Successful pain self-management depends upon your ability to accurately identify and solve both pain-related problems and other problems in your life. Unfortunately, many people with chronic pain have difficulties with this area. Following are some guidelines for effective problem solving. To make these steps easier to remember, follow the acronym "SODAS".

STOP:

- Identify your problems

The first part of STOP is to clearly identify the problems that are causing you stress. Problems may be found in a number of areas including the following:

1. Problems with your physical health

2. Problems dealing with your doctors and the medical care system

3. Financial problems

4. Work-related issues including unemployment or job dissatisfaction

5. Disability-related issues

6. Problems with your living situation

7. Problems in your relationships with friends, including not having friends

8. Family problems

9. Recreational problems, including not having enough fun or inability to do the fun things you used to do

10. Psychological problems such as feeling depressed or nervous, lack of motivation, trouble with bad habits, etc.

The second step is to clarify your goals, i.e., decide what you want to do about the problem. Begin by describing a particular problem situation and your usual responses to the problem in minute detail. Who is involved, what happens, where and when does it happen, how does it happen, why does it happen? What do you do or not do about the problem, how do you feel, why do you do what you do, what do you want or expect to happen?

After you have clearly described the problem situation in detail, you may want to try for a fresh perspective on the problem in order to clarify your goals. Maybe the real difficulty is not so much the problem situation itself, but rather your reactions to the problem. Or, perhaps you may be trying to solve a problem that is essentially unsolvable (e.g., trying to figure out how to make your pain go away totally and completely). This step requires clear thinking and an ability to break larger problem areas into smaller mini-problems.

EXAMPLE:

Bill frequently becomes anxious and angry trying to get to his appointments on time. Driving in the heavy traffic is frustrating, and Bill finds himself pounding his fist on the steering wheel and worrying about missing his appointment.

In problem solving, Bill might identify two distinct goals that would lead to very different outcomes. Can you think what they might be?

First, Bill may decide his goal is to get to his appointments on time. This may lead to options such as leaving his home earlier, scheduling appointments at lesser traffic times, or speeding. On the other hand, Bill may decide his goal is to stay calm while going to his appointments. This goal might lead him to options such as putting a relaxation tape in his car's tape player, using signal breaths, using cognitive therapy techniques such as asking himself if he is thinking rationally about what being late for his appointment means, and so on.

Clarifying goals in problem solving is an important, but often missed, step. Remember - "If you don't know where you're going, it's very difficult to get there!" Once you've decided how you would like the problem to be resolved, you're ready to plan out how to get there.

OPTIONS:

List possible alternatives

This step requires brainstorming and a willingness to be flexible and creative. Obviously, if the problem had an easy solution, it wouldn't really be much of a problem. Let your mind go. Try to break out of your mental rut by generating as many alternatives as possible, even if they seem far out. The more ideas you can think of the better. Write your ideas down on paper. See if you can come up with a long list.

This step may also involve getting more information. Getting accurate and useful information then becomes a mini-problem in itself (e.g., who can I turn to or where can I go to get more information regarding the problem?).

DECIDE:

Evaluate the pros and cons of each alternative

This step involves identifying the most promising approaches by considering the consequences of putting them into action. Alternative solutions to challenging problems usually have several pros and cons. Your task here is to carefully weigh the anticipated pros and cons of each alternative. Give this some careful thought. Write down the pros and cons on a piece of paper. Try to eliminate the highly unlikely outcomes with either catastrophic or Pollyannaish consequences. Consider whether the consequences are primarily long range or short term, and whether they primarily affect you or other people as well.

ACT:

Take action

The next step in the problem solving process is to take action on the alternative with the most pros and least cons. Think out what exact steps you need to take in order to put the plan into action. Begin with the first step. Do it now, why wait?

SELF-EVALUATE:

Evaluate the outcome

Before you evaluate the outcome of your chosen plan of action, honestly ask yourself, "did I give it a fair chance, or did I give up when I hit the first obstacle?" Do you need to make any modifications in your action plan? Did you overlook a particular step? Keep in mind that if a particular alternative is unsuccessful, you can always go to the next likely alternative (i.e., Plan B). But first, make sure you have given Plan A a fair chance to work.

Always keep in mind, IF THERE WAS AN EASY SOLUTION, IT WOULDN'T BE MUCH OF A PROBLEM IN THE FIRST PLACE.

Return to Pain Handbook Index