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Useful advice from a pain psychologist

stockbrokersstockbroker Posts: 464
edited 06/11/2012 - 8:36 AM in Depression and Coping
that During a good chunk of the last ten years since I have been living with pain, I've always thought it would be great to see a pain psychologist. Hey, I know when I'm in over my head. I either couldn't find one or (once) saw somebody who was part of a pain clinic who was just mean and nasty. Imagine my delight to have met THIS GUY. I want to share what I learned at me appointment. Then, if you guys are interested, I will continue to share.

This particular pain psychologist was in the Navy and spent (and continues to spend) time counselling veterens either injured during combat or suffering from post-traumatic stress disorder. He also is a pilot and a flight instructor. He told me that a pilot has a checklist as to what needs to be done upon descent. This checklist is for landing during normal (weather) conditions. So, you land the plane, you follow the checklist. You do it again, and again and again and twenty years worth of agains. But, as I said, this checklist is for normal conditions. Now comes an abnormal condition: turbulance, electrical storm, icing, etc.---YOU NEED TO USE A DIFFERENT CHECKLIST. He told me that I don't have a check list for how to deal with the situation that I am in-----that I continue to use my "good weather checklist" and "work harder, run faster, be smarter, figure it out" and its not working. He told me he has all kinds of experience in dealing with disabilities and he will help me develop that new checklist and that I can stop worrying, it will be okay. WOW. This guy struck a nerve. He made so much sense to me and not in the "booga-booga psychological mumbo-jumbo garbage but just plain common sense. I don't know how to deal with being in chronic pain. I know how to get an A in my class. I know how to make money at my job. That is, I know how to be successful by the standards society imposes and I have accepted but if I keep applying those same rules or standards to my current life of chronic pain, I am going to be unhappy. He is offering to provide me with a more realistic "checklist". This makes enormous sense in a very straightforward no jumbo-jumbo sort of way. I'll begin to get the checklist in two weeks. Let me know if you all are as excited by this concept as I am as I will continue to post what he tells me. Realize that what this PhD psychologist tells me is tailored for ME but I can't help but think that I am exceedingly ununique in my response to chronic pain. Susan.


  • Keep sharing, because you never know whose life it may touch!! I'm glad that you have found something to get excited about in your path for dealing with pain!!
    APROUD CANADIANveteranButNOTa doctor, my thoughts are my own
  • Thanks for offering and spending the time to share with us. I'll be reading about your experiences and information. THANK YOU!
  • I was told a somewhat similar thing last visit to.
  • I'm glad to hear that you had an excellent experience. I think it is great that you have been given a glance into Navy Medicine albeit through the back door. This is why I love Navy docs.

    Anyway, I too would be interested in hearing how this all pans out for you.

    Take care,

  • This may be the only time since I've been a member of SH that I wanted a post to be longer. Please continue.

    Thanks for this post.
  • I was feeling much better. The psychiatrist had been upping my antidepressent to what was the highest recommended dose. This, I thought, made me sleepy. (Of course depression will make one sleepy too so who knows.) Since I was complaining of being sleepy, Doc suggested I add a stimulant and gave me a box of something that is used for narcolepsy. I looked at this box for a few days and then decided I didn't want to start taking a drug to counteract the side effects of another drug whose theraputic value at these high doses was unclear. I decided to cut back on the anti-depressants (with the okay of my doc). Separately, my UTI cleared up and I am feeling one helluva lot better. Okay, back to the Commander. I asked him WHY, after I got my stimulator, after my pain levels were much improved did I succumb to depression. Why would I crash and burn when things were getting better? The commander expressed a view that I had considered: you know how when you're in the midst of a crisis, you are calm, totally aware, focused, not at all scared just in crisis mode taking care of business. And then the immediate danger passes and you feel the luxury of falling apart. Thats what the pain psychologist thought happened with me. My own opinion includes that explanation plus the following: for the past 10 years or so, I have been spending an outrageous amount of time trying to first rid myself of pain and then to reduce the pain to a tolerable level. This has been my number one job. Since I got the stim, that job has been phased out. Now what do I do with myself? I've given up so many of my old activities so that I could pursue this job, I'm left with very little to do. This psychologist thinks I've been working, exercising, on the go go go in order to distract myself from having to deal with my situation emotionally. So when I slowed down, I crashed and burned.
    I am going to go for a 15 minute walk every day at lunch time with one of my co-workers. The next week, I'll do 1/2 hour. Then 3/4. Eventually I'll just walk and not work at all. LOL.
    The commander asked me about my religious beliefs. I wasn't much help. He said that he has found that people who could put their experience into some kind of "grand plan", who could give it some positive significance (spin?) tended to deal better with lives disrupted by pain. That would be tough for me. When I see the commander again in 3 weeks, I will quote from Dr. House, "People get what they get. It has nothing to do with what they deserve." Susan
  • Thanks for sharing what you learned today. I have thought much of the same things. When I was making progress with my physical condition, working hard at doing it, my attitude was fairly upbeat and good. When things became stagnant and my efforts didn't help, my mood crashed. I think that is similar to what he is saying to you. As long as one is in the middle of a crisis and in the fight mode, one can handle the emotional part of this. When the "fight" ends, it is easy to get depressed. For me it was when no matter how hard I work, I stopped making progress and actually am regressing, that is when my mind started to fall apart. I too am seeing a psychologist and she is helping me to understand these things. I always considered it "weak" to need to see a psych doctor, but have learned this is far from true.

    Anyway, thanks for sharing again. You are helping a lot of us to understand what is going on in our own heads, and at the same time it is healing for you to share. By the way, I agree with your quote at the end.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • That rings so very true for me as well. When we are in crisis mode, we go from A-B-C etc; Then, when we hit the end of that chain and there is little to no more we just go, poof....I've felt it and thought it.
    Crisis mode is sometimes better, at least then I don't have to think so hard. I just DO. Problem with crisis mode is, usually someone is hurt :( not really what we want.

    I like the ideas, I am trying much the same, just DO SOMETHING, even a little bit helps.

    P.S. You write pretty swell yourself :D
  • Susan,
    R Sternbach the famed PM academic said that finding a cure and giving your sole attention to this focus can develop into making this goal your only objective and he suggested that we try no to make a career of being this person.

    Getting beyond the pain seem like not giving our imposed condition sufficient priority and that is not the case, that management process takes time and resilience, support with guidance, we have not done this before and no perceived blueprint is going to cater to our individual needs.

    It is always difficult evaluating which process to use fort he most part we adopt many strategies before we find the most suitable one. That alternative check list is a good one, that we can sometimes continue with ideas that once tweaked would be more effective, and doing the same thing over and over will a less than adequate outcome just enables us to keep doing that same process. It does sometime take another to review, the what, how and why we do things and those small changes will develop into a more suitable flight plan.

    Some of that uniqueness is learned behaviour the good and the bad, it has to be an ongoing process and as we progress what may have worked at one time is less favourable now we have moved forward. Changing our thoughts will bring success and as you say it may seem so simple an idea now, I am pleased you are encouraged by this change, it is more than just talking it better and in reality this process will not change the emphasis of your underlying pain only how you now interpret those previously held views.

    My four week residential pain management included just these sessions and as you I continue to benefit from a changed outlook.

    Thank you for sharing and good luck.

  • The more I read about other people's experiences, the more wowed I am. As a newbie to the site, I had no idea there were so many of us going thru such similar struggles. Thank you for being so brave in sharing your stories. I learn so much from all of you & make me feel so much braver. The alternative checklist made instant sense to me. Never realized I was setting myself up for failure by using my old "normal" checklist & it's time to recalibrate. Thanks for the reminder, Wrambler, to just DO SOMETHING. I've used that off & on thru the years but never made it a priority before, even tho it usually works. Why is it that the simple & obvious little techniques are the ones we so often overlook?
  • It really is about recognizing the "old" sage wisdom, truths that have been around for millenia. But, we forget, we dont realize where something applies, until issues like pain and life come up, and we begin to be curious about our bodies and our minds. With that special view, we can begin, to learn.

    Every day I learn some truth about myself, I learn something about my sweetie and I learn and teach my daughter. It really is about being open to the world and look at everything with wonderment eyes.

    Cheers - C45
  • what's the difference between normal list and crisis list?
    ones a to do list and the other is a DONT DO LIST!!!!!!!

  • So very, very true. I think I've learned more from going thru all this than I did when I had cancer. Keeping an open mind is crucial yet so hard to do when you are in so much pain & down. Thanks for the reminder on how much we DO learn from going thru these difficult times. I am always keenly aware that my children observe & learn from me in how I handle myself thru this. I am setting an example for them, even now that they are all adults, should they ever have to face anything similar themselves. It motivates me to be a better person than I sometimes feel.

    I like what you said about looking at everything with a sense of wonderment. Even in pain we can appreciate so much :)
  • I will ask Pete's question - I think the answer that it would help others!

    Can we continue, please?
  • Feels like I'm treading on slippery ground here, especially since I'm in a bit of crisis mode myself right now, but here goes nothing.

    Living in chronic pain, my "normal" is so different than it used to be. My redefined normal list is to make it through the day as happily as I can. That seems very important to me. It's a sliding scale according to my pain level, but I always strive to make it as happy a day as I possibly can. That's the only way I've found to cope with the pain & limitations with any sense of sanity. That way if all I can manage is to take a shower, at least I can sing while I'm doing it. I need to be able to look back on the day & feel like I accomplished something well, even it was only to make my husband laugh one of his big belly laughs.

    Crisis list consists of trying not beating myself up too much, since I feel so terribly guilty whenever I have a bad bout of depression. I do not WANT to be depressed. I do not want to be in crisis mode. I do not want it to be so HARD. But it is sometimes. Too easy to come down on myself & say it's one more failure, I should be able to have control over my emotions, even if I can't have control over my body. So my crisis list is setting a strict time limit on my pity party, getting up & doing something, anything, that will take my mind off myself for awhile, and looking at the note I posted up for myself that says "Your future is STILL what you make of it".

    Maybe I'm way off base or this is not what you are looking for & if it's not, I apologize but I would like to hear your thoughts, too.
  • I'll let you know what pearls of wisdom he gives me. To that end, I'll take some notes. As far as the crisis list goes I remember that one of the goals is to have more good days than bad. I'm sure TamTam's comments to Jane would receive a standing ovation from the pain psychologist. I know one of the goals is to get past feeling sorry for myself or have I mentioned that one already. That's a tough one. To borrow a Wrambler-ism, "boo-hoo poor me".
  • I appreciate your candor and applaud your enthusiasm. I can't wait to read more. I used to post more often on this website but as my pain has gotten worse and worse, I have avoided posting because I'm feeling so awful. My mom always told me, if you don't have something nice to say, don't say anything at all ;) I've had an underlying perception that the psychological aspect of this whole "chronic pain" thing is as overwhelming as the actual pain - just in a different way. I'll take any suggestions and insights you or anyone else can share. I'm at the point that I'm grasping at straws and would love to read more of your insights. Thanks so much. Kathy
  • Thank you for this posting, the alternate checklist is genious. It is hard to cope as is without adding the self imposed pressure of not being able to live up to our own expectations. I have always valued myself for my abilities to do this or that and take care of... Now, I am unable to do this or that or take care of... I am having to ask others to take care of me, help me. Ouch. I discovered I have little to no experience in asking for help. Patience for letting others do "my" jobs, etc. You caused me to look deeper at my checklist. Thank you.
  • This thread is very helpful.
    I have found for me it's going to be a mental challenge to 'reset' my outlook daily as I recover and continue on. I like this because it's helping me realize it's not just a physical recovery but also a mental one.

    Thank you and I'll continue to follow this!
  • I've been pronounced "mentally healthy" by the pain psychologist and so I don't have to go back to see him. Before I left, I asked him for his checklist for people in pain. He gave it to me. I wrote it down and now I can't find it. I promise I will give him a call next week (he's only in on Tues. and Wed) and have him give me the list again. Maybe someone else who is seeing a pain psychologist could take over this thread. When mine saw me taking notes, I explained that I was sharing what I learned with my friends at S-H. I did ask him, though, what was wrong with "compartmentalizing", kind of keeping busy and trying not to think about my pain. At one of our early meetings he really got on me for this. Hey, I thought it was a perfectly well-regarded and acceptable defense mechanism. This time, he qualified he response saying, yes, it was okay but I had to keep in mind that adjusting to my current situation would be an ongoing project. That my problems were going to get worse. Any part of my picture that is "degenerative" is going to get worse as I continue to get older so one must be regularly reevaluating the checklist. As for the present time, I feel a great sense of accomplishment in the fact that I have fixed dinner three nights in a row. Before I developed chronic pain, it never would have occured to me to consider cooking dinner an accomplishment. I've got a new checklist. Its a magical checklist in so far as I don't feel bad when I don't cook dinner. Isn't that great? Susan
  • I have found this all to be very interesting and very helpful - sorry to hear that you have been found of sound mind and our free psychologist info will cease ;)

    Your part about making dinner 3 night is wonderful and I can so relate.

    If I was able to jump up& down I would have last week - when I put my socks on by myself standing up! I looked around and seen no one was there to enjoy that moment with me, however me, myself & I enjoyed it none the less :)

    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • I have been very active in the other back pain forums but just discovered this one. The info from the pain psychologist is great. Thank you for sharing. I know we all want our old lives back.


    Spinal stenosis, spondolysis, spondolythesis, L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion with bone graft from hip, PT, accupuncture, prolotherapy, many cortisone injections, 4 rhizotomies
    L4/L5 laminectomy, L4/L5 360 fusion with instrumentation, L1 to L5 fusion, L5/S1 fusion w/ disc replacement, left and right SI joints fused.
  • We never acknowledge our achievements as we should and that learning about ourselves never stops, many never reach that perceived balance of improvement that was so attainable when we started off, as surviving itself gets in the way.

    If we can survive pain every day and many here do, we have already exceeded the capacity need to do anything we put our minds too, it is about breaking each element into reasonable steps and progression. That evaluation reassessment and goals setting never stops either, we have no sooner achieved one than the next one is before us.

    That healthy mental aspect is difficult to develop and sustain when the pain is constant and restrictive, small achievements become important and more worthy, the harder our life becomes the more we try as a consequence. Managing our pain is already within us and just needs to be moulded and reflected upon, brought to the surface. Every day illuminates another section of our development and through pain we seen with personal vision all those important things that zoom past unnoticed, and more so when the normal me existed.

    Pain has taught me about myself the caring and sharing for others and compassion for a collective existence, it is not of my choosing and a brave poster said she had learned more than from having cancer, which touched my heart.

    This life does not get easier although we learn to cope more effectively and it may seem to have improved.

    Take care John.

  • Thanks for sharing. The idea of the need for a new checklist was something I had never considered before. I am posting this two months after the last post, so I hope you are still working with the psychologist. AJ
  • So Mrs. Stockboroker. Where is this list you promised for about 2 months now?

    You start a thread going on this and then just duck out?
  • As I explained in an earlier post, I am no longer seeing the pain psychologist. I have been pronounced "mentally healthy". I promised that I would try to get the "in pain check list" from the pain psychologist (I'm assuming, perhaps incorrectly, that you've read my previous posts.) He, unfortunately, has not been available. He's been out of town. I'm guessing it has something to do with this shooting at the military base in Texas. If thats what you call "ducking out", I suggest you find your own pain psychologist. I didn't realize I had any sort of obligation to you, whoever you are.
  • You were very thoughtful to share any of your experience at all with us on your experience and I know that what you did share helped out many. The member that posted above made a very rude comment and for that I am sorry. If they would have read the entire thread before commenting they would have already known why that list was not forth coming. Please let the appreciation of many outweigh the rudeness of 1.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    Surely you were just joking?
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • I just came from my shrink...He had a few words I would like to share.

    He said his job is to help me feel less depressed.
    My job is to learn that even though I feel better I have limits. Overdoing things simply because I feel better mentally does not help my situation. The problem is still there, IF, big IF, I/we can learn to live within our limitations on good days as well as bad days, we may find ourselves having less bad days.

    He did not however tell me how to make the rain go away and my back stop aching when the weather changes.

    He did up my Flexeril to 3 a day and express his disgust with the local pain clinics refusal to treat any of their patients with any form of meds! I told him I wished there was someplace I could go that would take care of my SCS, my spasms and back pain etc. Not all this bobbing around from doctor to doctor. He did not mention that he is going to refuse to continue helping me and refilled all my scripts and upped my Lamictal to see if the dark days I keep getting every week or so will go away.
    He suggested those may be my own fault as I admitted overdoing things lately.

    For those following merrily along this trip with me.
    I still have not heard back from Human Resources. They don't seem to know what to do with me, so they are not doing anything yet.
  • It seems like such simple and sound advice, doesn't it? But, if you're anything like me, the limits of what you can do on a good day is not constant. So, one day you can go for a three mile walk with no negative consequences but another day that three mile walk will send you to bed for two days. Its a cunning bugger this pain of ours.

    FYI, while I was at the PM's office, I left a note of the pain psychologist along with a self-addressed stamped envelope, asking for the in-pain checklist. What I received in the mail was the form I have to fill out everytime I go there---you know, the little man where you have to make exes and os and slasheds and < and > for different types of pain on the body. So, I left him a voice mail asking again for the checklist but giving more context to my request. Susan
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