How Angry Do You Get About Your Chronic Pain Program?

February 6, 2008 by Christine Sutherland

Chronic pain is very different from acute pain, and many health professionals try to blame the patient by suggesting that the pain is the patient’s fault because of their thinking styles. Does that make you angry?

If you suffer from ongoing chronic pain you are a long way from being alone. Chronic pain rates have more than doubled in the last 40 years and we’ve got to the point now where around 1 in 3 people suffer, over 60% of doctor visits are due to chronic pain severe enough to prevent people from working, and where the cost of failed treatments for chronic pain is estimated at over $10 billion a year in Australia alone.

Do you feel an affinity with others like you who have tried out various drugs or exercise programs, or even had surgery to cut nerve branches, and yet still struggle with pain?

And as in most cases where the “cure” fails, has your doctor or therapist started telling you that your pain is in your head? Even worse, have you actually tried a course of Cognitive Behaviour Therapy where they told you that indeed the pain is your fault, because you’re causing the pain with your thoughts?

Sometimes they may even have told you that it’s your anger that’s creating the pain! What they need to realise is that it’s the failure of the programs that has given rise to your righteous anger! But how did it come to this?

It’s not really your doctors’ fault, or the fault of your health professional or therapist, because in most cases these people, although highly knowledgeable and highly experienced, are quite unaware of the failure rates of the treatments they use. For example, CBT is often described as the “gold standard” for treatment of anxiety, depression, and chronic pain. And yet objective assessment of studies show that it has the same failure rate as placebo!

So you do have a right to be angry, but now is the time to take that anger and use it to get the result that you actually want - reduction or elimination of that chronic pain! There certainly is a proven method with a high success rate, and we want you to use it and then tell your doctor about your success, so that other people who suffer from chronic pain can also be helped.

A BETTER WAY TO APPROACH CHRONIC PAIN

So your pain specialists don’t know that their methods have a high failure rate. Something most of them do know but try to resist, is that you are not deliberately causing your chronic pain. That it might be in your brain, but that it’s certainly not under your control! For your doctor to say that you should use willpower to change yourself or to control the pain is incredibly silly, and also brutally nasty.

Your pain specialist may have talked to you about lifestyle issues that affect your pain levels, but we’re yet to find a specialist who understands how and why these mechanism affect your pain, or what to do about them.

You see, chronic pain is almost never merely a physical thing. We can see from brain mapping that chronic pain uses very different nerve paths from acute pain. In fact the brain maps of chronic pain look just like the brain maps of anger, or sadness, or fear.

What this means is that a vast number of things impact on your pain, many of them outside your conscious awareness. These could be worries that you have, feelings of vulnerability, relationship or financial problems, work problems, and even diet, activity, support or privacy issues. (Read why below!)

Without question, for a chronic pain treatment to work, it must identify and resolve the conscious and unconscious triggers that are causing and escalating your pain, and these will certainly not merely comprise your physical symptoms. This will certainly not include doing anything so ridiculous as trying to force yourself to think using different words inside your brain!

When you understand how chronic pain occurs, this will make much better sense to you.

WHERE YOUR CHRONIC PAIN COMES FROM

Most chronic pain (but not all) sets in after an injury of some kind. At first there is acute pain which warns us that something is actually wrong and we need to take action and promote healing. The majority of people simply recover and have no further problem. But in the case of chronic pain, the pain hangs around, even though there may be no sign whatsoever of the original injury. This is incredibly distressing to the sufferer, especially if he or she is battling an ignorant or nasty workers’ compensation investigator!

Chronic pain is different from acute pain because it is not related to actual injury. If you were to look at a series of x-rays of people’s spinal columns, and try to guess which people had the most pain based on the evidence of damage, you’d be wrong, because there is no match.

Your chronic pain is created by your nervous system itself - not by any damage or injury that may be present. To help our patients understand how this could be, we offer the example of the electrical system that comprises a car alarm. If this system has a fault in it, it can cause the alarm to “go off” for no good reason at all, waking people up for absolutely nothing!

Except that your nervous system is much smarter (because it can and does learn) and more complex than a car alarm. It can go off because you have stress, or because it’s a cool day, or because you’re wearing prickly fabric, or because you sat down, or because ……. it goes on and on.

We use the term “pain pattern” to describe what is actually happening when your nervous system creates chronic pain, and we do that because it’s a reliable action. You feel a certain way, or a certain event occurs, and “bang”, here comes that pain again, or here comes that flaring again. The right name though isn’t “pain pattern” - it’s “conditioned response”!

Most people with chronic pain have a complex range of conditioned responses that need to be identified and desensitised. This means really learning to notice your environment and body feelings, and you’ll be surprised how easy and even fun that can be!

HOW CHRONIC PAIN CAN BE KNOCKED OUT FOREVER

It used to be thought that these types of conditioned responses of the nervous system were difficult or even impossible to do anything about. But nowadays we know that conditioned responses are nothing like as tough as we used to think, and in fact are incredibly weak provided we know how to work with them. (And telling you to change your thinking is NOT the way!)

We now know that conditioned responses are very vulnerable to breakdown. It’s not like the fear response you’d get if a stanger jumped out at you from a dark alley. That’s not a conditioned response, but a survival response! Conditioned responses are vulnerable because if they are interfered with as they try to “run”, they rapidly deteriorate and disappear.

But of course we’re not suggesting that we need to actually trigger the pain in order to eliminate it! That’s totally unnecessary! Rather, we ask the patient to focus on each thought or feeling pattern that’s become hooked into the chronic pain, and we teach the patient to run interference patterns over that. The process is called BMSA (Brief, Multi-Sensory Activation) and it permanently “deletes” the pain pattern.

THE BMSA CHRONIC PAIN PROGRAM - WHAT YOU CAN EXPECT

The first thing you need to be aware of is that this chronic pain program has an extraordinarily high success rate - some 80-90% of people experience total elimination or dramatic reduction of their pain, and quite quickly. A lot of people notice immediate improvement right from the very first treatment session, so you won’t have to wait weeks to see anything happening - in the overwhelming majority of cases, you’ll have an indication right away.

And what about the end result? Well 50% of people have completely wiped out their chronic pain, permanently. (This is an astounding figure when you consider that other programs regard 30% who only REDUCE their pain to be a great result!) The remainder reduce their pain by more than 50%, and a small number get no result at all. So far the failure rate (maybe 2%) seems to be due to actual medical factors, such as hip degeneration severe enough to warrant hip replacement.

And unlike what you may have heard from other clinicians, we’ve never blamed a patient for their pain!

Despite the speed at which the program works, it would be a mistake to regard it as an overnight miracle. Even if you get total elimination of pain immediately, you should nevertheless complete the program and continue tracking pain, flaring and medication rates. Most people find that they do still get some pain, with ups and downs, but that their chart shows a clear improving trend as they continue to make excellent progress.

The end result is complete elimination or excellent reduction of pain, with elimination or reduction of medication, and return to work or family life.

About the Author:

Christine Sutherland is a clinician of over 30 years’ experience and a specialist in chronic pain treatment. She is also the author of the book The Pain Train, which details the BMSA Chronic Pain Program