Five Pain-Prone Personalities

Erin was the "teacher of the year" three years in a row. Her classes were welldisciplined and orderly; every school day had a theme, and every theme had four or five fun activities to help the kids learn.

Though consistently punctual and efficient, Erin was always smiling and nice-never showing signs of irritation. She strongly believed that learning could happen best when the day was well-planned out and the kids were loved. But, at the age of 30, her teaching career was about to come to an end because of chronic back and neck pain.

Erin had been in continuous pain for seven years. Her first symptoms began in her mid-20s with pain to her shoulder and neck muscles, including muscle tightness and sometimes a burning sensation. The pain eventually spread to her mid-back, and she sometimes felt pain on the side of her elbow. The back and neck pain increased to the point that she suffered almost every minute of the day.

In addition, she had virtually no energy, making the task of getting through a full day with second-graders almost impossible. Then came the headaches and jaw pain. Her doctors told her that she had several problems: fibromyalgia, migraine headaches, tennis elbow, and TMJ syndrome (pain in the jaw, or in the temporomandibular joint).

One day after Erin had endured years of suffering, a friend-who had suffered similar symptoms but now was pain-free-told her about the Brady Institute for Health. I spent about an hour with Erin, exploring her past medical history; her list of medications and previous diagnoses; her psychological history; her spiritual history; and finally her lab work, X-rays, and physical exam.

She represented a classic case of Autonomic Overload Syndrome (AOS), which manifested itself as fibromyalgia with such symptoms as fatigue, muscle aches, headaches, and irritable bowel. She also had AOS symptoms of epicondylitis (tennis elbow) and jaw pain in the temporomandibular joint.

We reviewed the list of dangerous repressed emotions that were overstimulating her autonomic nervous system and causing her pain. Next we explored what could have caused the enormous mountain of dangerous emotions in the first place.

Her past was punctuated by many significant stresses and dangerous emotions. Her present circumstances were filled with the usual, sometimes overwhelming, stresses associated with being a wife, mother, and teacher.

But while she was describing her life, I noticed that she used phrases such as "time management" and "can't do it right" to describe the frustration of her daily routine. She also said such things as "You must think I'm terrible" and "They'll be so upset with me" and "I know I shouldn't think that way." These phrases were dead giveaways for the biggest cause of repressed and dangerous emotions in her subconscious mind: her pain-prone personality.

Erin fit into two pain-prone personality types: the perfectionist and the people-pleaser. Together, these personality types caused her to have huge amounts of dangerous emotions on a daily basis that had built up in her subconscious mind and resulted in her chronic AOS pain.

In fact, in my clinical experience with AOS patients, I have identified five major kinds of pain-prone personalities. These are categories of personal features and attitudes that make people more inclined to build up toxic levels of dangerous repressed emotions in their subconscious minds. The five are: (1) the perfectionist, (2) the people-pleaser, (3) the legalist, (4) the stoic, and (5) the fear-prone.

As you learn about these personalities, please remember that the main question to keep in mind is this: How does my particular personality cause lots of dangerous emotions?and therefore predispose me to AOS pain? Also, remember that your personality will stay with you for life, but you don't have to become a victim of pain-at least not if you're aware of the dangerous emotions often associated with your personality and you make a commitment to avoid repressing those emotions.

Now, let's take a closer look at the various pain personalities and see where you might fit in.

1. Are you a perfectionist? If you?re a perfectionist, you are conscientious, productive, and achievement- oriented. You are an extremely careful person. You want all your tasks and projects to be complete to the final detail, without flaws. Everything needs to be done right, and you have a clear understanding of what that means.

Does this sound familiar?

* I'd like all things to be done correctly the first time.

* My work area and my home are very neat and clean.

* My day is usually planned out carefully.

2. Are you a people-pleaser? If you're a people-pleaser, you are generally other-centered or otherdirected. In other words, you tend to put others before yourself because it is the good and nice thing to do. To avoid conflict, you rarely tell other people what you really think of them. Although you may have strong opinions, you usually won't strongly disagree with anyone openly. On the whole, most people would describe you as a happy, sweet, and nonconfrontational person.

Does this sound familiar?

* I put others before myself, because it is the good thing to do.

* I constantly try to reduce conflict.

* When someone doesn't like me, I feel guilty and hurt.

3. Are you a legalist? If you have a legalist personality, you should know that it is similar in some ways to the perfectionist: the perfectionist likes to do things right, but the legalist likes to be right in almost every situation or topic of discussion. As a legalist, when you make up your mind about something, you commit wholeheartedly to it and rarely change your mind. Just as you honor your commitments, you expect others to honor theirs as well.

Does this sound familiar?

* Life has to make sense and must preserve the heritage and commitments of the past.

* Most of my friends agree with most of my beliefs and positions.

*I am usually right in every discussion, because my views are based on solid knowledge.

4. Are you a stoic? If you are a stoic, you are uncomfortable with having or expressing strong emotions-anger, abounding joy, passionate love, or deep sorrow. Your feelings are not for the public. Crying in movies, in religious services, or in other public places is way out of bounds. You believe that strong emotions such as fear, envy, passion, and love should be kept to oneself. When you do cry, you feel weak and exposed. You tend to repress your emotions instead of letting them be known.

Does this sound familiar?

* If I bottle up my emotions, then people will know that I am under control and I will avoid all types of problems.

* I'm uncomfortable with strong emotion? I've always been this way.

* I'm not trying to hide my emotions; I just don't feel as strongly as others do.

5. Are you fear-prone? If you have a fear-prone personality, you almost always anticipate that the worst will happen. You think that you're weak and frail, and you feel that life in general is stacked against you. You may mistrust most people for quite a while until you start to feel safer and more comfortable around them. Your mind always goes to the worst possibility in any situation, which makes you feel that life is out of control.

Does this sound familiar?

* I find it hard to think about dangerous and scary things.

* Life often seems out of control; nothing ever seems certain anymore.

* A day does not pass without me feeling worried about something.

Do you have a combo personality?

About two thirds of AOS patients seem to identify with one of the above five pain-prone personalities. The other third are a mixture of various pain-prone personalities-usually two of them. As a result, they are often referred to as combo personalities.

In general, the more severe and pervasive your pains, the more likely it is that you have more than one set of painprone personality traits. For this reason, combo pain personalities typically suffer from the more complex chronic pain packages, such as fibromyalgia.

Now what?

You should note that I refer to personalities in the present tense. You will still have your same personality. The difference is knowing how your personality causes dangerous emotions. Then you can learn to neutralize the harmful effects of the repressed emotions on your body. Also, you can better understand how to identify dangerous emotions as they're happening so that you won't have to suffer from having a mountain of them build up and overwhelm your autonomic nervous system.

It is my hope that you begin to understand how your past experiences, present circumstances, and pain-prone personality all contribute to the repressed dangerous emotions that cause AOS. Most important, I hope that you can overcome these conditions. You should be pain-free for life!

Scott M. Brady, M.D., is the author of Pain Free for Life and the administrator of Florida Hospital's 16 Centra Care urgent care clinics. Visit Dr. Brady at www.BradyInstitute.com.

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