Taming The To Do List Monster: Goal Setting With Chronic Pain

This post was originally posted on Blogger September 28, 2024.

Living with a chronic illness often feels like a never-ending battle against your own body. When you suffer from chronic fatigue, ongoing pain, and brain fog, they can make even the simplest tasks feel overwhelming, and even impossible, as well as make things like multitasking extremely difficult. My ability to multitask effectively disappeared years ago, and last year's breakdown pretty much destroyed any chances of me multitasking anytime soon. I have learned that when it comes to setting and achieving goals, breaking them down into small, manageable tasks and focusing on one task at a time increases my chances of successfully achieving those goals. It’s taken me a long time to learn how to break my goals down into smaller tasks and to find a system that works best for me, and it is something I will always need to actively work at. 

The truth is, setting and achieving goals is possible, even with chronic pain. It just requires a different approach. One that acknowledges the limitations of your chronic pain, while still allowing you to move forward in a way that feels manageable and empowering. It’s hard to feel useful when you are restricted physically and mentally, so learning how to break your goals down into smaller tasks is an important skill that doesn't just boost your productivity, it boosts your self esteem and confidence. It’s also very satisfying to cross things off your to do list. 

There are also many mental health benefits of breaking your goals down into smaller tasks. This is so that they are realistic and attainable and it doesn’t feel like such a big job. It also:

• Increases your likelihood of success. Breaking goals into smaller, manageable tasks makes them seem less daunting and increases the likelihood of achieving them. This is especially important if you are like me and can’t be on your feet for very long. By breaking things down into smaller tasks, I can chip away at them throughout the day.

• It can improve your focus and concentration. Focusing on one small task at a time can improve concentration and reduce the likelihood of becoming overwhelmed. I use a focus timer app and when I am focusing on a task, I am getting into the habit of writing down what is distracting me so I don’t forget, and then I get back to focusing on my task.  

• It increases your motivation. Completing smaller tasks provides a sense of accomplishment and progress, boosting motivation and encouraging further effort. This is certainly true if you have self esteem issues. By crossing things off your lists, and reaching your goals, you create a positive cycle that naturally encourages more of the same thing - more task completion, reaching your goals, and even setting new goals.

• You gain increased flexibility. Breaking down goals allows for greater flexibility in adapting to changing circumstances or health conditions. Chronic pain is what it is, and in my case it’s not going to go away, so I have to work with what I got. By being flexible and adapting to things as they arise, while still working towards your goals, you are creating a positive result.

• It reduces stress and anxiety.  By focusing on smaller, more manageable steps, individuals can experience reduced stress and anxiety associated with large goals. I find this especially true. When I break down a goal into smaller tasks, it can seem like a lot, so I like to pick 3 tasks off that list that I commit to that day, and work on those. I can always do more if I am able, but I usually stick with 3 as I have to be careful not to overdo it. 

Chronic pain and some of my medications significantly impact my cognitive function. It goes beyond some Brain Fog for me. My thought processes and focus is constantly being interrupted and overwhelmed with multiple, simultaneous, and severely distressing pain signals that are assaulting my brain continuously, so it takes all my focus and concentration to block that out, so that I can focus on what I am doing. It is challenging, and severely impacts my quality of life. Over the years I have learned that:

• When you have chronic pain, it makes it really difficult to concentrate. With pain signals constantly bombarding the brain, it makes it hard to focus on anything else. As my pain goes up and down, so too does my ability to concentrate. Anything the least bit distracting, and I go way off course, and have to remind myself to refocus. Or I’m unaware of what is going on around me because all my focus is on the task. I say tha the house could literally burn down around me and I wouldn’t notice if I’m really focused. 

• I suffer from a terrible memory and my brain freezes when I’m asked a question, as my memory can be quite fractured and all over the place. It causes me to remember things in pieces, and not necessarily in chronological order. This is because chronic pain can disrupt the hippocampus, a brain region crucial for memory formation, and being that my brain is always busy dealing with pain signals, I can’t really truly focus, as the pain is too big of a distraction. It means I struggle to remember what I’m saying, what others are saying, what I’ve just read, what I’ve just written, what I’ve just watched on TV. Everything that goes on around me in the day, I’m not able to retain much of it. It’s actually quite embarrassing and makes me feel like I don’t  have a brain. 

• It also impairs my working towards my goal to be more organized. Pain can interfere with the prefrontal cortex, the area responsible for decision-making and planning. Being organized is something that I’m learning again. It is a skill that does not come naturally to me anymore and I get confused and overwhelmed when there are things that take multiple steps to complete. My mom helps me A LOT, and is helping me stay organized. 

Does any of this sound familiar? These cognitive challenges are strikingly similar to those experienced by people with ADHD. I often compare my brain to an ADHD brain. Both groups often struggle with:

• Executive dysfunction which results in difficulty with planning, organization, and task initiation.

• Effective time management. I have problems with organizing my time - estimating time, prioritizing tasks, and meeting deadlines, despite my best efforts otherwise.

• When you are dealing with chronic pain 24/7, it increases your sensitivity to stress and frustration. Your body is in distress, and it puts emotional stress at a level that you can’t not be distressed. This means that things that would not normally be stressful, can be very stressful, and little things can cause great upset.

So, how can you achieve your goals when your brain feels like it's working against you? I have to focus so hard on the task I am doing, that I literally block everything out that’s going on around me. My brain cannot do those two things at once. If I need to be thinking, I need silence. I can’t have the TV or music playing because my brain gets jumbled when it has to process two different things simultaneously. Especially competing sounds. To achieve my goals, I created a simple system of breaking down my goals into microtasks, literally writing each step down. I can only stand for about 5 minutes before my back and legs become so painful I need to sit, so I really do need to have my tasks broken down into 5 minute chunks. The key I have learned is to break down large goals into smaller, more manageable goals that are achieved a little at a time. All those microtasks add up and before you know it, you’ve accomplished your first goal. Here's how:

1. I started small. Instead of tackling a huge project, I like to focus on one tiny step at a time. Want to write a book? Start with writing one paragraph a day. Or, start a journal so that you can write your story in smaller, more attainable chunks.

2. Learn how to prioritize effectively. Identify the most important tasks and let go of the rest. It's okay to say "no" to things that drain your energy. One of my favourite quotes is something my mom started saying to me after I fell, and that is “Rome was not built in a day”. So true!

3. I like to make organizing in my calendars, lists and journals bright and colourful. I like having my lists, calendars, and mind maps, which help me stay organized and help me track my progress.

4. It helps me with my flexibility, and taking in what is now, and not what was, or what could be. Your health can fluctuate, so be prepared to adjust your plans as needed. Don't beat yourself up if you have a setback. Just get back on track and keep going. If you are being hard on yourself, sometimes it’s helpful to rate the severity of the setback. It might not be as big of a deal as you think. 

5. I celebrate and reward my wins. By Acknowledging and celebrating every accomplishment, no matter how small, it helps build momentum and motivation and increases your confidence, skill and self esteem.

Some tools and techniques I find useful are:

• The Pomodoro Technique: Work in short bursts with frequent breaks to avoid burnout. I use an app for this. 

• Timeboxing or Scheduling: Allocate specific time slots for different tasks to improve focus and productivity. Don’t forget to also schedule in self care activities. 

• Practicing meditation and mindfulness: Practice mindfulness to reduce stress and improve concentration. I use a couple different meditation apps for this purpose. 

Other tools and techniques that people with chronic pain can use to manage their goals include:

• Mind mapping: Visually organize thoughts and ideas to break down complex goals and see connections between tasks. I am very curious about mind mapping and if it can help me improve my level of organization. 

• Habit tracking: Build positive routines and track progress towards goals, fostering a sense of accomplishment. I use the app Fabulous for habit and routine building and tracking.

• Support groups or accountability partners: Share experiences, gain encouragement, and stay motivated with others who understand the challenges of chronic pain. My mom is my accountability partner and support person who helps me stay organized and accountable.

• Assistive technologies: Utilize tools, apps and devices that can aid in task completion and reduce physical strain.

Remember, you are not alone. Millions of people are navigating life with chronic pain and other chronic illnesses. By breaking down your goals and using strategies that work for you, you can achieve amazing things, even on your toughest days. It may take time and effort to develop a system that works best for you, but the rewards in terms of productivity, self-esteem, and overall well-being are significant. Don't be afraid to experiment with different approaches and seek support from others when needed. With patience, perseverance, and the right strategies, you can overcome the challenges of chronic pain and achieve your goals, no matter how big or small. Embrace the journey, celebrate your progress, and remember that every step forward, no matter how small, is a victory.