A new study suggests that the widowed do better with chronic pain than married people — or anyone else.
When I was widowed suddenly at age 46, it was the worst thing that had ever happened to me. The foundation of my world collapsed. I now had to be the only parent to my two grieving girls. I had to learn to manage the microfinancial empire of my household. I had to do all the driving and many other things my husband had done.
But most of all, I had to cope with my own pain. Unlike other blows life had dealt me — breakups, professional failures — I could not assuage it with the comfort of friends. It was like a fire I had to walk through to get to the other side. And I did, eventually, even with a few scars. Since then I have felt stronger to deal with life’s wounds. But I’ve always been a baby about physical pain. As I get older and imagine I may someday have to suffer ongoing physical pain, I doubt my ability to endure it. So I was intrigued when I spotted new research suggesting that widows do better with chronic pain.
The study, published in the journal Pain Research and Treatment, is titled, “The relationship between marital status and psychological resilience in chronic pain.” The results surprised its authors. After evaluating almost 2,000 patients at the medical College of Virginia pain center, the researchers expected to find that married people, because of the support of and connection to their spouses, would do better at dealing psychologically with chronic pain. That was the conventional wisdom at the time, that social networks played a powerful role in coping and resilience. Yet it was only widows and widowers who suffered less depression, anxiety, frustration, fear and anger in response to their pain. Neither married, single, divorced nor separated patients did better as a group. Other factors, such as pain intensity, gender and ethnicity, did not play a role. Nor did age. In fact, the widowed ranged from 16 to 73, with an average age of 41.
Widows and widowers, says lead author James Wade, a professor of psychiatry at Virginia Commonwealth University School of Medicine, viewed their pain as just as disruptive to their lives as the other groups, but they didn’t suffer the same frustration, depression or anger. “We think,” he says, “that loss may force us to develop coping strategies to bounce back from threats to your quality of life, a kind of emotional inoculation against future lifestyle threats.” That, he says, is very good news for an aging population, a significant portion of whom can expect to live for years after the death of a spouse.
Are certain personality types susceptible to suffering more psychologically to chronic pain? People who tend to “catastrophize,” or ruminate on and magnify bad things and feel helpless, may be more vulnerable to chronic pain’s effects. (This is a psychopathology in which the person is dominated by negative thoughts, and is not the same as complaining or whining.)
While some psychologists and pain experts find these results odd and needing further study, some also consider them promising, not to mention surprising. Simon Rego, a psychology professor at Albert Einstein College of Medicine, says the authors’ idea of “emotional inoculation” fits with the “exposure” model in cognitive behavioral therapy, which he practices at Montefiore Medical Center. People with emotional disorders like claustrophobia or social anxieties, for example, may avoid situations that trigger fear or anxiety. Claustrophobics may shun all crowded spaces, and those with social anxiety may avoid speaking up in a group. Through gradual exposures, the therapist will help them to face these things. The more we deny or ignore difficult situations, he says, “the weaker we get at confronting them and we build up a closet of skeletons we’ve never confronted.” Because widowhood and its emotional consequences are unavoidable, those who have lost a spouse may be compelled to hone their coping skills as a way to survive.
When Wade found through a battery of psychological tests that widowed people did better, he and his team speculated that because losing a spouse to illness rather than divorce or separation is out of a person’s control, being widowed may lead to developing additional coping strategies.
Widows may also be better equipped to manage chronic pain because spouses may even become enablers of pain. “Sympathy for pain behaviors can act as a reward,” says Laura Watson, a gerontological psychologist at California State University at Fullerton. “‘Oh, sit down, honey, I’ll do the dishes.’ Having a sympathetic spouse can foster dependency, while widows might do more things for themselves.”
It is important, Rego says, to distinguish the suffering of chronic pain from the literal sensation of pain. “Suffering,” he explains, “is in the emotional, cognitive and behavioral response to that pain.” For example, when people believe their lives are ruined and they can no longer do anything, they decrease their social activity and their exercise. “‘I can’t do anything,’ is a thought. We try to get people to do more within what’s realistic. Then they’ll feel better.”
Perhaps because of this, Watson says the majority of widows bounce back within two years of their loss. “Several theorists,” she says, “think the process of going through something like spouse loss can create increased resilience.” And this can feed into a greater sense of autonomy and confidence. When widows successfully learn to do more for themselves and take over areas their spouse once handled, they may feel more capable than they had before.
The current study was not designed specifically to look at widowhood, but noted the interesting correlation between pain measures and marital status. It will take more research to evaluate widows’ sense of mastery and whether that affects their experience of pain. “But if these results hold up to scrutiny,” she says, “it could be really powerful in the field.”
And in my life — if I am ever put to the test.