Written by: Amanda Levison, M.S., LMHC, LPC, CCBT
Imagine you’ve been invited to join the annual family “Picnic in the Park” with a few other outdoor activities to follow, and yet you’ve been experiencing intermittent episodes of lower back pain for the past year. You made it to the picnic last year with no pain present. However, with how your pain has been persisting this time around, you don’t think you’ll make it for the event. Now you’re faced with the choice, “Should I cancel?” or “I should go, but what if my pain worsens while I’m there?”
Oftentimes, people are faced with having to cancel plans due to an underlying condition, and even so, they place blame on themselves even though it is not their fault (i.e., "I'm so sorry for canceling again; I'm the worst!"). However, you should never have to apologize for engaging in self-care and listening to your body’s needs. Dealing with a chronic disease is tough. It dramatically impacts your day-to-day life, often resulting in canceled plans to take care of yourself. On an emotional level, you may experience guilt or even express numerous apologies for not being able to attend to your originally scheduled plans. Yet, it is important to listen to your body’s needs and maintain a healthy well-being. You should never have to be sorry for it, as taking care of yourself and knowing your limits are vital for your well-being.
So, here are several healthier alternatives to use instead.
Education is Key!
One way to navigate canceling plans due to chronic pain is to educate your friends about your condition. It might not be an easy conversation, but those around you must understand what you are going through and how having chronic pain affects all aspects of your life. Share with your friends how other factors, such as stress, impact your chronic pain. Do not blame yourself when you are having a flare-up since they can happen out of nowhere unexpectedly. If you are the person on the outside being educated by a friend with chronic pain, do not blame your friend; chances are they already feel bad about their pain enough as is. In most cases, there is little the person can do, and therefore, it is out of their power or control to prevent the pain from occurring. But it is in your power to be educated about their pain, provide support and within their power to do the educating!
Sharing at the Last Minute
Having an educational conversation will make life and your loved one’s lives much easier. Your friends and family may not realize how much this impacts your life on a day-to-day basis. Make it clear that this condition affects you significantly and may cause you to cancel plans at the last minute and/or as late as the day of the event or get-together. Remember, though, that you only have to share information you are comfortable sharing. This way, there is mutual understanding and effective communication within the relationship. This will also be helpful so you are not constantly regurgitating reasons for missing out. Therefore, instead of apologizing every single time you need to cancel, you must inform them, "Hey, I cannot make it today," and, with their awareness of your situation, no further explanation is necessary.
Build Your Support Group
A support system is essential for people living with chronic pain. You must be supportive when they call to say that they cannot make it to the desired scheduled plans. Check-in with your friends and let them know they are missed and/or you are thinking of them. If your loved one is okay with it, do not hesitate to ask questions to offer comfort and mutual understanding. However, try to keep them manageable. This is about more than just the details of their condition and how it affects them. They will explain that on their terms. Ask what they want or need from you or what you can do to be supportive.
Check in with Your Emotions
It is hard not to place blame on someone when plans get changed or canceled. Your feelings of being frustrated when someone cancels are valid, but you must appropriately handle them. Do not take it out on your loved one, as they are dealing with an insane load of negativity already impacting their well-being. Remember that no one chooses to have chronic pain. It is not their fault, and they do well to remember that.
Walk a Mile in Their Shoes
If you become frustrated, just ask yourself what you would do in their situation if your body were begging for rest. Is this event they are missing out on more important than their well-being? Taking perspective will help you immensely. Show them that you understand they are canceling because of something out of their control. As a friend, it can be hard to be flexible at times. Being disappointed and voicing that feeling is okay because friendships are a two-way street. Make a point to offer other times that you can do what you plan. When making plans with this friend or family member, remember that they could at any given time need to cancel so that when or if this occurs, you have already anticipated it, and your feelings of disappointment or upset can be minimized.
Establish Healthy Boundaries
If you are the person dealing with pain, establishing boundaries about your chronic illness can also be helpful in this sort of situation. Do not push yourself or say yes even though your body is screaming no. Make that clear with whomever you need. Many questions about your condition may be thrown your way, so set boundaries about what you wish to tell them.
Set Clear Expectations
One way you can share expectations is by stating, "I have told you what I am comfortable sharing; just know that when I need to cancel, it is because I prioritize my health." Setting clear and consistent expectations about what they can expect from you and what you expect from them is vital for maintaining healthy boundaries, educating them about your chronic condition, and reasoning for the cancellation. Setting clear expectations can be about how much you are willing to share with them vs. how much research they should do on their own, what you expect when it comes to planning, and anything else you wish to share.
Being Present Without the Pain
Another way to navigate canceling plans is to not automatically say no. If you can, you can always go to or engage in the activity for a shorter period by doing what is manageable based on your pain level. For example, if your friends are going bowling and you want to go out but physically cannot do the activity, you can talk with people but not play. You can limit what you do to help you cancel plans less often and still maintain healthy boundaries and clear expectations. Try to get involved in activities that will put less strain on you. Go to a friend’s house for dinner or have them pick you up to go to a restaurant. Go out for a movie night or host a movie night from the comfort of your own home; basically, anything that may work for you when managing your pain in a less straining environment. This reduces strain but still allows you to connect socially and overall have a good time! By staying committed to your accommodation plans, you are reducing the chances that you will have to cancel.
So, Remember…
After informing others, you still will have to go through needing to manage canceling. It may be helpful to educate others that when you make plans, there is always a chance of canceling for health reasons. Make it clear that you are tentatively agreeing but will need to check in to confirm or decline the event day or that you will participate in a limited way, such as sitting and enjoying everyone's company or leaving early. When making plans, you should be planning time afterward to rest and recuperate. This goes physically for your body and also for your mental well-being.
Mental Health with Chronic Pain
Chronic pain is not always physical! People who suffer from medical conditions such as bipolar disorder, anxiety, or depression may have periods when they can engage with friends and family. However, when they cycle back to depression and discomfort, their ability and interest in engaging with anyone or any activity will be significantly diminished or dismissed entirely. In this case, even a limited amount of time with others may still be too much or more than they can handle. Understanding what your loved one is combating with their pain may help you better understand what is feasible for them to engage in and what is not. This will also help you not personally take their need to cancel at a moment’s notice. It is personal for them, but they are not setting out to intentionally offend or upset others; therefore, it is not personal against you.
Holistic Methods to Reduce Chronic Pain
Suppose there are ways to employ alternative therapies such as yoga, meditation, or breathing exercises. In that case, these are all great ways of minimizing pain that you would otherwise be unable to manage. Trapped energy within the body can exacerbate chronic pain. Some alternative methods of releasing negative energy can significantly help you tolerate your pain and raise your pain threshold. Another way to reduce chronic pain is to change your diet. Some foods we eat increase inflammation in the body. Inflammation is one condition that can significantly improve pain and our ability to maintain our mobility. Reducing our intake of some of these food items will limit substantially and/or reduce the inflammation stored in our bodies and minimize pain levels. Neurofeedback is also an excellent form of treatment to address pain management. Doing these things can allow you to gain more control over your pain issues to reduce unnecessary pain from your chronic condition. In addition, having people who understand our pain conditions and our need to cancel plans when necessary is priceless in reducing any unnecessary stress and anxiety that canceling on others creates.
If you struggle with a chronic illness, seeking help from a mental health professional can benefit you. They can help you to process your pain and frustration with what you are going through. Try to connect to others who know what it is like to cancel on others constantly. One way is to find a support group with others who share your chronic illness. This way, you can try to put yourself at ease for canceling plans due to your condition and know that others understand your dilemma and are here to help!