It is very difficult to deal with the reality of acceptance whilst easy to talk about it. Pain sufferers find it very challenging that they cannot any longer manage an important ability they feel they should perform with ease. People with a chronic pain disability show no outward signs of their restrictions and others treat them as normal, expecting them to be able to do things normally too. Coping with the loss of usual functioning is difficult as can be the attitudes and beliefs of other people towards pain conditions. However, the conflict which exists cannot usefully be continued and sufferers benefit from working on acceptance of the situation.

In most things we have to accept the reality of what we are and what the present situation is. We can in many cases make changes to our situation to improve things and get closer to what we want to be. However, in some cases we are stuck with the situation we are in and we have no option but the accept it or fight against it. Fighting it generates, as we have seen, conflict which has undesirable consequences. Gradually moving towards acceptance can free us from this conflict and allow us, finally, to work at our difficulties in a productive manner.

Not accepting the situation means we cannot release ourselves from the conflict and can’t take on our or others’ suggestions for improvement. If I won’t give in to the pain or let people down by admitting I can’t do something then I won’t see why I should do things any differently or accept a lower standard of performance of the job. This way the route to making the necessary changes can be blocked, getting in the way of our progress towards where we want to be. If we say This is the reality of the situation and I have to work with that we can step forward and begin change.

The scripts we use, the words which we say to ourselves about our abilities or our desires, are important in how we act. They are often unconscious, these specific interpretations and ideas about ourselves. We might say My fitness is at a good level and I can manage social activities, sports and my life all together, which would be a good position to be in. If a person has a pain syndrome or low back problem their scripts will run in different ways such as My pain disables me and I don’t think it is ever going to improve so I won’t be enjoying any activities in the future. This is the underlying message a resigned person might have constructed for themselves.

However, very negative scripts, constantly going round and round in our minds, lead to negative thinking and depression. One approach is to consciously generate new scripts and an example of this might be Even though I do have a pain condition which limits my ability, if I manage my situation well I will be able to do many of the things I want to in a modified manner. This is a realistic description of the situation and more likely to lead to a realistic assessment of our situation and a more positive approach to any action which could be taken to improve it.

Realistic scripts have the benefit of being more positive than the typical negative ones although they should not really be positive as such as if we look through rose-tinted spectacles we will be disappointed pretty quickly when we really see where we are. A more positive approach allows us to participate in the management of our condition, perhaps with the help of a health professional, when previously any new ideas would have met with resistance.

So if we can accept the situation to some extent it is much more likely we will adopt adaptive measures to improve our condition. The typical behaviour we adopt when we have a chronic pain problem, to push through the pain until the job’s done can be altered.