Motivation? What motivation

Do you ever wonder with chronic pain where your motivation goes? Why accomplishments just seem... meaningless? One does tend to blame the pain itself. Like it sucks the life out of everything but there was a study done that suggests otherwise.

A series of experiments in mice by Malenka and his colleagues, described in a study published Aug. 1 inScience, showed that persistent pain causes changes in a set of nerve cells in a deep-brain structure known to be important in reward-seeking behavior: the pursuit of goals likely to yield pleasurable results. Malenka’s lab has been studying this brain structure, the nucleus accumbens, for two decades.“We showed that those brain changes don’t go away when you transiently relieve the mice’s pain,” Malenka said. The experiments also indicated that the mice’s diminished motivation to perform reward-generating tasks didn’t stem from their pain’s rendering them incapable of experiencing pleasure or from any accompanying physical impairment, he said. Your Medical Guide
 Fields, who did not participate in the Malenka group’s study but wrote an accompanying perspective piece published simultaneously in Science, described the psychological effect of chronic pain as “the clouding of the future. There’s no escape from it. You want it to end, but it doesn’t.” As a result, people become pessimistic and irritable, he said. “People come to expect the next day is going to wind up being painful. It just takes the edge off of life’s little pleasures — and big pleasures, for that matter.”Your Medical Guide
The study was interesting in that they had mice who would nose a spot to get a reward and then they increased the amount of nosing they had to do to get that reward. And the chronic pain mice lost the motivation to do so. Physically they were able to. Their pain was treated. And still they had no motivation to get that treat.

Because with chronic pain effort seems like a momentous amount of energy being lost. And all our energy is on tolerating this pain, combating this fatigue and getting what needs to be done done. We have nothing left for motivation. We really force ourselves to do things. Force and force and force, but the motivation isn't there. We fake motivation.

So that sensation that you have no motivation to get through the day, to attain the goals you need to or even attain the goals that are seriously meaningful to you could have little to do with the pain aspect of the chronic pain... but is part of the persistence of the chronic pain itself. We no longer have the sense of their being a reward for our behavior. We no longer have a sense of pleasure from our accomplishments. It has been dulled.

And I think of this in the sense of discussing self-worth with my psychologist. Yes, there are meaningful things I do. I am aware of this logically. But I do not feel it. I do not feel any sense of 'accomplishment' from it. I have a difficult time just finding the motivation to do those things, or any damn thing to be honest. It is like a fatigue laden blanket of an existence. And when I do things that, yes, are meaningful... there is not real sense that this is something important or special or makes me worthy as a person. And my god, thinking about work is an entirely different issue. Motivation there is energy sapping. Just motivating myself to get up to go to work knowing how painful it will be is a real ordeal. Getting through a day should be an accomplishment but really it just makes me exhausted. And then repeat.

It does take an edge off life's little and big pleasures because they are all tainted by pain and fatigue. It does make a person pessimistic because we are aware there is no end.

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