Pain and Silence
RATE

Anyone who knows me would say I talk a lot. I’m friendly, loquacious, extroverted, and open. I always received full participation points in every high school and college class I took, my hand shooting into the air when a question was asked or a debate initiated. I have in-depth discussions with people I’ve just met and three-hour phone conversations with old friends. At a party or community event it can take me an hour to make my way across a room, so frequent are the chats I have along the way.

Unless, that is, I’m in a lot of pain.

Pain: A personality changer

Most people wouldn’t relate their core personality traits with the level of pain they’re in, as most people don’t experience high levels of pain on an ongoing basis. However, living with rheumatoid arthritis (RA), I am always in pain. On a good day, there is mild achiness in my joints that I’m able to push outside of my focus. During a flare of symptoms, the pain can be so intense I’m unable to make a movement without keenly feeling the weight of gravity on my aggrieved body. Just as my levels of pain, inflammation, and fatigue vary according to the whims of RA, so too does my talkativeness.

When I’m in pain, my extroverted nature folds in on itself. I cease seeking the energy I get from being around others, instead reserving the dregs of fuel remaining to tend to my body. I want to be shut away from others, buffered and separate. The social butterfly I typically am seeks a return to the cocoon. Pain changes my very nature.

Socializing during a flare

Recently I had the opportunity to spend time with two college friends I rarely see, one of whom lives on the other side of the country. I didn’t want to talk about the flare I was having and how much it hurt to move, to sit, just to be. I wanted to instead focus on catching up on their jobs, children, and current interests. However, avoiding discussing the flare wasn’t making it easier to talk about more pleasant subjects. I tried to summon up the energy to follow the conversation, make at least a few contributions, and ask questions about their lives. However, my brain felt wrapped in fog and gauze, my focus kept shifting to how much I hurt, and I felt zapped of all energy.

After a while, the difference in my demeanor became obvious to my friend, who asked, “Are you okay? You’re not talking very much.” I briefly explained that I was having a flare, and then returned to following along their conversation. With RA being an invisible disability, my old friends weren’t able to readily tell from my outward appearance that rheumatoid arthritis was heavily impacting me that day; however the change in my personality and behavior was a telltale sign to these old friends that something was wrong.

In situations where I’m in pain and in the company of people who don’t know me well, such as colleagues and acquaintances, they may not notice a difference in my demeanor. I worry that they’ll mistake my pain-flattened affect as a flat personality, not knowing that it’s really due to contending with pain. At work, when pain initiates reticence I worry this will be mistaken for a lack of expertise or passion about my work. Long term, I’m able to be excellent at my job. However, if you catch me on a bad day you may think I’m mediocre, solely because I pull into myself when I’m in pain.

When I’m feeling this way, I’m reminded of the typically friendly dog who, when injured, goes to a quiet corner or under a porch to nurse its wounds. Although my urge to retreat is as temporary as the flare, life’s responsibilities don’t always allow me to take the solitude I crave until my symptoms have eased. Rheumatoid arthritis takes so much away from us. Stealing away our energy to talk, engage, and be lively with those around us, this disease can, even if temporarily, change our very natures. This disease can literally take the words right out of our mouths.

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