The family is a complex organism. And, like any organism or system that has diverse parts that make up the whole, it functions best when all the different elements are in good working order. Often, the system can completely break down when one part becomes broken or dysfunctional. Systems theory is an interdisciplinary field, the study of the nature of complex systems in nature, society, and science. By using the theory, it is possible to analyze and describe any group of objects that work in concert to produce a result. The family has been identified as such a system. Each member of a healthy family takes part in the dynamic functions of the family, where each has responsibilities and roles to play. Additionally, there is support within a healthy family that encourages each member to act independently. Family systems research has developed an understanding of the family as an organism. Families are more than just individuals who live together. Everything that happens to one member has an effect on others within the family system. Therefore, if one member is in pain, the equilibrium of the family shifts and each family member changes and adjusts accordingly. After a while, the symptoms seem to take on a life of their own and seem necessary for the family to function, even if the symptoms aren’t needed. This strain of one of its members in pain is a struggle even in a well-functioning family. Mom in pain does not parent the way she used to; an adult son in pain becomes dependent on his parents while they are preparing for retirement, not parenthood; a spouse in pain may no longer provide emotional, financial, or sexual support. Family system theory works with families as they exist by trying to coordinate the strengths of each member into the reality of a painful condition for one of its members. Setting up flexible roles for each member is vital for families. Roles are patterns of behavior by which individuals fulfill functions and needs within the family. When role responsibilities are taken seriously, most families can usually cope not only with the stresses and strains of everyday life, but also with unexpected crises and normal changes that occur over time. Family roles include parent, spouse, aunt, brother, sister, child, grandparent, and so on. Connected with each role are specific expectations within the family on how those roles should be performed. Healthy families are expected to provide money, food, shelter, and clothing for all members; to be nurturing and supportive of other members, including providing warmth, comfort, and reassurance; to provide life skills development for both children and adults; to maintain and manage the family system, including discipline and enforcement of behavioral standards; and, in a marriage, to provide for the sexual needs of both partners. In a healthy family, roles are clearly identifiable so that everyone knows what his or her responsibilities are. Ideally, these roles should be allocated fairly so all family members feel they are doing their part and the family unit is running smoothly and responsibly. Obviously, when someone in a family is injured, it will have an impact on everyone in that family. When dad breaks his leg, the entire family is forced to change and make allowances for the situation. However, when the calamity is long-term, such as in the case of chronic pain, it becomes more than merely making allowances for the situation. Everyone’s life changes. These changes can be social, economic, physical, and psychological. In most cases, family members at first draw together while readily accepting other roles and responsibilities. However, as the situation continues for months or even years, the family can begin to experience considerable stress and changes are bound to occur.
Some common family problems that can result from long-term chronic pain. They include:
- Withdrawal from normal family activities. Many people isolate themselves from the rest of the family when they’re in pain. Some shun family activities and outings.
- Alienating your family as a result of irritability and temper outbursts. It’s a sad fact that many in chronic pain take their frustrations out on the people closest to them. If your pain makes you irritable and frustrated, you can alienate family members through crankiness and losing your temper. Your actions can compound your already delicate problem by adding guilt for your actions. It puts added stress on the family because they may feel like they have to continually “walk on eggshells” to avoid further upsets.
- Losing identity. Chronic pain can hinder activities that once supported your feelings of masculinity or femininity. Some women believe they are less than a woman if they are unable to do activities associated with the female role such as cooking, cleaning, and child care. Men may feel they are less than a man if they aren’t doing the roles traditionally assigned to men like bringing home a paycheck or playing sports with the kids. Chronic pain can cause a complete role reversal. Additionally, chronic pain can interfere with a person’s sexual identity by making him or her unable to enjoy relations with his or her mate.
- Being treated like an invalid. Family members can treat someone in chronic pain as though they’re more helpless than they really are. The family may be more protective than necessary.
- Being misunderstood. On the other side of the coin, some families have a difficult time grasping how bad off a family member in chronic pain can be. A common complaint is that the family expects more than the person in pain is actually capable of doing.
The real key to maintaining health as a family system is being able to adapt to changing circumstances. In general systems theory (GST), a system that is unyielding and unable to change is considered a sick system. Ludwig Von Bertlanffy was an early pioneer in GST and his works are an integral part of understanding how systems work and why they break down. Therefore, as chronic pain takes over someone in the family system, it is often necessary for each member to reorganize and to acknowledge and accept different roles and responsibilities in order to maintain the healthy family. New or altered roles are likely to be long-term, but changing, so it is necessary for the family to reassess the situation on a regular basis and be flexible. The reassessment will help the person in pain understand that he or she has not lost total control of his or her life and that he or she can grow and change, and so can the family. Understanding that the whole family is being affected gives everyone involved an opportunity to identify and take care of potential problems. This blog post is an excerpt from A Day Without Pain (Revised) by Mel Pohl, MD, FASAM; Published by Central Recovery Press (CRP). Photo credit: lorenkerns via photopin cc