One thing that comes up time and time again in pain management is goal setting. I have been told how important it is, but for whom? The Occupational therapists and physiotherapists say you must make goals otherwise how can you measure progress? But is striving for progress always helpful? For me it most certainly isn't.
Goal setting sucks. It reminds me of what I can't do and how out of control my life is. It sets me up for failure and that make me feel worse, not better.
I am a highly motivated person and despite my poor health and disability I have made some pretty big achievements in my life. I have written and published novels, mastered many crafts, I've published my own websites, organised a reunion event and with my husband I have raised three children.
I have also failed at a lot of things that most people take for granted. I left school before completing my A-levels due to ill health, I failed at studying with the Open University, I failed my driving test and I have never been in paid employment. I pushed myself towards those goals because they were expected of me, but I failed because I was too ill. They seemed achievable at the time and I was encouraged to work towards them but I could not complete them. That makes me feel stupid and useless, which is crazy because it wasn't my fault.
We are told that goal setting must be SMART, specific, measurable, agreed, realistic and timed. When you're living with a chronic and fluctuating health condition setting goals can be just as challenging as working towards them.
What is achievable? On a good day I might be able to prepare a light meal, with support from my PA or husband. On a bad day I struggle to sit up in bed and eat a sandwich. How can you determine if something is achievable when you don't know what you'll be capable of from one minute to the next?
Goal setting assumes that you are physically capable of making progress. For some people that might be true. Some chronically ill people are mentally defeated by their illness, they sit in bed all day believing that they are not capable of doing anything. I can see how goal setting might be helpful to them but not everyone is like that. I'm certainly not!
There are also some people who push themselves to extremes. They set a goal that is not achievable and go ahead and do it anyway, then suffer more pain and symptoms because of it. I'm occasionally guilty of that but I understand the boom and bust principle and how in the long term that only makes things worse.
My problem lies in the fact that at the moment I am not physically capable of making progress. My ongoing health problems bombard me with varying symptoms every day whether I like it or not. It's often too much for me just to manage the basic activities of getting out of bed, washing, dressing and eating. My symptoms flare up for no reason at all. I am not in control of them and despite my best efforts I can't stop flare ups happening. I am never symptom free.
That's OK. It's something that I have learned to live with. I know there is no magic bullet, I can't make my health problems disappear. I do what I can, when I can. I understand that if I do too much I will suffer an increase in symptoms and if I am lazy and sit on my bum all day long then deconditioning will make it harder for me to get up and do things. It's all about balance. I'm not exactly happy with that but I accept it.
So why do I need goal setting? I don't need goals to make me motivated or focused, I don't need to be encouraged to do things. Of course there are things that I want to do but I know that if I could do them, I'd already be doing them and if I can do them now maybe I'll be able to do them in the future if things ever improve.
Some people must be helped by goal setting otherwise they wouldn't keep teaching the principles, would they? But I know from speaking to other chronically ill people that I'm not the only one who finds it unhelpful.
It's condescending, I know how to plan and break tasks down, I just can't always do it because I'm ill. It's also depressing when you set a goal and you know what you need to do to wark towards it but then you get too ill to even try. It reinforces all the negative aspects of being ill and it's beyond frustrating. It's even worse when people tell you to set easier goals. If they are easy you just do them, you don't have to make any effort to do them, there is no achievement, it's not even a goal so it feels completely pointless. It doesn't help you progress. It just sucks.
I am giving up on goal setting. It doesn't work for me. I know that any progress I make will come naturally. If I have to strive for progress then it's going to come at a price, and I usually can't afford it.