk, physical exercises, or both, you can learn a lot by tracking your responses over time. Consider logging your physical and emotional feelings in a journal or in a mindfulness app like Jour (a free app which prompts users to answer questions like “How do I feel right now?” at the same time each day). You can incorporate these practices into your day at regular times, like right after you wake up and right before you go to bed.

By building self-checks into my daily experience, I find that I began to more habitually listen to my body’s signals and to become a more fluent reader of its patterns. Specifically, I became more aware of pain triggers and of practices that relieved pain or simply made me feel good.

Learning more about my body was empowering. I felt better informed about my own needs, as well as better equipped to respond to those needs in real time. Sex was no longer such a source of anxiety for me, and my partner and I felt like we’d had a breakthrough whenever we identified and worked through a longstanding issue. (For example, by modifying the angle of my body, I no longer experienced flashes of pain in my right hip.) As time passed, however, I discovered that it was easy to lose focus on the process of self- communication⁠ in pursuit of these fixes. After becoming frustrated when an apparent “magic bullet” solution stopped working, I realized that I needed to reframe my understanding of what successful bodily communication looks like over a lifetime.

4.   Think “Process,” Not “Progress”

As you learn more about your body, it’s easy to get trapped in expectations of a progress narrative. I know more about my needs, so I should be able to just fix the problems and do fewer check-ins, right? This mode of thinking, however, doesn’t respect bodily communication as a goal in and of itself. If you treat bodily communication as a means to an end, you may struggle to ascertain and adapt to the inevitable ways your needs will vary.

Whether we have chronic pain or not, all of our bodies are constantly evolving and changing from day to day. Rather than treating your body — or anyone else’s — like a question with a stable answer, think of it as a conversation partner. These practices for keeping lines of communication open will always be there for you! Remember that, just like in relationships with people you love, talking through needs, wants, likes, and dislikes is an ongoing process — one in which all participants deserve to be treated with compassion.

Chronic pain can be scary and frustrating. But your body wants to help you by communicating about its needs. By making efforts to really hear or feel what it’s trying to tell you, you’ll find that not everything it wants to share with you is painful. You can also learn what brings you pleasure and comfort.

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