How caregivers can respond when patients take their pain out on us

A columnist explains how her spouse's chronic pain can lead to bursts of anger

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by Alliah Czarielle |

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Pain can alter people’s behavior, causing them to act out in unusual ways. People experiencing a severe degree of pain may hurt others emotionally or physically, often without meaning to. They might say demeaning things to their caregivers while in the throes of pain, even if they’re normally calm, respectful, and composed.

As a wife and carer to my husband, Jared, who has severe hemophilia B, I have experienced drastic changes in his attitude during instances of pain. He’ll lash out and criticize me, even for small things.

I understand that this comes from heat-of-the-moment frustration, but it still hurts whenever he takes his emotions out on me.

Why pain alters attitude and behavior

Pain affects a person’s mood and cognition. According to a 2020 article published in Practical Pain Management, “Pain is hard-wired as a social alarm of a threat, which is then selected over other competing demands and triggers behaviors that interfere with normal life functioning.”

A person experiencing pain may attempt to engage in problem-solving behavior, hoping to get to the root of the issue. Unfortunately, many individuals don’t have techniques at their disposal to achieve this. As a result, they may feel stuck in an endless loop, never arriving at any real solution.

There are also various other factors affecting a person’s perception and experience of pain. Personality, beliefs, gender, age, culture, and even emotional reactivity can all influence how someone responds to pain.

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Anger is displaced fear

In Jared’s case, his typical response to discomfort is anger. This is not ideal for me, and he is very much aware of it. However, he admits to having difficulty controlling his anger response when met with certain stressors, especially pain.

I’ve heard a saying that goes: “Anger is fear with no place to go.” Fear often triggers anger. When met with threats to our safety or well-being, we may overcompensate by acting in ways that are violent or aggressive, even when the threat is relatively small.

How a carer can respond to a loved one’s anger

I’ve turned to internet forums in search of ways that a caregiver might best deal with anger. Many suggested that the caregiver should try to be the bigger person while setting gentle boundaries. For instance, a caregiver might calmly tell an angry patient that they’re doing their best to solve the situation. If the patient is being rude, the caregiver might calmly set a boundary, stating that the patient isn’t allowed to talk to them that way.

But when the person you’re caring for is your spouse, things might be different. Being together on a daily basis breeds familiarity. When you’re used to your spouse being kind and caring, seeing them suddenly turn callous and aggressive might cause you to feel equally angry toward them. Over time, unresolved anger can become resentment.

When you’re the one closest to the person experiencing pain, you may become the frequent target of hurtful remarks or actions. The emotional toll of such an experience may eventually strain your relationship.

In such cases, it’s important that carers are aware of how pain affects behavior. We must understand that pain-induced behavior is often not a true reflection of character. That way, we can remind ourselves not to take it personally when the people we love suddenly change.

We must also learn to balance our caregiver role with self-care. This includes maintaining our personal boundaries and learning to respond calmly yet firmly to our partners when they treat us in ways we find unacceptable.

Pain is not an excuse for ‘bad’ behavior

It means a lot to me that Jared owns up to his actions when he oversteps my boundaries in a moment of stress. Treating people in undesirable ways isn’t “normal” in any scenario.

More importantly, caregivers are human, too. Though we often strive to provide the best possible care for our loved ones, our best may look different from day to day. At times, we might be capable of extreme patience; other times, our patience threshold might be lower because we are more exhausted or dealing with other personal issues.

As for Jared and me, we practice open communication at all times. Once the stress has subsided, we talk about what happened. I let him know if he has offended me in any way, and he also tells me what he felt at the moment he snapped. We also talk about how we can do things differently next time.

I’ve also learned that humor can be a powerful tool for diffusing negative emotions. It helps that I can “get him back” in mildly annoying yet harmless ways — like two kids teasing each other!

Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to hemophilia.


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