I was landing in Salt Lake City to spend Father’s Day weekend with my son and daughter-in-law. While standing at baggage claim I heard a father yelling at his daughter to hold still. I looked down and saw a remarkably cute five-year-old little girl with curly hair being stopped in her tracks from just being curious and looking around. He would never yell at his boss or stranger like that? Why his daughter? Anger is bad for your overall health, particularly mental health. There are documented correlations between anger and other negative moods such as anxiety and depression (Linton). It also negatively impacts social interactions. (Harris). Chronic pain patients express their anger towards themselves, other people, and even abstract objects, such as one’s situation in life (Okifuji). Research also shows that anger associated with chronic pain has a detrimental effect on familial relationships and creates spousal tension. Defining Abuse Family members are in interpersonal relationships that meet deep needs from one another. They include mutual signs and expressions of acceptance, love, and respect from one another. They need shared empathy, mutual understanding, and amiability. These needs sustain healthy familial relationships. These deep need that can be met by a close family also puts them at risk for more abuse. They will put up with more to get them met. You will understandably remain angry and focused on relieving your pain until it is solved. However, in chronic pain there is no end in sight. Consequently, all of your attention will be honed in on you—your poor quality of life, failed treatments, unjust and tragic life position, etc. You are left with little focus and energy for the needs of others. There is less empathy for others when you view your own pain as being of the greatest import. It always takes precedence over the wants, goals, and circumstances of other family members. You lose the capacity to act in a manner that is compatible with what familial relations need—e.g., expressions of acceptance, empathy, etc. You cannot reach out if you are just trying to survive. Abuse(n.) is a lack of awareness of the needs of others. To Abuse(v.) is to treat someone in a manner that neglects his or her needs. When you are angry it is all about you. There is such a strong conviction of “being right” in your views that you cannot see why others don’t agree with YOU. Anger is the antithesis of awareness. I would never abuse my family Really? I understand that you do not want to abuse your family. Then why is it so pervasive? No one likes the word “abusive” even mentioned and much less to believe that the word applies to them. If you express frequent disapproval, are often irritable, and habitually neglect the wants, goals and circumstances of family members, then your behavior qualifies as abusive. I will never forget the story that was told to me years ago by a woman who was really struggling with chronic pain throughout her whole body. She wrote a short summary of her childhood that I cannot locate. She described an idyllic childhood with frequently family outings and a lot of love between her parents. Her father lost his job when she was twelve and it was if a dense fog rolled in through the front door. Her life went from being filled with joy to one filled with drinking, arguing and domestic violence. The contrast was remarkable and her life continued in a downward spiral. Pain and Workers Comp Family Anger Guidelines Here are a set of rules or guidelines to deal with imbedded family anger: Acknowledging anger and familial abuse Circumventing it. Acknowledging anger and abuse: Actively imagine yourself when you are particularly upset about your chronic pain—when your pain is particularly intense, when you’ve had an unsatisfactory visit to a physician, or when you’ve had an argument with your claims examiner. Instead of imaging how you feel in this scenario, imagine what it is like for your family members to be around you. How do they feel? Are they happy to be around you? Sad? Afraid? Count the number of daily family interactions affected by your chronic pain. What are these interactions like for your family? What do your family members feel and think during and after these interactions? Ask your family members what it is like to be around you when you are upset about your chronic pain. Ask them what it is like to be around you generally since you developed chronic pain. Don’t respond to their answers. Just listen. Circumventing it: When you are upset, disengage. Do not talk with your family members when you are angry. Instead, stop whatever you are doing and take a mental “time-out.” Relationships aren’t improved with angry interactions. Only when you are no longer angry, talk to your family member about what was making you upset. Spend one month listening instead of talking. Don’t give any advice to your spouse or children for a month. Instead, listen to them about their goals, daily struggles and victories, etc. Don’t offer opinions about your children’s values. Just try to find out who they are. Protect your family from your pain Make a commitment to be an inspiration to your family. Make a daily conscious decision to aid, listen, motivate, and support the goals and well being of your family Pain = anger = abuse S.J. Linton SJ, et al. The role of depression and catastrophizing in musculoskeletal pain, Eur J Pain (2011); 15: 416–422. Harris S, et al. Role loss and emotional adjustment in chronic pain, Pain (2003); 105: 363–370. Okifuji A, et al. Anger in chronic pain: Investigations of anger targets and intensity. J Psychosom Res (1999); 47: 1–12.