“Jesus wept.” (John 11:35)

Before Jesus wept, the previous verses tell us that Jesus saw Mary, the sister of Lazarus, and those who were with her weeping, and He was deeply moved and troubled. We know that Jesus was not weeping for Lazarus, for He knew that within minutes Lazarus would no longer be dead.

Jesus would raise Lazarus from death, bringing him back into the world of the living. Jesus was weeping because of the suffering of Mary and her companions.

That very short verse of “Jesus wept” brings me great comfort, because it tells me that Jesus is moved by our suffering and pain, even to the point of tears. Consider that for a moment: Jesus sees our suffering and is deeply moved by it. Can you imagine Jesus weeping because of your suffering?

I don’t believe that Jesus is on a continual crying jag in heaven, but I am comforted with the fact that He is moved to compassion by what we suffer and endure on this earth. I am convinced that Jesus sees our suffering and that He cares what happens to us. He sent His Holy Spirit to comfort us in our troubles, and He lives in us through His Spirit. Yes, Jesus knows what you are going through, and He cares that you suffer and are in pain.

The next time you find yourself suffering, enduring some terrible sorrow, picture Jesus, two thousand years ago at a graveside, surrounded by people suffering terrible grief, He loved them so much that He wept with them, suffered with them, even though He knew within minutes tears of grief would be changed to tears of joy.

Someday our tears of heartache will turn to tears of joy at our own graveside leading not to death, but to eternal life. Meanwhile Jesus sorrows with us, He knows the depth of our grief and suffering, and it matters to Him, it affects Him, but joy is coming soon.

Prayer: Dear Lord, You count our tears, You know our grief and suffering, thank You that our pain and suffering matters to You. Help us not to forget that joy is coming. Amen.

About the Author:
Karlton Douglas has Chronic Fatigue Syndrome and Crohn’s Disease, and he takes great comfort in the compassion and love of Jesus through his affliction.

State officials in California are pressing to revoke the license of a doctor linked to several fatalities due to overdoses of prescription narcotics including OxyContin, hydrocodone and Xanax. An article in The Los Angeles Times reports that at least six men have died of overdoses after visiting general practitioner Lisa Tseng, some of whom were known addicts. According to the Associated Press, in addition to misconduct charges from the Osteopathic Medical Board of California, Tseng faces an investigation by the U.S. Drug Enforcement Administration into her prescribing practices.

I don’t mean this post to be negative, but it will be.  I’m writing about some personal things with the hope that someone out there may find something useful in my experience. (I promise, in my next post I’ll share a couple of awesome bird pictures I got on our last kayak outing, so come back for that, ok?)

Over the past several winters here in Michigan, I’ve been experiencing increasingly severe seasonal affective disorder (S.A.D.).  I’ve dealt with it by escaping down to Savannah, Georgia, for a few days each spring. But that’s reactive rather than proactive, and now that I’m already starting to feel the effects of it as our days grow shorter this year, I’ve decided to be proactive about how I deal with it this year. I just ordered a light box and am hoping I’m one of those people who experiences life-changing benefits from the light therapy. Fingers crossed… I just can’t bear the thought of feeling crappy for the next 6 months.

Today was a pretty bad day for me — I spent the whole day in and out of bed, unable to even get myself motivated to get a shower.  This was partly because of my chronic lower back pain and partly because of too much time spent watching cable news (more on that particular problem below).  I’m making an appointment with a chiropractor tomorrow, hoping that will help my back.  Having this pain every day has become unbearable. I know I should have gone to a doctor years ago about it, but I let it go on and just continued to use my microwave heating pad multiple times a day to ease the worst of it. But it’s got to stop. I’m sure that having chronic back pain has contributed to my depression in the winter, and even this summer it’s made my life miserable. Some days the pain is so bad that I can barely move my hips, making it uncomfortable to sit or stand or even to lie down. I wouldn’t wish it on anyone.

As for the cable news addiction…I noticed after 9/11/2001 that I was spending more time every day watching the news, but I thought it was a short-term reaction to the scary events of that day. But over the years since then I’ve continued to spend hours a day flipping between the major cable news channels, often noticing that the bad news has negative effects on my mood.  The news over the past couple of years has gotten worse, from disasters like Katrina and Pakistan to the economy and political extremists. So today I googled “addicted to cable news” and found a blog post by a guy who broke his addiction to cable news. He lists the positive changes to his life that resulted, including an optimistic outlook and positive conversations with others.  I’ve toyed with the idea a couple times recently, but today I’ve decided to go ahead and give up the news cold-turkey. No more MSNBC or CNN for me.  It’ll be harder to give up Brian Williams, but I think it’s necessary.

I’ve always rationalized my need for the news as a way of being a responsible citizen, of keeping myself informed.  And I still believe that, but I think I can use the web to get the information I need while filtering out the murders, animal cruelty cases, and other violent stories. It will probably take some time to figure out the right balance for my online news reading too, but at least I’ll have more control over what I’m exposed to.

And to reinforce my commitment to avoiding bad news, I’m going to pay more attention to the Good News Network. If you haven’t seen it before, it’s just what it sounds like: a website that gives you positive, uplifting news rather than the negative and fear-inducing stuff fed to us by other news outlets. I’ve been subscribed to their Facebook feed for a couple months now and really enjoy the stories they publish. I highly recommend them if you feel the way I do about the overwhelmingly negative news.

Well, not exactly the real world – yet – just the clinic.

A man I’m working with is very worried about his back.  Some years ago he had a discectomy and his surgeon told him he needed to be ‘very careful’ with his back – and so he has.  No bending, twisting, lifting for this man!  He’s given up some of his favourite things like fishing and whitebaiting and even golf because of this worry, although when I talk things through with him he’s not exactly sure what might happen if he ‘disobeyed’.

Let’s call him Matt for wont of a better name (and yes, as usual, details have been changed to ensure confidentiality), and he’s a fairly ‘blokey’ man who loved his fishing, diving, and taking off for days in his converted bus with his partner.  He’s just recently hurt his knee in a fall, and although the knee has been slow to recover, he’s now on the mend – but his back pain has become much worse.

Matt’s previous back problem involved a large disc prolapse, compression of the nerve root, and radicular pain radiating down his left leg.  After his surgery, the leg pain completely went but as often happens, he was left with slight low back pain.  Matt told me he could usually manage this and it didn’t bother him because he was ‘very careful’ with his back.  When he said ‘very careful’ what he meant was he’d stopped all those things he’d enjoyed and when he got pain he immediately thought of what his surgeon had said, and worried that maybe his back was ‘under stress’ and he might have a recurrence of that pain that he had experienced before.

While his knee is settling down, Matt’s back pain has increased – and to cap it off, he’s now got pain in all his joints.  Matt’s not one to visit the doctor unless he ‘has’ to, and he hasn’t mentioned this widespread pain to his doctor – and his fear was that this pain ‘must be’ rheumatoid arthritis.  He doesn’t have any RA in his family, but his understanding was that RA is something that affects every joint, it’s progressive and certain to mean he will be crippled (his words).

I guess we could say that Matt is a man with health anxiety, and more specifically, pain anxiety – and kinesiophobia.

Matt’s worry about his back pain has lead him to see his GP to get an MRI to ‘find the cause’ of his increased pain, and to ‘get it fixed’.  Unfortunately, even though he hasn’t any specific signs to suggest the need for an MRI, he’s been referred for one (see my previous posts on ‘is reassurance reassuring’!).

I spent a while discussing the possible outcomes of the MRI with Matt.  Maybe there will be a clear anatomical change that will account for his back pain and a clear surgical solution.  Maybe there will be a slight anatomical change but no surgical solution.  Maybe there will be no anatomical change at all.  What will he do?

I should add at this stage that Matt and I spent quite a while with one of our doctors looking at his previous surgery and the possible explanations for his increased back pain.  Even though he had a clear explanation, his questions were answered and he has had a good response to medication suggesting that the pain is most likely due to central sensitisation, Matt is not convinced he should change his practice of avoiding movements involving his back.

At our session, Matt and I discussed the effect of his avoidance strategy.  He’s aware that it’s not working for him, and that it means he has given up many of the things he really enjoys – but at the same time, to him the risk of ‘doing damage’ is far too high. So I suggested to him that we go through a set of photographs (the PHODA) to look at exactly which movements and activities he felt he shouldn’t do – and would avoid.

Together we sorted through the 100 photographs of people doing everyday activities.  He sorted them into two piles – one that he would do reasonably happily, and the other of things he wouldn’t do.  Sixty seven of the photographs were sorted into the pile of things he wouldn’t do. Things like carrying a load of washing, picking up a planter pot, pushing a wheelbarrow, twisting to reach for a book, reaching above his head to retrieve a box from the top shelf…

Things he would do included some activities that looked very similar to the ones he wouldn’t do. For example, he wouldn’t bend over to pick up a pair of shoes from the floor – but he would reach across a bed to pull the duvet up.  He wouldn’t reach across a table to pick up a book, but he would reach forward to prune a rosebush.  In both of these cases the postures he adopted were the same but for Matt, there were clear ‘reasons’ one movement was fine, and another was not.

He and I have agreed to develop a hierarchy of these avoided activities. We’ll put the photographs in order from least bothersome to most avoided.  And we’ve agreed to work through each activity and firstly identify what it is about the activity that concerns Matt.  Then I’ll show him how I’d do the movement, and he will attempt to do it the same way.  I’ll ask him to rate his level of concern out of 10, and to rate the likelihood that what he fears will happen out of 10.  Then he’ll do the movement, and repeat the measures.

What we’re trying to do is test his hypothesis that these movements are going to do what he fears. It seems that although he’s concerned that he might ‘damage’ his back, the cue that he uses is his pain level – and he is not happy about fluctuations in his pain, both because it might mean his back is ‘getting worse’, but also because he is fearful that he won’t be able to ‘handle’ the pain (remember he’s usually a pretty staunch and blokey man).  He’s got a few theories about how his back works, but readily acknowledges that he doesn’t really know all that much about his spine, just what his surgeon has told him.

I’ll keep you updated on Matt’s progress as we work through this exposure activity.  I think this is a great opportunity to help Matt learn both about his body, and that he can cope with fluctuations of pain.  I’ll be listening carefully to what he thinks is going on, so I can set up ‘experiments’ that we can do together (at least initially) to test out whether his hypothesis is correct.  Matt seems satisfied that I’ll be ‘doing the worrying’ for him, and that he’ll be doing the activities in our environment.  My plan is that once we’ve managed it in the clinic, he will feel confident enough to practice the same activity at home.

For some more details on the graded exposure process and the theory behind it, here are several papers:

Wicksell, Rikard K; Ahlqvist, Josefin; Bring, Annika; Melin, Lennart; Olsson, Gunnar L. Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial. Cognitive Behaviour Therapy. Vol.37(3), Sep 2008, pp. 1-14.

Linton, Steven J; Boersma, Katja; Jansson, Markus; Overmeer, Thomas; Lindblom, Karin; Vlaeyen, Johan W. S. A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work-related activities. European Journal of Pain. Vol.12(6), Aug 2008, pp. 722-730.
Vlaeyen, Johan W. S; de Jong, Jeroen; Sieben, Judith; Crombez, Geert. Graded exposure in vivo for pain-related fear. Turk, Dennis C [Ed]; Gatchel, Robert J [Ed]. (2002). Psychological approaches to pain management: A practitioner’s handbook (2nd ed.). (pp. 210-233). xviii, 590 pp. New York, NY, US: Guilford Press; US.