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What if your greatest challenge in dealing with chronic pain also generated pain?

As someone who specializes in treating patients with chronic pain, I often hear what the greatest challenge patients have with their situation.  Perhaps you may relate to one of these:
  • “I am hyper-vigilant that no one touches the painful body part because I don’t want it to trigger a pain flare.”
  • “When l feel the remnants of pain inside me, this triggers the fear of it coming back and l want it to stop.”
  • “l am worried about tomorrow and going anywhere out of my comfort zone.  Will I be able to get to my chiropractor?  My doctors?  l am also afraid of not being able to reduce my current pain levels.”
  • “I am so worried about having pain that I can’t control.  I know my anxiety doesn’t help, but I can’t stop it.”  
  • “I am so used to pushing and overdoing it and l know it makes my pain worse but I have a hard time balancing overdoing it and slowing down.”
And how do most patients deal with this?  By trying to fix the body part that is hurting.  And yes, that’s because local tissue can be generating pain.  And I’m sure you may have already tried or use any one of the following effective interventions that target the physical body part like ergonomics, posture, movement, exercises, surgical procedures, non-invasive modalities like physical therapy, massage, CBD, chiropractic adjustments, and acupuncture, as well as medications, diet and supplements to name a few. 
While these interventions are often very helpful, sometimes it still isn’t enough.  Because the root of these challenges isn’t being addressed by physical interventions.  Let’s look at the root of these greatest challenges:
  • I am hyper-vigilant…
  • I am worried…
  • and “I can’t stop…
What do they have in common?  All of these challenges deal with our reaction to pain.  And not only do these challenges make living with chronic pain extremely difficult, they actually could be contributing to pain itself.   
What?  How is that?
This is because research on chronic pain has shown that there is another source of pain, your brain, your mind and emotions.  The technical term is called “central sensitization” and there’s been an incredible amount of research on pain over the last couple of decades that shows:  Painful thoughts from your mind, pain-related fears and unresolved emotional pain can all cause physical pain.
So what to do?
Trying to simply stop yourself from having certain thoughts or feelings doesn’t work and it could be making the situation worse.  Research published in the Journal of Pain, the official journal of the American Pain Society shows that our efforts to control pain increases our awareness of pain itself.  People who tried to control pain were simply more aware of pain more quickly and more of the time.  
And what about trying to have a “stiff upper lip” or being stoic and simply trying to push through, does that help?  Unfortunately, not only is it not helpful but it too could be making the situation worse.   Researchers from Johns Hopkins have found that alexithymia, challenges in expressing emotion and focusing outward instead of inward, makes pain more intense.
So if trying to control or push through physical pain and painful thoughts or feelings makes the situation worse, what can you do?
I believe I’ve found a solution to this challenging situation.  Not only do I have my own experience with chronic pain, I’m also a physician specializing in treating it.  Needless to say, I’ve explored and heard about many different treatments.   I have found that a psychotherapeutic modality called, Internal Family Systems (IFS), is tailor made to address this type of internal conflict.  
IFS is based on the notion that our personality is made up of parts.  Most people don’t have control over these aspects of their personality, or parts and they often react automatically to situations.  Challenges occur when parts of us react in ways that cause problems, like trying to stop painful thoughts for example.  IFS is a way of developing a relationship with these parts of our personalities so we can find out why they do what they do.  And, we can also help heal any pain or vulnerability that may be fueling their internal reaction.  Once that happens, we can then choose how we want to respond, rather than just reacting.  
Does this really work for pain?  Yes!
Research published in the Journal of Rheumatology has been done utilizing IFS with rheumatoid arthritis and not only did they find benefit but the benefit persisted.  Within 3 months of participating in weekly individual or group IFS sessions, there was a statistically significant drop in patient’s pain and joint swelling.  In fact, over the course of the 9 month study, there were even some cases of remission (according to the creator of IFS, Dr Richard Schwartz).  1 year after completion, patients still had a statistically significant improvement in joint pain, depressive symptoms and self-compassion.  IFS has also been designated as evidence-based by the National Registry of Evidence-Based Programs and Practices.
I’ve received training in IFS and have served as faculty at the University of Santa Monica’s Spiritual Psychology program since 2012 primarily in the Consciousness, Health and Healing program.  It’s been one of my greatest joys to assist students and patients in transforming and healing their relationship with pain and their health.  
Have any questions if Internal Family Systems can help you?  Setup a free 15 minute consultation with Dr. Chee to see if IFS is a good fit for you as well as answer any of your questions.
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