Psychology/Hypnosis And Pain Management

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Permalink Reply by Melissa J. Roth on December 5, 2009 at 7:55am

My perspective is that I never knew a psychologist who could get a client out of pain regardless of all the talking and testing in the world and regardless of whether their pain was due to a somatization of an emotional issue or any other reason (example: surgery, childbirth, injuries). It does not matter whether they have zero psychological issues or over the top psychological issues. Pain is a collection of sensations---just like hunger, fatigue, thirst, a caress. It doesn't matter whether the depression came first or as a result of the unrelenting pain. Is it ethical to leave the client in physical discomfort for the average of 3 years of psychotherapy it takes to work through psychological issues in traditional talk therapy? Or, would it be more efficacious to give the client palliative care and then suggest that they seek psychotherapy? IF you do pain control ethically then you will know to put the client's unconscious mind in an Ericksonian bind so that they can get whatever benefits the pain was giving them in a healthy, positive and beneficial way. That way you are not masking any other issues but you are giving relief to your client. And, it has been my experience, that the vast majority of the depression/anxiety/emotional issues will evaporate once the client gets relief from their physical symptoms.

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Permalink Reply by Melissa J. Roth on December 5, 2009 at 7:56am

Mike,
Go to the Medical, Health and Wellness group. There was a good discussion of pain control early in the history of Hypnothoughts on that group. It might help you a lot, certainly will give you some food for thought.

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Permalink Reply by Michael Ellner on December 5, 2009 at 9:35am

Great post Melissa -- I agree!

Think about it -- Michael,
Do you really think that feeling stuck, unhappy, lonely, sad, afraid, stressed and/or depressed are mental
disorders when a person is trying to cope with chronic pain? I mean really, do you think that feeling depressed about the prospect of never working or leading a normal life again is more than a normal human reaction.

In my opinion we need to understand that making these normal human reactions into mental disorders is a common practice so that people in licensed professions can get paid to treat them (there is no way to get payment through insurance without a diagnosis)... In my opinion this crap is actually detrimental to their patients/clients. If you want to understand the extent of that problem, see the growing literature on the adverse effects of "medicalization" of complaints...in behavioral health as well as physical medicine. We are not encroaching on the turf of licensed professionals - People who feel better - Heal Better and more effectively...

Michael E.

Melissa J. Roth said:

My perspective is that I never knew a psychologist who could get a client out of pain regardless of all the talking and testing in the world and regardless of whether their pain was due to a somatization of an emotional issue or any other reason (example: surgery, childbirth, injuries). It does not matter whether they have zero psychological issues or over the top psychological issues. Pain is a collection of sensations---just like hunger, fatigue, thirst, a caress. It doesn't matter whether the depression came first or as a result of the unrelenting pain. Is it ethical to leave the client in physical discomfort for the average of 3 years of psychotherapy it takes to work through psychological issues in traditional talk therapy? Or, would it be more efficacious to give the client palliative care and then suggest that they seek psychotherapy? IF you do pain control ethically then you will know to put the client's unconscious mind in an Ericksonian bind so that they can get whatever benefits the pain was giving them in a healthy, positive and beneficial way. That way you are not masking any other issues but you are giving relief to your client. And, it has been my experience, that the vast majority of the depression/anxiety/emotional issues will evaporate once the client gets relief from their physical symptoms.

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Permalink Reply by Peter Bateman & Lorraine Gleeson on December 6, 2009 at 12:53pm

Hi Michael
I have to agree with Melissa and Michael.
So far we have had clients coming to us after psychotherapy,CBT,counselling. One client had been repeatedly abused raped by their father and other family members, after 12 years of all of the above, 6 sessions of hypnotherapy and for the first time in her life she felt great, she even wondered if it had really happened to her, no longer feeling the emotional pain of degradation. I have recently worked with a client who had several weeks of CBT for a recent fear of driving, all she got from it in her words was she was told what she already knew. I'm not knocking any of the above as there are people including myself who have made some positive changes through counselling and psychotherapy. However it doesn't seem to deal with the underlying issues, which hypnosis can bring up. When looking at the reasons for the driving fear it was inter related to her childhood and her previous car, the previous car issue was looked at on her CBT sessions, no change, and she was put on anti anxiety drugs which she felt made her worse.
As therapists we have to listen to what our clients need and find the best way of helping them move forward. We have worked with clients who've had migraines for years, with one the subconscious told us it was the only way it could get her to rest. If your client is in pain you have to deal with it and any of the attached emotions if you cant, pass them onto someone who can until you are ready. I noticed on your page you are dealing with sports, have a look at Rene,s bit about hypno pills and pain management. I get the impression you are reading yourself out of what you want to do, look at what works for people
and use it or find someone that teaches it, you will probably find you are very capable.

Good Luck

Pete

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Permalink Reply by Michael Jackson Burney on December 6, 2009 at 1:28pm

Great feedback and thanks to all! Anyone know a practitioner working with Hospice patients whom I might befriend to learn their approach? Mike

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Permalink Reply by Dr. Tom Virden on December 11, 2009 at 7:58am

The Pain Patient Profile (P3) is a test aimed at helping the non-psychologist determine wheter a referral for psychological treatment may be helpful. As a psychologist who works primarily with chronic pain, I tend to incorporate hypnosis with pschotherapy (primarily Acceptance and Commitment Therapy), often while working in concert with their medical providers.

I use hypnosis initially to introduce hypnoanalgesia and stress reduction, but eventually it becomes a tool to enhance mindfulness and the act of altering one's relationship with unhelpful thoughts and feelings (cognitive defusion). This, in turn, allows the client to occasionally experience pain, cope with it, and still live a full and valued life.

Tom
www.creativepsychological.com

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