If you don’t know whether or not you have a problem, it can be extremely difficult to find a solution. Have you ever had a situation where you were very enthusiastic and excited about achieving a desirable goal and then got in your own way? I know I have.

There are many different ways of talking about that part of ourselves that both protects and sabotages us—sometimes at the same time. Some people call this our psychological defense system. Others call it denial, while still others call it the inner saboteur. Have you ever heard the expression “the committee in your head?” For others it’s the angle or devil on your shoulder and for still others it’s the “monkey mind.”

The way you also can think about this protective dynamic is that it’s the combination of our thoughts, opinions, beliefs and conclusions that we have developed over our lifetime to either protect us our get our needs met. At times it has a very high positive payoff and we do obtain protection and get our needs met. Unfortunately, at other times it can become a blind spot that is actually hurting us more than helping us.

I’ve seen many people who were living with chronic pain who developed coexisting disorders but they were unaware of this happening. Some of them developed depression, anxiety, or sleep disorders that they didn’t manage very well and experienced life damaging consequences. Others also started have problems with their pain medication management and developed a substance use disorder—prescription drug abuse or even addiction—and didn’t see it.

This was the reason I wrote the Denial Management Counseling for Effective Pain Management Workbook that might be a helpful resource for some of you reading this Blog. I believe that learning to identify and manage denial is a necessary first step for people living with chronic pain who want to learn how to develop and implement an effective pain management plan.  This workbook is designed for people who have experienced significant problems related to living with chronic pain, but who honestly don’t believe—or don’t want to believe—that their decisions and behaviors are undermining what could be an effective pain management plan. 

A major obstacle to recognizing these self-sabotaging behaviors and achieving effective pain treatment is the denial system—that psychological defense mechanism that protects us from devastating pain and problems that is automatic and unconscious.  It is important to remember that this system of defense was developed to protect us from being overwhelmed by what I call Painful Reality. 

To learn more about denial and pain management please check out my article From Denial to Effective Chronic Pain Management that you can download for free on our Article page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people in chronic pain who have any resistance and denial and want to learn how to develop a plan for helping them identify and manage their denial please go to our Publications page and check out my book the Denial Management Counseling for Effective Pain Management Workbook. To purchase this book please Click Here.

To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

I’ve had reinforced again this week the importance of stress management for people experiencing any type of medical condition. It’s even more important when they have coexisting disorders. People with chronic pain and coexisting addictive disorders have two major reasons to learn effective stress management: (1) to lower the intensity of their pain; and (2) to help them avoid a relapse back to inappropriate medication including alcohol or other drugs.

Stress is a blessing and a curse.  We need stress to motivate us and help us deal with life on life’s terms.  Stress also gives us energy and fuels the fight, flight, or freeze phenomenon.  On the other hand stress can be a curse for someone in early recovery.  Stress is a major trigger for protracted or post acute withdrawal (PAW), and often leads to increased urges and cravings to use alcohol or other drugs. The stress response is a combination of biological psychological and behavioral factors.

In response to stress the body mobilizes an extensive array of physiological and behavioral changes in a process of continual adaptation.  This is an important part of the body’s defenses with the goal of maintaining homeostasis and coping with stress. The body reacts to stress by secreting two types of chemical messengers – hormones in the blood and neurotransmitters in the brain.
 
Hormones alter the metabolism of food for fuel and energy for the fight-flight response. In the brain neurotransmitters trigger emotions, such as aggression or anxiety that prompt a person to engage in fight-flight or freeze response to stress.  This leads to self-defeating behaviors.

One of the first steps in effective stress management is to learn how to identify and challenge irrational thinking that leads to uncomfortable emotions and anticipatory pain.  For example if you’re under high stress the thought might be “I can’t stand this… I need a pill.”  This in turn could lead to, fear, anger, anxiety, or even euphoric recall—anticipatory excitement.

The next step is to be aware of and learn how to manage those uncomfortable feelings before they lead to self-defeating urges.  Developing recovery-prone feeling management skills is very important.  Learning to share with trustworthy people is one way to deal with uncomfortable emotions.  If the feelings are too intense or overwhelming, counseling or therapy may be necessary.

If those negative urges do surface, it is important to learn how to make healthier decisions before indulging in self-destructive behaviors.  There is a decision point between the urge and the behavior that is almost non-existent when people first get into recovery.  If people keep “reacting” to their impulses instead of thinking and “responding” they very well could relapse.  That is why learning impulse control and delayed gratification is so important.

The final part of stress management is to learn relaxation and stress reduction techniques.  For some people this includes options such as meditation, yoga, Tai Chi, breathing exercises, etc. Some people like to use soothing music to relax.  These relaxation interventions need to be coupled with developing an effective diet and exercise program. 

Yes stress is a blessing or a curse, and if you want to stay serene and reduce your pain learning to identify and manage your stress is very important.  Relapse prevention is an inside job, but that doesn’t mean you have to do it all alone.  Help is out there if you’re willing to reach out.

To learn about stress and chronic pain management and to learn how to evaluate your stress levels please read my latest article The Stress Pain Connection that you can download for free on our Ariticles page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people in chronic pain and want to learn how to develop a plan for managing their pain and coexisting psychological disorders including depression or addiction effectively please go to our Publications page and check out my book the Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to listen to this interview.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Sometimes people living with chronic pain drop into a deep dark trance. Pain, especially chronic pain, is an emotional condition as well as a physical sensation. It is a complex experience that affects thought, mood, and behavior and can lead to isolation, immobility, and sometimes drug dependence or addiction.

In those ways, it resembles depression, and the relationship is intimate. Pain is depressing, and depression can cause and even intensify pain. People living with chronic pain have three times the average risk of developing coexisting psychological disorders—usually mood or anxiety disorders—and depressed people have three times the average risk of developing chronic pain.

The combination of depression and pain is reflected in the circuitry of the nervous system. In the experience of pain, communication between body and brain goes both ways. Normally, the brain diverts signals of physical discomfort so that we can concentrate on the external world. When this shutoff mechanism is impaired, physical sensations, including pain, are more likely to become the center of attention.

Brain pathways that handle the reception of pain signals, including the seat of emotions in the limbic region of the brain, use some of the same neurotransmitters involved in the regulation of mood, especially serotonin and norepinephrine. When regulation is impaired or fails, pain is intensified along with sadness, hopelessness, and anxiety. And chronic pain, like chronic depression, can alter the functioning of the nervous system and perpetuate itself.

I believe that for people to move beyond suffering, and even surviving and get to thriving with chronic pain—especially with coexisting depression—needs a multidisciplinary treatment plan.  To learn more about the importance of a multidisciplinary pain management plan please read The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Ariticles page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.