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Chronic Pain

Our team of Sanomentologists work with patients suffering from chronic physical and emotional pain at a psychological level. It is made up of a number of protocols that work together to help with pain from issues such as Arthritis, Back Pain, Crumbling Spine, Fibromyalgia, Scars, Post Thrombotic Syndrome, ME/CFS, MS, all types of old injuries and many more.

The basis of this treating a client suffering from Chronic Pain is the understanding that pain is only a message.

It can be divided into different categories:

Acute: This is pain that is in response to an imminent or ongoing threat to the body, either from external damage like injury or internal damage such as disease. This pain is usually resolved once the underlying cause is removed or resolved. We don’t not usually deal with this kind of pain, although in emergency situations we can help to a point.

Chronic: This is termed as any pain that continues after a period of time (around 6 months) or continues after the underlying health issue has been resolved. This is termed as pain that you shouldn’t be experiencing; pain that has no medical reason to exist.

Nociceptive: This is the sort of everyday pain we can experience to warn us, such as to not touch a boiling kettle. It is caused by the detection of damage or potential damage to the internal and external body.

Inflammatory: Inflammation is part of the body’s natural response and defence mechanism, and part of the role of the inflammation is to increase sensitivity to prevent further injury while the area heals. In the short term this is essential, however if the inflammation becomes ongoing or goes to areas not needed then it is a problem.

Myofascial: This is pain in the connective tissue of the muscles, caused by tiny “knots” that form from excessive strain, injury, or sometime inactivity.

Neuropathic: This is caused when the nerves themselves become damaged or dysfunction due to illness or disease. The pain is not a response to any cause, rather like a car alarm going off due to a short circuit.

Psychosomatic: This is pain caused by emotional, mental or behavioural factors. Most pain has an element of this tied to it as physical and emotional pain share the same pathways and activate the same areas of the brain. Emotional pain will make physical pain much worse.

Breakthrough: this is the sensation when pain “breaks through” medication used to control it. It is most common in diseases such as cancer

Incident: this is the term used when pain results from movement, such as the lifting of an arm

Surgical: Pain caused by an open wound such as a surgical cut. Pain can persist after the wound has healed.

Phantom: Pain that occurs in a part of the body that had been amputated.

Idiopathic: This is the term for pain that seems to have no underlying physical cause. This includes illnesses like fibromyalgia, and Irritable Bowel Syndrome.

Pathological: This is pain that is a response to something that would not usually cause pain.

Allodynia: This is linked to Pathological pain, and is pain caused by gentle stimuli such as the touch of clothing.

Hyperalgesia: This is a condition where pain is much stronger than it should be. It can be caused by over use of opioids.

Dysesthesia: This is similar to Allodynia, but may be accompanied by other sensations such as wetness, burning, itching etc.

For many people, their pain will fall into several of the categories listed. For terms of RPET training we will simplify the grouping into 2 categories, Acute and Chronic. Acute is pain that is needed to help healing, chronic is pain that has lasted longer than the healing period needed, or pain that doctors can do nothing about except give pain killers.

Why do we have pain?

Most people regard pain as a bad thing, a negative feeling they experience. This leads to negative feelings toward the issue, causing the pain to become a self-sustaining sensation. Many people (not all) suffering from long term chronic pain conditions become very negative people in all aspects of their lives. This then creates more emotional pain, which feeds the feelings of physical pain.

Realistically, as already stated, pain is only a message. It is nothing to be taken negatively or to fear.

For most pain, initially it is essential to alert the body to a problem, but once it’s been addressed the message is no longer required.

Often the message is ignored, not acknowledged, especially if the pain is a response to emotional factors. The message will then get louder and louder until listened to. Ignoring it or fighting it is the worst mistake that could be made. Fighting it is a conscious reaction, and the unconscious mind is much more powerful.

Another important factor to realise is that all messages of pain, as with any actions of the body, are created originally with good intent. The protective aspect of the pain may not be against physical threats, but also mentally perceived threats such as phobias, fears etc.

If pain remains after it has been acknowledged and dealt with, then this will be down to the unconscious operating from fear (Ref The LAF Model). It will keep the messages of pain around as chronic pain for a reason, and that will be a fear of something negative happening if the pain goes.

If these fears continue, they are referred to as Secondary Gains. The reason to keep the pain is greater (as perceived by the UM) than the reason to remove it.

Secondary Gains can be grouped into two classes, internal and external factors.

Internal Secondary Gains: These are the internal reasons for the Unconscious to keep the pain despite healing or the fact there was no apparent injury initially. Examples of this can be:

  • To protect from a repeat of the action that caused the injury.
  • To prevent the client from doing something that he doesn’t want to do, eg shopping, work.
  • To prevent a client doing things that the UM thinks are dangerous due to other negative programs running, these pains will include ones relating to phobias, childhood trauma, abuse, PTSD etc
  • Pains due to emotional issues such as depression, anxiety and other mental health elements.
  • If the client has been told they will always be in pain, then it will become the reality. Issues such as arthritis, sciatica, back problems etc are common for this gain.

External Secondary Gains:

In these situations, the fear of what will happen if the client doesn’t have the pain makes the protective quality of the pain valid. These can include:

  • Financial benefits, disability, insurance claims and the like.
  • Attention and sympathy. The pain may have started out from an injury but once the client started getting attention then it activated the reward system in the brain.
  • Identity, once the client has lived for a long time with the pain, it becomes part of their reality, and they fear what life will be like without it.

There are many more possible secondary gains, all unique to the individual’s personal circumstance and personality. Often the therapist doesn’t need to know the reason to keep the message of pain, the Unconscious knows and can be asked to delete the message.

Remember, there is a positive intention motivating any pain, and a context in which this pain has value. It is our job to mediate with the unconscious to bring it to the realisation that the intention is no longer valid.