What bothers you most about having arthritis?
Some people say the pain, or taking meds, but most everyone agrees that one of the most difficult aspects of this disease is the unpredictability of the symptoms.
You don't know from one day to the next what to expect. When something happens, you try to reason — was I stressed? What did I do to trigger this? Am I having a reaction to medication? Is the disease progressing?
Most of the time you don't get a definitive answer.
The not knowing means you have the feeling of being out of control — of your disease, your body and, sometimes, your life.
I have heard this expressed by my patients, and on the CJ message boards. Psychologists have termed the effects of these feelings "learned helplessness."
A famous study was done with dogs (before the ethical treatment of animals was established as a mandate). Dogs were given a brief unexpected shock through a floor grating. There was an easy escape from the shock — they could jump over a low wall.
Then they were given the shock — on an unpredictable timetable — and there was no escape. When the dogs realized they couldn't change or have any influence on what was happening to them, they lay down on the grate and just quit.
What was more troubling was that when the researchers removed the partition so that the dogs could escape, they didn't even try. They had given up. They learned that they were helpless, and so they lost their initiative.
What does this have to do with arthritis?
Sometimes people who have unpredictable events, like pain or reactions to medications, behave like those dogs. They feel they can't have any effect on what is happening to them — and they fall into a helpless or hopeless state of being.
Some biologists have wondered if this is a hardwired response — not a psychological reaction like "I'm just quitting," but a way our brains have been designed to work so that we don't waste a lot of energy in a situation that is intractable.
I'm inclined to believe that because the folks I know who have these bleak periods where they feel nothing will help seem to fall into them without conscious choice.
There is another chapter on this research though, and it is a hopeful one. Further exploration and experimentation (without the shock treatment!) has demonstrated that our brains are not like animal brains.
Even something hardwired as learned helplessness can be unlearned, and "un-wired."
It takes some attention, and some ways of talking with yourself or others, but you can regain some feeling of control, some hope and some energy.
My next column will help you figure out some ways to do this.