On Living a Valued Life, Even During Challenging Times

A question I hear often in my practice (or some version of it) is: "How am I supposed to focus on what matters to me when my life is genuinely falling apart right now?"

Maybe it's chronic pain that doesn't let up. Maybe it's a new medical diagnosis, a caregiving role you didn't choose, grief that hasn’t resolved on a set timeline, or a work situation you didn’t plan for. These aren't cognitive distortions to be challenged away, nor is it about the power of positive thinking. They're real. They’re objectively stressful. In fact, I’d be more concerned about you if you didn’t have a reaction to the above mentioned challenges. However, one of the most common traps I see people fall into is the belief that a meaningful life has to wait—that it's something that resumes once the hard thing is over.

Now that I’ve emotionally recovered from graduate school, I’ve been able to reread some of the books I rushed through and didn’t get to fully appreciate the first time. Among those books are Viktor Frankl’s Man’s Search for Meaning, and Edith Eva Eger’s The Choice. Dr. Frankl and Dr. Eger both write of their experiences in Nazi concentration camps, their liberation from those camps, and their long, difficult recovery. Dr. Frankl, who later became a psychiatrist, and Dr. Eger, who later became a psychologist, both arrived at a similar conclusion: Suffering is often unavoidable, but how we relate to it is not. Dr. Frankl wrote about finding meaning even inside unimaginable circumstances—not by minimizing the horror of them, but by recognizing that the one freedom that can't be taken is “to choose one’s attitude in any given set of circumstances, to choose one’s own way” (p.66). Dr. Eger, decades later, described a similar idea: “Here you are! In the sacred present. I can’t heal you—or anyone—but I can celebrate your choice to dismantle the prison in your mind, brick by brick. You can’t change what happened, you can’t change what you did or what was done to you. But you can choose how you live now. My precious, you can choose to be free” (p.395). 

I want to be careful here, because again, this isn't just about thinking positive. It isn't a suggestion that your pain, your loss, or your circumstances aren't really that bad. It's almost the opposite. It's an invitation to hold two things at once: this is objectively difficult, and I still get to decide what I move toward.

The space in the middle

Dr. Frankl described a gap between what happens to us and how we respond, and in that gap lies our capacity to choose. In my work with patients managing chronic pain and chronic illness, I see this gap show up constantly. Pain flares. A new injury shows up. A piece of unexpected news arrives. The stressors themselves are not usually optional, much like Drs. Frankl and Eger’s experiences. It wasn’t part of their plan to be sent to concentrations camps, much like it wasn’t part of our plan to have our challenges happen to us. But what a person does next—withdraw further, talk down to themselves, cancel plans, snip at loved ones, abandon the things that matter to them—or respond in a way that's aligned with their values, even in a modified, smaller, or more paced way—that's where the real work happens.

This is, in a sense, exactly what we focus on when I treat chronic pain: Not whether the pain can be eliminated (often it can't be, not fully), but whether a person can still move toward a life that feels worth living in its presence. You can’t change what happened to you, but you can choose how and where you carry it.

Pacing committed action in our valued domains

Living a valued life can be more difficult if pain and chronic illness are also a part of the picture. To help with this, one tool I come back to is time-based (or activity) pacing. On the surface, pacing can sound like a consolation prize, but I assure you, it isn't.

The instinct, when something matters to you, is often to throw yourself at it completely — to "push through" until the task is done or the project is finished. All or nothing. If I can’t do something the way I used to, it’s not worth doing. Or the opposite: I must do it just like I used to, no matter the cost. We often worry about the cost later. For many people managing a chronic stressor, that approach creates a cycle: overdo it, crash, recover, overdo it again. Over time, the crashes get bigger and the valued activity gets smaller, until it quietly disappears from a person's life altogether, not because they stopped caring about it, but because the boom-and-bust pattern became unsustainable.

Pacing helps with this. Instead of letting your symptoms decide when you stop—which usually means stopping only after you've already paid a steep price—you build in breaks before you reach that point, using time as your guide rather than task completion as the guide (or how much is left to finish). The paradox is that this usually allows people to do more of what matters to them over the long run, not less. A small walk around Liberty Park that's paced by seated breaks on the park benches is more sustainable than a two-hour all-out effort followed by three days of recovery. A return to a beloved hobby in fifteen-minute increments, building gradually, tends to last. An all-or-nothing approach doesn't. I’ve been fortunate enough to witness the positive effects of pacing in thousands of patients first-hand. Pacing can not only help with completing tasks that you need to do (e.g., chores, assignments at work), but more importantly, can help you complete the tasks that you want to do (or haven’t done in a long time). 

I think of pacing as a practical expression of exactly what Drs. Frankl and Eger were describing. It isn't avoidance of the stressor, and it isn't denial of its reality. It's a deliberate, values-driven way of saying: This limitation is real, and I am still going to find my way toward what matters to me, on terms that let me keep showing up.

What this looks like day to day

If you're living with an ongoing stressor, physical, emotional, or circumstantial, it can help to ask:

• What is one value I haven't been able to express much lately, because the stressor has taken up so much space?

• Is there a smaller, paced version of that value I could reintroduce this week?

• When the hard moment comes, what's the gap between the stimulus and my response? And what do I want to put in that gap?

  
  

I want to be clear that none of this erases the challenge or what happened to you. Drs. Frankl and Eger didn't survive the camps because they thought positively about them. They didn't build their careers or write their books by deciding their trauma wasn't real. They both insisted on the opposite: On looking squarely at what had happened to them, while also refusing to let it be the only thing that defined what came next. That refusal, paced and practiced in small, sustainable ways, is often where a valued life actually gets rebuilt.

If you're navigating an objective life stressor (whether it be emotional, medical, or circumstantial) and want support with learning how to move towards what matters most to you regardless, feel free to reach out to schedule a free consultation.

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Dr. Amber Martinson is a licensed clinical health psychologist and is VA-certified in Cognitive Behavioral Therapy for Chronic Pain, Cognitive Behavioral Therapy for Headache, and Primary Care Mental Health Integration. She has authored many peer-reviewed research articles in the area of life-limiting illness, chronic pain, and mental health.