Adversities and setbacks are normal parts of our lives and we are challenged at various times by pain, stress, illness, mental difficulties or disability. Much of what happens is outside our control and we vary greatly in our ability to manage these stresses effectively. Our level of coping with these typical difficulties is an important factor in deciding how effective and content we are with our lives. A realistic approach with an achievable plan for dealing with the problems makes a successful outcome more likely.

Many of the adverse situations we face involve one particular occurrence which is difficult to cope with, loss. When we have no pain we accept the situation without thinking how and when pain intrudes and limits our world we feel the loss. Pains can affect everyday activities such a sitting in a pub or restaurant, going shopping or getting the housework and gardening done. It can be difficult even to accept the gradual reduction in our physical capacity which follows getting older, but if severe pain problems force significant changes upon us we find the sudden limitation of normality hard to cope with.

Other losses we can suffer are loss of a relationship, death of a loved one, loss of job, loss of role in life, loss of income, loss of a part of the body and so a loss of our sense of self and self-esteem. Loss of some kind which leads to the single most disabling condition in the world, depression. When we are depressed we undergo a change in our brain chemistry which causes us to think negatively and to apply a continual negative bias to all our thinking and conclusions. This is important for its own sake in terms of our mental state but also because a high proportion of depressed people suffer a pain condition of some kind.

We may not be that successful in coping with and coming to terms with these losses. Hopelessness may be the result if we become depressed so we lose the motivation to take the required actions which would ameliorate our condition and situation. Cognitive therapy and antidepressant drugs can be used as required to kick start the improvement process of more realistic thinking and begin generating helpful approaches to our troubles. We can react in an entirely different manner to these challenges by fighting strongly against them.

Pain sufferers typically say I'm not going to let my condition beat me, making the situation a competitive one which they are going to win against the pain. This approach is a common one as sufferers try hard to keep control in adverse conditions, fighting to maintain their activity in getting things done such as their day to day chores and things they feel they should be able to do. This approach can however have a real disadvantage as the continual struggle against the pain can lead to a deterioration in pain, reduced activity and depression.

Conflict is one of the most important concepts here. The conflict exists between what we think we should be able to do and what we can. We can feel aggressive towards the pain and towards the world which demands things we cannot supply. We can thereby develop a relationship of conflict with others and within ourselves which can obstruct us from generating alternative approaches to our problems and gets us stuck in a rigid behaviour. These problems are all related to not accepting the reality of our situation and we cannot move forward as those actions are not acceptable.

The idea of acceptance is important and should not be mixed up with resignation. In resignation we feel helpless and that we just have to accept everything, thinking that nothing much will change things for the better and we have to put up with the situation permanently in this way. This kind of very negative assessment of the problem will lead most likely towards depression and make it unlikely the person will take actions to get themselves out of their situation. It is undesirable to feel resignation and more functional to learn acceptance and so work at changing the future for the better.