The Cycle of Acceptance

By Jack Harich - June 23, 2002

If you have a condition like pudendal neuropathy, you need to realize that constant pain, no diagnosis, or treatment failure usually causes intense frustration, anger, denial, agression, depression, and such. This receipt of bad news is all part of a perfectly predictable and normal pattern. It is nothing to be ashamed of or feel guilty about. But if it's never happened to you before, you may not recognize the pattern for what it is, and become trapped in a downward spiral of inability to deal with your problems. This pattern causes the average person to begin thinking irrationally and behaving abnormally.

The pattern is called the Cycle of Acceptance. Entering it is unavoidable upon receipt of bad news. How long it takes you to complete the cycle is critical. The longer you are in it, the less likely you will ever fully complete the cycle, the more likely you will be unable to manage your condition wisely, and the more likely you will be terribly unhappy.

Study the Cycle of Acceptance Diagram closely and ask yourself if this is happening to you. Many of us have gone through this. Take heart. Nearly all of us have emerged from this unpleasant but common phenomenon okay. We can help you through it too, if you will just honestly acknowledge what is happening to you. For more on this see Accept Your Condition (need to add link to FAQ What Second).

The key steps are easily memorized:

1. Denial.
2. Anger.
3. Depression.
4. Bargaining.
5. Acceptance.

Note that the Cycle of Acceptance phenomenon can cause people to engage in complaints (due to frustration), arguments (due to frustration and agression), and attacks (due to agression). This is perfectly normal behavior, but it is unproductive and distracting. Therefore these are unacceptable types of behavior unless those you are communicating with are prepared to deal constructively with your behavior.

If you do not honestly acknowledge the Cycle of Acceptance and try to get to the acceptance stage, you will be emotionally vunerable and probably undergo tremendous emotional suffering. Three extreme forms of this are pathological behavior, severe depression, and emotional breakdown.

1. Examples of pathological behavior are prolonged vicious arguments, verbal attacks, verbal abuse, physical abuse, and substance abuse. Pathological means behavior that is habitual, maladaptive, and compulsive.

2. The second form, severe depression, is similar to emotional breakdown, but is less healthy because it lacks the tendency for self repair that occurs when breakdown causes the mind to take a rest. There are many theories. One is that depression centers around being subconsciously convinced a problem is insolvable no matter what you do. This makes the conscious mind feel trapped, hopeless, and full of despair. Insolvability is a rational, normal, initial conclusion, but is often false, due to misperception of the problem or unawareness of a solution or a problem solving path to at least a partial solution. The depressed mind is muddy, while the one in breakdown has gotten away from the source of the problem and is thus cleared up a little.

For these reasons and a host of others that are little understood, severe depression frequently leads to thoughts of suicide. Despite strong taboos, this is a perfectly normal response and nothing to feel guilty about. All the mind is doing is examining alternatives. In fact, due to the prolonged intense pain of PN and the way this disrupts one's normal lifestyle and happiness, if you never consider the option of suicide for at least a little while, you are probably in the minority and are not examining alternatives. The drawback to suicide is it's an inflexible, permanent alternative.

The first step to get out of depression is to acknowledge it is happening and is a normal, expected part of the Cycle of Acceptance.

3. The third form, emotional breakdown, is the mind's way of dealing with inability to find a rational way out. Instead of continuing to take action that is leading nowhere, the mind does nothing for awhile. While this is called a breakdown, it is actually a reliable coping mechanism that almost always leads to a return to a normal existance, and understanding and acceptance of the "problem." The mind is simply taking time off to repair itself.

In many cases the "problem" is not the original problem, but a new one you became emotionally vulnerable to while suffering from the first problem. For example, those suffering from stress or pain are much more vulnerable to psychological abuse, also called verbal abuse. An example of this, believe it or not, is the prolonged arguments and attacks emanating from individuals on the Yahoo pudendal group in Spring of 2002. This is a case of pathological behavior directed against those who are emotionally vunerable due to their condition, and it can lead to emotional breakdown, depression or a person leaving the community. If too much of any of this happens, the community is destroyed.

Therefore we must help our members though the Cycle of Acceptance not just to help them help themselves, but to preserve a healthy community.

Pain Causes Psychological Problems

A New York Times article on "Calling in the Pain Team, Specialists in Suffering, June 23, 2002, had this to say:

"Dr. Levin said that, unlike acute pain, which has a purpose, as when you touch a stove, chronic pain is not adaptive. 90% of its victims suffer from psychological problems, including personality disorders and major depression."

Comments

One person said: "I also want to tell you that I like that you are addressing the psychological aspect of this condition in your site. This is an important area that people deal with when living with chronic pain."

Another said: "I think it's great that you candidly stated that the PN pain is sufficient to contemplate suicide...as I certainly did. If I had seen this clearly stated, it would have given me hope that I wasn't the only one thinking about it. You've communicated the uncommunicated! I've found that there are a lot of people out there that are thinking about it, but very few will be the first to admit it. I certainly couldn't blame someone for ending it all, as this stuff is a hell on earth." (Suicide is also mentioned in the first question in the Frequently Asked Questions.)

Another said: "I've used you Cycle of Acceptance in our local endometriosis support group. It has been very helpful."