The Six Fs of Pain
Setbacks occur during chronic pain recovery – sometimes often. And while many people will ‘keep calm and carry on,’ for the perfectionists of us out there, chronic pain setbacks can seem much bigger than they need to. When an unexpected flare-up occurs, the perfectionist in us can go into overdrive. He may feel offended and self-critical, and may automatically go into a problem-solving mode, conjuring up an inner dialogue with common themes. For instance, you may have experienced a similar inner dialogue as the following brief depiction:
“How did this happen? I developed a skill after all and should be able to stay out of pain by now. Its so frustrating. Why did my body betray me? If I can just figure out what went wrong, why the pain is returning now, we can get back on track. But what if this pain doesn’t go away? What if it goes back to the way things were before? I don’t think I can handle that. Uggh, why did this have to happen now – I’m so done with this.”
In his book ‘Unlearn Your Pain,’ Dr. Howard Schubiner talks about the Six Fs – common unhelpful ways of relating to pain symptoms. The Six Fs are: fear, focus, fight, frustration, figure out, and fix. In the above inner dialogue, you may notice several of the Six F’s appear in rapid succession.
All too often I catch myself, especially when experiencing the challenges of even a minor chronic pain increase, running through some of the Six Fs. My default tends toward ‘figure it out’ where my inner Sherlock Holmes searches through my past to determine the ‘cause’ of my current discomfort. Focusing only on the symptom is also common for me, as well as just general frustration. And when I really take stock of how I am relating to the symptoms in unhelpful ways, I have regularly confronted the paradox of PRT: how it teaches one to apprehend pain through a stance of open curiosity rather than the agenda setting of the Six Fs.
Much of the work of processing through pain hinges on letting go of the desire to be rid of pain and/or control pain through agenda setting. This can be a steep learning curve, especially for those who like to set goals and achieve them. Many people reading this may even feel frustrated at the thought of letting go of a goal or objective. But I can tell you that chronic pain doesn’t follow a carefully orchestrated plan. Instead, it is like an unruly toddler who, when told to follow the rules, does the opposite.
Often, I have found that pain just wants to be heard, not told to change, to quiet down, to get figured out, to get fixed, or to fall in line with the objective. It just wants to be heard. And when we get a chance to drop the plans that we have for it (as is recommended in the practice of somatic tracking) and just attend to the sensations with curiosity and openness, while the pain might not go away immediately, something else magical happens: the pressure to conform to an ideal evaporates. In this space of curious listening, the brain learns how to recover relief and generate soothing rather than stress. And that unruly toddler — he quiets down, without the pressure to do so of course.