“Have a positive attitude.” 

How many times have we heard that one? While your emotions can not cause facial pain, they no doubt affect your symptoms. But how can you maintain good thoughts when you feel so lousy? This challenge, of course, does not pertain exclusively to facial pain, but to any time when things do not go as we wish. But in the case of ongoing illness, seeing the positive presents a continuous struggle. 

Your moods are not perfectly correlated with your physical state. Most likely you can recall times that despite much pain or fatigue, you were able to cope and even achieve high spirits. Perhaps the weather was perfect, good friends visited, you just accomplished something or helped somebody, making you feel good about yourself. Other times, depression seems to take hold even when your physical discomfort is at a manageable level. Why is this? 

Answering this question is the key to finding optimism. Sometimes it seems we have fallen and the waves continue to crash on our heads, as we fight to rise, only to be knocked down yet again. But that same ocean sometimes allows us to find a wave we can ride smoothly to the shore. What can we do when we feel under the waves? How can we find the strength to climb back on top, and the patience to know that we will? 

Cognitive exercises for a positive attitude

Here are ten cognitive exercises I use to maintain the most positive attitude I can: 

Expect bumps! It is important to acknowledge that we will sometimes feel down. Who wouldn’t? But by expecting rather than dreading down time, such periods become more tolerable. In addition, recognizing that you will have blue periods helps keep them in perspective. You will be able to say to yourself, “I was depressed before, and got out of it; this time, too, it will pass.” It is easy to forget that before your facial pain, there were times you felt down. Now these periods are wrapped up in your medical problems; but everyone gets depressed some of the time. After accepting that we will sometimes feel sad, and even experience self pity, you can concentrate on ways to shorten these periods and make them fewer and farther between.

Track the changes. Keeping track of moods helps put ups and downs into perspective. During your best times, make a conscious attempt to capture the feeling. Post notes on your wall or refrigerator attesting to the way you feel. Living with chronic pain easily creates a Jekyll-and-Hyde persona, where your optimistic self and your flare-up self are not sufficiently acquainted. When we feel bad, it becomes quite difficult to imagine that things can be otherwise. Similarly, during times of improvement, it is amazing how quickly you may forget how bad a previous period was, making subsequent flare-ups not only intolerable but shocking. Counting and measuring the duration of the bad times — as well as the good ones — can put them into perspective. It may be that over time, your worst occurs about once a month, although it feels much more frequent. This knowledge is empowering, because you can remind yourself that a bad flare is, for example, your monthly temporary setback, and find ways to ride it out until our baseline returns.

Stockpile fun distractions. We all need to keep lists handy of the things that make us happy. One of the cruelties of our condition is that when we need distractions most, we are least equipped to seek them out. For this reason it is important to compile a list of our favorite activities when we are feeling optimistic to be used when we most need them. People with facial pain often describe how sometimes pain can be put on a back burner, so to speak, when they become engrossed in an activity. This is not only a psychological but a physiological response: our brains can only process so much input at once. When we are engrossed in a beautiful movie, talking to a good friend on the phone, or listening to our favorite music while lying on a heating pad or in the bathtub, we can trick our pain receptors into leaving us alone! Meanwhile improvements in spirit have an added impact on our entire well-being. Laughter is good medicine; while dwelling on our troubles tends to compound them.

Shape your perspective. Is the glass half empty or half full? Perspective determines, quite literally, how we view the world. Having chronic pain creates an ambiguous construction of reality for you. Developing a condition that makes you feel more dependent and less productive is likely to be a huge disappointment. Yet as we get older, it becomes more likely that we, or somebody close to us, will experience debilitating problems. People are often forced to adapt to sudden, new conditions by adopting a perspective that accommodates change. Our perspectives are shaped by the comparisons we make and the expectations they create. 

Create a new self. If we hang on tightly to the “old self” we were, finding the value of our “new self” becomes increasingly difficult. (We may even exaggerate how fit that person was: “I didn’t need any sleep, I never felt bad, I could do anything!”). This does not mean we should totally discard our previous conception of self; rather, we need to find a way to integrate the two. In other words, we should seek to find in our new bodies new ways to enjoy and experience the things that we had done before. Consider all the aspects of yourself that you like, and the things that you most want to do; then step by step, find ways to achieve as many of these as you can. At the same time, recognize that your expectations must shift so that you can once again meet them. 

Don’t forget the good stuff. While the physical symptoms of facial pain can feel all-encompassing, there are other parts of your life–our social relationships, passions, family — that also exist. By focusing on the positive aspects of your life, you become more aware of how many there are: the friends who stuck by you, the activities you still enjoy, and the accomplishments you have been able to achieve, however small, under very different conditions. 

Because each task now represents a challenge, you should celebrate whatever you manage to accomplish. As we have been told many times, if we shorten the list and pace ourselves whatever we do eventually adds up to something to be very proud of.

 It could be worse. As comparisons shape our view, it is helpful to find comparisons that will provide a fuller appreciation for what has befallen us. OK, the “eat because children are starving in (fill in the developing country)” did not work for you as a child. But try to think of it this way: Many bad things happen in the world. The odds are that some of them will happen to us. Not because of anything that you have done, but because, as the saying goes, shit happens. So, this is what has happened to you. Examine what you have: (a) You know our condition is not terminal, so you need not begin contemplating our pending mortality. (b)You have gotten through it so far and you can keep going. (c)There is always hope for new treatments and therapies to make you feel better. 

Keep the hope alive! There is so much room for hope. You are in a far better position than the generations before you who suffered without ever receiving validation. We know much more about the important roles of exercise, medication, stretching, pacing and meditation to bring relief and a sense of control. Furthermore, as medical research increases, it is only a matter of time before better therapies (and perhaps even a cure!) are introduced.

Lean on me. A single most important predictor of how we do is the support network we create. We certainly appreciate what it means when someone helps us when we feel especially lousy. Make sure that, within your means, you continue to be a good friend to those you care about. We still have lots to give. During a good moment, write to a friend that you are thinking about her. Help your family and friends find ways to maintain their relationship with you. Try to be open with family members, while at the same time supportive of their needs. Put yourself in their shoes as often as possible — it can be scary to have someone you love be in pain. Also make sure to seek help outside of your immediate circle so as not to drain your closest friends and family. FPA Support Groups are a perfect supplemental group of people who will understand what you are going through. 

Indulge whenever you can. Facial pain may provide time to focus on our thoughts. Most people do not have the luxury of taking time to relax and think. OK, we did not ask for these “time outs.” They are demanded by the needs of our bodies. Nevertheless, we have control over how we use this extra time. Instead of dwelling on what our bodies are not doing, give your fantasy full liberty. Turn these rest periods around to be an indulgent time. In our mental playground, we can practice dance steps we used to know (for there will be some times we can dance!). We can use the time to think through problems we face and how we want to spend time when we are feeling ready, or we can analyze a movie we recently saw, say prayers, or mentally write a letter to a friend.