When I transitioned from the zero gravity world of swimming to "dry-land sports" I was abruptly introduced to the world of injury and persistent pain. Blown out wrists (10 yrs ago), a chronic hip impingement, a neck injury, etc. each flare up on their own persistent yet unpredictable schedules, impeding the activities and lifestyle I love.
Therefore, when a Chronic Pain Assessment & Intervention opportunity popped up this week I was beyond enthusiastic. Medical teams and treatments can only do so much, but how can I as a mental health therapist help my clients with something physical like pain? What can one do when the doctors say "I don't know what to tell you", or when healing drags on for months, or turns into a chronic pain situation?
Here is a brief summary of the main take-away points that may help you or a loved one:
Acute vs Chronic pain
Acute pain is expected to fully subside or heal, and responds positively to targeted medical treatments. Pain is considered chronic however if it is still being experienced 3-6+ months after the point you or your medical team expected it to have healed, and is less likely to be positively responsive to medical treatment.
What works for acute pain may not work for chronic pain
You may be quick to jump to common pain mitigation strategies such as rest, medication, medical therapies or even operations. However in some situations the tools that are great for acute injuries may be non-effective or even worsen chronic pain. Here are two examples:
Hyperalgesia. This is when you actually become more sensitive to pain which can be caused by long term use of opioid pain medication.
Rest. While rest can be a useful tool for acute injury (e.g., broken leg) this may be unhelpful for chronic pain as it can create an overly sedentary or isolatory lifestyle that prevents you from completing basic tasks, hobbies or activities. Instead, you may need to perfect your ability to pace your efforts without completely stopping or overly resting.
It is important to pause and objectively assess if the tools you are using to cope with chronic pain are helping, not helping, or worsening your pain experience and lifestyle.
Pain is a very personal experience
One size does NOT fit all when it comes to pain. What may send one person through the roof could feel only moderate to someone else. Therefore you cannot assume things such as "I should be over this by now" or other invalidating expectations.
Your experience of pain is learned as well as built from factors such as your history, how your family reacted to your pain while growing up, situations that increased or decreased your tolerance, your core beliefs and how you mentally relate to pain, etc.
What your goal IS and is NOT
When working with a therapist to help deal with chronic pain, the goal is NOT to treat the pain/injured tissue or even necessarily lessen the pain directly. The latter can be a wonderful positive consequence, but should not be your primary goal. Rather the goal IS functionality and acceptance. Focus on changing your relationship to the pain you experience and how much it does - or hopefully doesn't - affect you from having a full, powerful life.
What you'd work on in therapy
Again, your therapist will not be focused on treating the pain/injury itself but rather helping you shift your relationship with and experience of pain. Therefore you can expect to address:
Your goals and expectations
Positive and negative experiences you've had with medical providers
Beliefs, thoughts and assumptions that may be keeping you stuck
What heightens and lessens your experience of pain
Tools to objectively and effectively track your progress
Coping tools to navigate big feelings and hard moments
Empowered decision making and strategizing
How to identify and use your support tribe
If you are reading this either for yourself or a loved one, I'm sorry that you're going through pain and hope that this information provides some guidance or relief! If you are interested in gaining the support of a therapist, feel free to reach out or use search tools such as PsychologyToday.com that allow you to set therapist filters including: Chronic Pain speciality, your specific insurance carrier, age of yourself or child, etc.