Saturday 17 May 2014

Ruminations on The hidden Psychology of Pain

Top of my reading list at the moment is The hidden psychology of pain by Dr James Alexander who's ideas support and further develop the ideas of Dr John Sarno re the origins of chronic pain. Sarno's ideas were that a lot of chronic back pain and pain syndromes like Chronic Fatigue Sydrome/ME are a psychologically driven response to unresolved emotions. Sarno's ideas are revolutionary and challenging to current medical thinking but as he is an MD and has treated a lot of people using his protocol, there are many clinicians who are beginning to take him seriously. John Alexander is one of them but he differs in that he is a psychologist so has, perhaps more of an idea on the psychological determinants of this. he has suggested that our response to pain is determined by our thinking about it - i.e. whether it dominates our lives, we catastrophise it, and interpret its meaning as one of 'things getting worse'. Certainly in my clinical practice I have noticed this tendency in the clients who fail to get better and I remember my own experience here too. I think I belong to that category or 'ruminators'. He refers to a couple of Pain Questionnaires1 that help determine these responses and therefore allow us to rate our contribution to pain and therefore suggest ways of re-training the mind (via hypnotherapy, psycho-sensory techniques such as EFT, etc).
My contribution to this debate is that trauma may be at the heart of this 'sensitisation' of the mind. I am coming to believe that all of us have traumatic memory - some small, some large but that the cumulative effect of these poorly processed emotions is one of priming the autonomic nervous system (the fight and flight mechanism) to one of hypervigilance - and the end result of that is that when challenging events do occur in later life (like accidents, viral infection, etc) our system (especially the adrenals) are so severely compromised that the immune system is depressed and we end up in a cycle of pain and worrying about pain...

This then becomes our focus and we start our journey to find external solutions, whether it be conventional or alternative. We fight the notion that the answer is in us as that seems like blaming ourselves for our pain when we feel innocent (which is correct - we are). But we need to take responsibility and begin to explore the old hurts (without endlessly recounting them) so that we can heal. I recommend Eye Movement Desensisation and Reprogramming (EMDR) for this as it heals the hurt without retriggering. It is quite profound.

I myself and having (EMDR) therapy so that
i/ I know what it feels like and
ii/ I can be cleared of my triggers to get my mental attic cleared
Both of these help me to be clearer when helping my clients.

I started by looking at my blood phobia which is something that limits me and makes me embarrassed (I feel faint if I even look at it). This seemed simple enough. But within a couple of sessions other images and ideas popped into my head unbidden and these have to do with my grandmother and mother and certain panic feeling they had. I have no doubt for myself that I have trauma from my early years (ages 2-3) which I don't remember but seems to keep me forever looking out for failure and disaster. This inner exploration is very interesting and has had the useful corollary of reducing my Reynaud's symptoms (white finger) and generally my anxiety levels.

So, I look forward to a day when I am free of these things and hope to be able to use my learning to help clients in pain - those who are willing to go beyond the external search anyway..

1 The Pain Catastrophizing Scale by
Michael JL Sullivan, PhD

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