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37Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: CommunicationHow Chronic Pain Gets in the Way
Fear ofthe pain
Loss ofintimacy
and socialcontacts
Others feelrejected and
withdraw
Increaseddisconnection,
conflict, orisolation
Tension inrelationships
Chronic paincan disruptimportant
relationships
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38 Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: Communication StylesBeliefs Strategy Frequent Feelings
Passive • You matter andI don’t.
• I must give inwhenever there’s conflictbetween my needs andyours.
I often feel:
• Helpless
• Resentful
• Unappreciated
• Worthless
Assertive • My needs andopinions matterand so do yours.
• I speak for my needs.
• I will listen to yours.
• We can negotiatesomething that works forboth of us.
I often feel:
• Self-respect
• Confident
• Caring
• Helpful
Aggressive • I matter andyou don’t.
• I attack to win at all costs.
• I will meet my needs andexpress my opinionswithout regard for you.
I often feel:
• Angry
• Impatient
• Rushed
Passive-aggressive
• You matter,but so do I.
• I will give in if there’s anyconflict but will find a wayto get back at you, likelywithout telling you.
I often feel:
• Angry
• Resentful
• Confused
• Unappreciated
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39Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: Assertive Communication
Effective and assertive communication is very important for managing chronic pain.
Being assertive means:• You exhibit self-esteem. You can:
• Express your personal likes and interests.
• Think and talk about yourself in a positive way.
• Accept compliments comfortably.
• You handle difficult situations. You can:
• Disagree with someone directly and with respect.
• Ask for clarification confidently.
• Say “No” without giving in to anxious or guilty feelings.
• Ask for what you want clearly and confidently.
• You reach out to connect with others. You can:
• Feel comfortable giving honest compliments.
• Actively keep in touch with friends.
• Take the first step in forming new friendships.
You are assertive when you stand
up for your rights without violating the
rights of others.
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40 Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: CommunicationBuilding and Enhancing RelationshipsRelationship-Interfering Behaviors Relationship-Enhancing Strategies
• Turning down plans or not answeringthe phone
• Suggesting alternative activities instead ofturning down invitations
• Pacing and planning ahead
• Excessive pain talk • Limiting pain talk
• Remember you are more than your pain
• Overdependence on others
• Learned helplessness
• Refusing to let others share responsibilities
• Balancing asking for help with findingalternate ways to complete tasksindependently
• Not speaking up
• Passive response
• Assertive communication
• Assuming others don’t value your friendship • Giving yourself credit for your contributionto the relationship
• Seeking new relationships and findingsupportive friends with shared interests
• Engaging in pain behaviors — grippingpainful body parts, groaning, excessive useof pain props
• Using subtle strategies to cope with pain(example: using the restroom to get astanding break)
• Lashing out — aggressive response • Laughing and positive exchanges
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41Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: “I” Statements: Key Points• Get prepared before you bring up an issue you need to talk over with someone. First review
your thoughts, emotions, and ideas about the situation. Agree on a specific time to talk with theother person.
• Meet the other person with respect and confidence. Show this in your tone of voice and bodylanguage.
What to do: What to say:
Step 1 Describe the issue in factual, neutral, unexaggerated language, using only the present or most recent example.
When ...
(Describe situation, “just the basics” of what happened)
Step 2 Focus on your feelings rather than blaming, judging, or interpreting the other person. This fosters communication because the other person won’t need to defend themself.
I feel ...
(Emotion named in one word)
Step 3 Say what you think about the situation (your opinion or interpretation) and how you feel as a result. OR describe how the situation affects you (the consequence).
Because ...
(Express your opinion or perspective OR describe the effect/consequence the situation causes for you)
Step 4 Suggest a specific solution stated in a positive way.
I need…I want…I wish…I would like…
(State your specific, positive solution)
“I” statement example:
“When you get home from work two hours later than you said, I feel anxious and worried, because I think you’ve been in an accident. I would like you to call me when you know you’ll be late.”
Avoid these common communication barriers:
• Describing the issues using “loaded,” attacking, or sarcastic words.
• Expressing an opinion and calling it a feeling.
• Forgetting to be specific and positive.
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42 Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: Practicing “I” Statements at HomeThink of a situation that you’ve wanted to talk over with someone close to you. Write an “I” statement for that situation. Before you talk with the person involved, review your wording with a good friend or someone from class.
When
I feel
Because
I want/would like
Think of someone you’ve been wanting to praise or compliment lately. Write an “I” statement for positive expression using the format below:
When
I feel
Because
I want/would like
Then, share this with the person you plan to communicate with.
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43Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: Identify Left or Right Hands
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44 Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: Steps to Sharpen the Brain’s Map of the Body
Identify left vs. right
Rolling
Imagine the movement
Move with intention
A walk will make my back feel better.
Scooting
Reaching
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45Managing Your Pain Participant Workbook
2020 Kaiser Permanente, Northern California. The Permanente Medical Group, Inc. all rights reserved.
Health Engagement Consulting Services. 00110-010 (Rev. 03/20)
Lesson 6: SMART GoalsAs you set goals, assess whether each one fits the SMART criteria (below). Each week you’ll set new goals to develop skills to manage your pain and feel better.
S SpecificWhat do you want to accomplish? Specify what, when, with whom, and how often.
M Measurable How will you measure your progress toward your goal?
A AchievableIs your goal realistic? Do you have what you need to meet it? Think about your time, health, finances, etc.
R RelevantIs your goal meaningful and important to you? Is it in line with your values?
T Time-bound Set the time period for meeting your goal.
Week 6
Mind and Body GoalsThis week’s goal ties in with this value: .
This week I will (what)
(how much) (with whom)
(when) (how often).
1 2 3 4 5 6 7 8 9 10
MY CONFIDENCE LEVEL (1 = not at all confident, 10 = very confident)
Movement/Exercise GoalsThis week I will (what)
(how much) (with whom)
(when) (how often).
1 2 3 4 5 6 7 8 9 10
MY CONFIDENCE LEVEL (1 = not at all confident, 10 = very confident)