Sunday, January 19, 2014

Why I'm Smiling (It's Not What You Think)

A year after the onset of my constant, unyielding headache, my partner Brendan came home from a visit with a close family member visibly frustrated. This loved one, on board since the onset of my pain, had made an offhand comment about how I couldn't be doing that poorly, since every time he saw me I was smiling.

Two years into chronic pain, B and I decided we could not put off international travel plans indefinitely and braved a 2 1/2 week trip to southern Africa to visit a dear friend in the Peace Corps. I vomited three times the first morning in Botswana, going on to average at least one pain-induced puking session a day over the course of our trip. But that first day, I was also given my Tswana name by a few of the locals in Molepolole: "Bitumelo," which literally means "happy." I was smiling.

Pain isn't always written on our faces.
These are just two quick examples of a situation the chronically ill/hurting face on a daily basis. Unless we spend the duration of an encounter crying, whining, or stoically silent, we open ourselves to questions like, "Do you still have [insert condition here]? You seem so energetic." Worse, others don't even ask; they make statements full of assumption: "You look so happy! You must be feeling better."

I understand why people associate smiling with well-being. Studies show that even doctors treat and prescribe differently based on a patient's physical presentation. (For more on this, see my piece on Gender Bias in Pain on Adios Barbie.) But let's face it, there are many socially-sanctioned reasons to smile. Many of them have nothing to do with feeling good, and when dealing with someone who has chronic illness or constant pain, entertaining only one interpretation of a smile can be extremely invalidating of our experiences.

A few reasons I may be smiling:
  • It's polite. In our culture, bright eyes and a smile are the easiest ways of making oneself friendly and approachable. This expression says, "I'm paying attention to what you're saying. I'm interested in you." And it isn't exactly socially acceptable to curl up in a ball and whimper, even if that's what I feel like doing.
  • I'm happy to see you, despite my pain. This is twofold: As a person who rarely gets out of the house, I genuinely smile as a response to seeing someone I love, but I also particularly make an effort to smile to show you that I'm happy to see you.
  • I'm protecting you. I get it. It's hard to maintain a relationship with me when I am so low-functioning. I want our time together to be pleasant, and I recognize that me acting like a Debbie Downer is depressing, and won't encourage you to hang out with me again.
  • I'm protecting myself. Sometimes, I just want to pretend I'm "normal" for a little while, to get a mental break from the discomfort and monotony that make up my days. Sometimes, I am in so much pain (or so exhausted) that I feel like I might burst into tears if anyone probes farther than polite greetings.
  • It releases endorphins, the body's natural painkillers. It may seem ridiculous to a healthy person, but I have to make conscious efforts to engage in activities that produce neurotransmitters like oxytocin, serotonin, dopamine, and endorphins (which reduce pain/stress and increase feelings of well-being). I eat certain foods, I meditate, I do yoga, I listen to music, I get out in nature... and I smile. It's one of many healthy, natural forms of self-medication.

This is by no means an exhaustive list, and it's important to recognize that the reasons those with chronic pain or illness might smile are as varied and individual as the people themselves. It's merely meant to open the door to discussion and personal reflection. Maybe the next time a loved one makes an assumption about your smile, you'll feel comfortable offering a gentle correction. Maybe the next time you see someone else smiling, you'll think twice before jumping to conclusions, and ask an open-ended question instead.


Why do you smile? Feel free to chime in in the comments section below, or join me on Twitter (suggested hashtag: #ismilebecause).

8 comments:

CrippleBaby said...

Well said! :) I always say that ol' saying, "If you didn't laugh, you'd cry!" and I really agree with all your reasons to smile. Just because you're ill, doesn't mean you want to be, or even look, miserable all the time. I'm new to reading your blog and can't wait to read more x

Abez said...

You hit the nail on the head. I have POTS, EDS, and Sjogrens, as well as TOS, a bad old knee injury-and three children under the age of seven- so honestly- I am always in pain of one sort or another. Someone said to me, "But really you seem so cheerful!" What alternative do I have, moping? sulking? wallowing in self-pity?

Just because I'm in control of my attitude doesn't mean I don't live daily with the kind of pain that people would otherwise take a sick day for.

Maddie Ruud said...

You are both spot on. Dwelling on pain doesn't change it. And while others would probably run to the ER if they experienced our pain levels, that simply isn't practical for someone who is in constant or near-constant pain. We learn to make the best of things, or we'd never leave our beds!

Thanks so much for your sharing your experiences.

Short & Sweet said...

Respect xo

Short & Sweet said...

Respect xo

David Barnes said...

I was in a pretty good mood this morning right out of the gates and got better as my walk progressed. When I was about a block away from the church I saw one of my moms who had the most amazing smile on her face. I asked her why the smile and she said it was because her daughter had been smiling as she went to nursery school.So my thought right now is on the viral aspect of smiling and the fact that when I see you and you smile, you make me smile.

Janet Fraser said...

So true about what's "behind" the smile. Apparently, Thailand is "the land of a thousand smiles" because Thai people have a different smile for each mood. In Thailand, it was difficult for me to realize that a smiling face was not always the supposedly simple expression familiar to someone from North American culture. There is more subtlety and complexity to a smiling face than we in NA generally realize.

Heather Grace said...

I smile b/c... I'm not a total bitch, even tho the stupid "you're looking better..." remarks kinda make me want to rip your face off and stomp on.it. Metaphorically, of course! ;)