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Chronic Pain and Your Social Life: Ask Noah

Clients with whom I've worked suffering from chronic pain symptoms often articulate to me that the most frustrating aspect of living with chronic pain is the unpredictability of the symptoms themselves.
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Q: Noah, I suffer from fibromyalgia pain, acute body-wide muscular and joint pain and tenderness. My workplace is decent and they're very understanding when I need to leave early for a doctor's appointment, or to take a day off due to extreme pain. What's really upsetting me lately is that this pain prevents me from enjoying my social and personal life -- canceling plans or dates with women and friends, etc. I'm frequently in so much pain or too fatigued to have fun. I'd really appreciate your help with this!

A: It's very difficult to focus on enjoying a friend's company when you're consistently monitoring your own physical state. The pain you're living with is not only affecting your body, but also impacting upon the manner in which you interact with the world as a whole.

I appreciate the stress this causes and the severe emotions that it must produce as well. Clients with whom I've worked suffering from chronic pain symptoms often articulate to me that the most frustrating aspect of living with chronic pain is the unpredictability of the symptoms themselves. They feel that they are always in a defensive posture, resulting in an inability to live life in the present moment.

I think it's important that you make even casual friends aware of your pain. This will inform them of the reason behind canceled plans, leaving early or not always being fully attentive when in their company. Perhaps even more importantly, it will take the stress off you of having to constantly seem "pain-free."

In operating this way, you will not only be informing others of the chronic nature of your condition, fibromyalgia. You will also be including them in your particular process of socializing, which will absolutely result in a more relaxed, more enjoyable social life for you.

When you enroll your friends in exactly what it is you're dealing with, you'll create a more stable environment, inherently fostering friendships based on acceptance rather than expectation.

You may not fully believe this but your friends will feel so touched and trusted by your honesty they'll be entirely accommodating to your needs.

As you actively pursue "enjoying" your social life more, work on being kinder to yourself. Be careful not to bite off more than you can chew, and pace yourself. Evenings out need to be more structured for you. It is totally reasonable for you to be very specific about how you spend your time in social situations, so as not to exert more energy than needed.

Even in those moments when you're having fun and feeling virtually symptom-free, I would encourage you not to overdo it. Remember, it's essential to be vigilant about your self-care.

When you can, I would suggest avoiding huge crowds and loud concerts, instead opt for dinners and art exhibits.

You're obviously never going to get it perfect. And try not to spend so much time over analyzing your evening plans that you forget to enjoy yourself.

It's magical thinking to believe you will be able to socialize like your peers without your body reminding you of your chronic pain. Understand that there's no shame in creating a social world that suits your individualized needs. Find enjoyment in the fact that this is your right, and feel confident around doing so.

You've succeeded in doing this at work. Now it's time to take care of what happens after 5!

Thanks for writing, and keep your head up.

Please send all questions and comments to ASK NOAH at

Have a profitable and peaceful week,


This column was originally posted on March 15, 2013.

For more by Noah Kass, click here.

For more on chronic conditions, click here.