This is not just an academic issue for me. My wife, Elizabeth, was diagnosed with fibromyalgia (FM) a few years ago and is disabled from working due to several conditions associated with FM. I'm also a psychologist in private practice in Costa Mesa, California, who often works with FM patients, and I have the privilege of being on the Board of Directors of the National Fibromyalgia Association. It is my pleasure to offer the following practical suggestions to help you better support your friend, spouse, or relative who has FM.
FM is a pain amplification syndrome. One's central nervous system is sensitized to experience a lot more pain than others would under similar conditions. For instance, Elizabeth 's osteoarthritis and rheumatoid arthritis, as well as other conditions, are much more painful for her than for someone who doesn't have FM. One rheumatologist told her that it's as if the "pain switches of the brain get locked on." Must reading for you is the NFA's excellent brochure "About Fibromyalgia." As you educate yourself, you'll be less likely to blunder into saying things like, "It's all in your head." (Medical research has shown, for instance, that there is more Substance P [which facilitates the transmission of pain] in FM patients' spinal cords. Also, they have significantly reduced dopamine synthesis in multiple brain regions.)
Elizabeth is a "gamer." She'll quickly say "yes" to many activities with friends. But she can't count on being able to "answer the bell" when the time comes and sometimes has to cancel. Remember when you've been too sick to do something you really wanted to do and how disappointed and even guilty you felt for canceling? Sometimes she'll push herself to go and then have a day afterwards when she is in a lot more pain and can do little. These are common experiences for someone with FM. Don't stop asking her or him to do things with you. Even if the person with FM can't make it, he or she feels good for continuing to be asked.
If you care about someone who has FM, don't feel sorry for yourself because of how it's changed the relationship. If you do, you'll start to feel guilty as you realize the great physical discomfort he or she experiences daily. Instead, treasure what you do have. I guarantee you'll feel a lot better if you do, and the relationship itself will improve.
When I told Elizabeth about this article, she said, "Be sure and tell them how much I appreciate you for doing the vacuuming, the bulk of the grocery shopping, and other physically painful chores!"
We all like to be understood. A person with FM often feels isolated and misunderstood. You don't have to give great advice to be tremendously appreciated. Sometimes they will want to express their frustration and other times they'll want to focus elsewhere. We all love it when someone works at tuning in to how we feel and what we think.
Catastrophizing about one's condition has been shown to actually increase both pain and disability. Instead, keep a balanced perspective on not just what they can't do but what they can do. They are not helpless! Treasure them for their strengths.
Conflict, stress, and criticism all have been shown to increase pain. This doesn't mean you don't deal with issues in the relationship. It does mean that you be respectful and caring as you discuss differences (which is how we should deal with others anyway!).
Research has shown that spouses of those with FM have an increased risk of withdrawal, a weakened immune system, deterioration in physical health, discouragement, worry, and loneliness. Twenty-five percent of spouses are diagnosably depressed. These issues all can be countered, but it requires extra attention to self care. I love my 2 and ½ mile brisk walks by the Back Bay three or four times a week with Duncan , our dog. If faith is a resource to you, as it is for me and Elizabeth, that can be a powerful help. Continue doing enjoyable activities and keeping other friendships going. These are all good things to do, whether a spouse, relative, or friend has FM. Recent research by Martin Seligman, Ph.D., on happiness has shown that savoring briefly each night three good things that happened that day significantly increases happiness and decreases the risk of depression.
Psychologist John Gottman's research on marriage has shown that couples who have five times more positives than negatives in their interaction have almost no chance of divorce! The same principle applies to any relationship.
Vidal Sassoon said, "The only place where success comes before work is in the dictionary." This is really true of all relationships, including the one you have with the person with FM. You really have everything to gain by implementing these suggestions. Otherwise, as Richard Wilbur said, "What is the opposite of two, a lonely me, a lonely you."
Dr. John Fry has been a psychologist in private practice in Costa Mesa, California, for more than 25 years. His wife has fibromyalgia and he is on the NFA's Board of Directors. Learn more about his practice at www.drjohnfry.com.