Linda MacEachern, photo by Ryan Wilson, IWK
“Many women coming into this clinic have had long journeys of invalidation by health care, family members, and colleagues, so feeling truly heard is key,” says Linda MacEachern, social worker on the IWK Endometriosis and Chronic Pelvic Pain (E&CPP) team. “Since pain is invisible, many have felt judged or that they are burdens to their families, workplaces, partners, the health care system, and society in general.”
McEachern provides support to women whose quality of life is significantly impacted by chronic pelvic pain, counselling them, and at times, their partners. This is often with an Acceptance and Commitment Therapy approach, aimed at fostering some degree of acceptance of chronic pain, making space for, and managing, the mental health issues associated with chronic pain, and working towards a life of meaning.
“Counselling is aimed at coming to a place of living with pain and grieving the life that women may have wanted versus the life they are living; in terms of their mobility, fertility, employment, mental health, intimacy with their partners, and so on.”
This includes practices of mindfulness and self-compassion, encouraging women to see their emotions and behaviours as valid in the face of suffering.
“Because chronic pain can be so challenging to fully understand and treat, there is often a sense of frustration about lack of targeted and adequate pain relief or the side effects associated with some treatment options,” says MacEachern. “At times, women feel hopeless and question the point of continuing in treatment, or whether their lives are worth living.”
Mental health education about these difficulties and ways of coping with and managing these issues is a significant portion of MacEachern’s role.
“Depression, anxiety, and complex trauma are common among women with chronic pelvic pain,” says MacEachern. “The invisibility of pain leads women to perceive that others judge them harshly, particularly as they “look fine”. In addition, the lack of adequate understanding about women’s health broadly and the stigma which is sometimes felt by women in discussing gynaecological issues can present another layer of struggle with shame.”
Having a social worker involved from the beginning of the patient’s assessment allows for a broader understanding of the complexity of the pain experience, and the treatments available. The patient feels emotionally supported and the multidisciplinary E&CPP team are aware of ongoing concerns or needs of patients.
“I think women benefit from someone sitting with their vulnerable emotions without “fixing” them or giving a particular strategy,” says MacEachern. “Many women’s lives are compromised in part due to a fear of doing things with pain on board. This role provides a space for women to work through some of that fear and move towards things they may have avoided for some time.”
March is both Endometriosis Awareness Month and Social Work Month.