Contact sgrinstead@cenaps.com or call (916) 575-9961 to sign up or for more informationRelapse Prevention Therapy Support Group   ·    For people in recovery from any addictive disorder who Do Not want to relapse·       Identifying and Managing Warning Signs that lead to Relapse·        Closed Group for 8-10 members (Phone Interview required)·        Beginning Monday, May 23rd at 6pm – 8pm for 14 Weeks·        Cost:  $60.00 for each group session or $700.00 – for 14 sessions
Dr. Stephen Grinstead will lead this group that is specifically designed for people in recovery who either have a history of relapse or have core personality or life-style warning signs that could lead to becoming dysfunctional in recovery with an eventual relapse around alcohol or other drugs.
The new Relapse Prevention Therapy Workbook, by Terence T. Gorski and Stephen F. Grinstead will be at the core of this therapy group which participants will need to purchase prior to the group starting.
Participants will be guided through each exercise in the workbook to ensure they get the full benefit of each process.  During group sessions participants will share their progress and/or difficulties with each exercise or discuss and problem solve other stuck points in their recovery.
Participants the 14 Session Relapse Prevention Group will accomplish the following:
·         Identify and learn to manage stress that can sabotage their recovery process.  Participants will learn the importance of understanding and using a stress thermometer and other new tools to keep their stress levels in check.
·         Complete a Life and Addiction History that is designed to uncover hidden self-defeating patterns (also called warning signs) that follow people into recovery. If these are not identified and managed effectively, they could lead to a potential relapse process that may result in alcohol or other drug use.
·         Complete a Recovery and Relapse History that is also designed to identify warning signs (or self-defeating patterns) that could lead to relapse.
·         Create 10-14 personalized strategic warning signs that will need to be managed using the Gorski-CENAPS® Warning Sign Cards in the workbook.
·         Identify Three Critical Warning Signs and learn to fully analyze the TFUAR Process: Thoughts, Feelings, Urges, Actions, and Reactions that can lead to relapse.
·         Develop a recovery plan that is designed to help identify and manage potential future warning signs that could lead to relapse.
·         Create morning and evening inventories that are designed to enhance a recovery and relapse prevention plan.

When you live with chronic pain, it can be very frustrating when you aren’t getting the pain relief you want. I know that when I experience a pain flare-up, my first reaction is I want it to stop — now! Because many pain medications were developed for acute pain conditions, problems can arise when you use them for chronic conditions. When people are in pain, they often have a need for instant gratification (I want it, and I want it now). While acute pain medication can give them the relief they are looking for, it can also lead them down the path to the quick fix.

Being able to tell the difference between appropriate and effective use of pain medication and the beginning of abuse is sometimes difficult to determine. There are progressive stages of problems that include medication dependency, medication abuse, pseudo-addiction and, finally, addiction. The confusion and uncertainty of this progression can be a challenge for both you and your treatment provider.

Some people living with chronic pain are afraid to take their narcotic (opiates, etc.) medication because they have heard horror stories of people getting hooked on pain pills. This leads to a decision to under-medicate, to live in pain and suffer. If you happen to be in recovery for alcoholism or any other drug addiction, the problem is even worse. If you under-medicate, it could trigger a relapse when you try to manage your pain. Or you could overmedicate, which may lead to a rapid tolerance buildup and, finally, reactivation of your addiction.

Understanding Addiction

In this section, I will use the terms addictive disorders and addiction to discuss what the DSM-IV-TR™ (Diagnostic and Statistical Manual of Mental Disorders; Fourth Edition, Text Revision) classifies as substance use disorders and is also referred to as chemical dependency, or psychological dependence.

I define an addictive disorder as: A collection of symptoms (i.e., a syndrome) that is caused by a pathological response to the ingestion of mood-altering substances and has 10 major characteristics that I have listed below.

Common Addictive Disorder Symptoms

1. Euphoria
2. Craving
3. Tolerance
4. Loss of Control
5. Withdrawal
6. Inability to Abstain
7. Addiction-Centered Lifestyle
8. Addictive Lifestyle Losses
9. Continued Use Despite Problems
10. Substance-Induced Organic Mental Disorders

Differentiating Between Addiction and Pseudo-Addiction

No one who is in treatment for chronic pain starts out with the goal of becoming addicted to their pain medication; nevertheless it happens at least 10 percent of the time. If someone has a family member with addiction or mental health conditions, or if they have a personal history of addiction or mental health problems, they are at high risk for racing through the progression of addiction.

People at risk for addiction react differently from the very first experience of taking pain medication. With ongoing exposure, they experience the seeking/reaching stage, at which time they begin to doctor shop. There are many questions to be addressed when treating someone who has chronic pain and coexisting substance use disorders. The three most important ones I talk about at my Addiction-Free Pain Management® trainings are these:

1.    Are we managing pain but fueling the addiction?
2.    Are we treating the addiction but sabotaging the pain management?
3.    Is it addiction or pseudo-addiction?

The term pseudo-addiction is fairly new to the addiction treatment field, but has been used in pain management for quite a while now. The point to remember is that even though pseudo-addiction looks like addiction, it is actually caused by an undertreated or mistreated chronic pain condition. However, the treatment plan for pseudo-addiction and addiction is identical. The major danger of pseudoaddiction is that if it is not adequately addressed, it can turn into full-blown addiction — sometimes quickly, sometimes slowly.

I have worked with many patients over the years who were labeled “prescription drug addicts”, but who were actually suffering with pseudo-addiction. A client, Sharon, was an example of how damaging a misdiagnosis can be. Sharon was in her early forties and came from a fairly normal and religious upbringing. She had never used alcohol or any other drugs, including nicotine, and, up until her chronic pain condition, had never used psychoactive prescription medications either.

Sharon began having infrequent migraine headaches and went to her general practitioner who gave her Vicodin, which worked for a time. As the Vicodin began losing its effectiveness, her doctor prescribed OxyContin, but she also used Vicodin for breakthrough pain. Sharon later found out that she would have been better off using migraine-specific medication from the start.

Although barbiturates and opioids are sometimes considered effective for short-term migraine relief, many doctors are now recommending against prescribing this type of medication for long-term use. The risks for potential dependence and abuse are too high, and there is a real danger of developing medication overuse headaches (sometimes called pain rebound or transformed migraines).

Because transformed migraines are difficult to diagnose, many people are not being treated appropriately. Treatment is further complicated by the chronic nature of migraine headaches. People with transformed migraines may overuse pain relievers, both prescription and over-the-counter, on a daily basis with or without having a headache. This puts them at risk for building a tolerance to the drugs. Additionally, taking too many pain relievers containing caffeine can also lead to rebound headaches.
As Sharon’s migraines became more frequent, she began taking more and more medication to get any relief. As the dose increased, her family and then her doctor became concerned that she had become addicted to the OxyContin and Vicodin. Sharon’s doctor told her he couldn’t help her anymore unless she went into an addiction treatment program.

Sharon’s family found an addiction treatment program that said they treated pain and prescription drug addiction, which is when her nightmare began. While undergoing detoxification from the OxyContin and Vicodin, Sharon was forced to stand up in front of groups and identify herself as a drug addict. She was not even allowed to say she was a prescription drug addict, which was humiliating for this very conservative woman.

After Sharon stopped all of her medications, the migraines kept coming back. To add insult to injury, when she asked for help with the migraines, the program staff said she was “drug seeking” and all she needed to do was “turn it over” and work the steps. Even though I’m a big advocate of a 12-Step approach for people with addictive disorders, it can be dangerous to label or advise chronic pain patients in this manner.

Sharon was discharged from this program with a letter to her doctor stating she was an addict and should not be given opiates anymore. She became depressed and attempted suicide. Sharon’s family finally sent Sharon to the pain clinic where I was consulting. I met with her several times, assessed her case and discovered that her diagnosis was not addiction, but pseudo-addiction.

Addressing Pseudo-Addiction

As mentioned above, pseudo-addiction describes patient behaviors that may occur when pain is under-treated. People with unrelieved pain may become focused on obtaining medications, clock watch or otherwise seem to be inappropriately drug-seeking. Even such behaviors as illicit drug use and deception can occur in the person’s efforts to obtain relief. Pseudo-addiction can be distinguished from true addiction in that the behaviors will resolve once the pain is effectively treated.

• Pseudo-addiction looks a lot like addiction
• Patients may appear to be “drug-seeking”
• Patients may need frequent early refills
• Behaviors are caused by under-treatment
• Problematic behaviors resolve when the patient’s pain is adequately treated

As this was the case for Sharon, the pain clinic prescribed migraine-specific medications, since opiates are contra-indicated for ongoing migraine treatment. There are seven triptans (Imitrex, Maxalt, Zomig, Amerge, Axert, Frova and Relpax) that were developed for and FDA approved as migraine abortive (management) medications. These medications work to stop the migrainous process in the brain and stop an attack with its associated symptoms.

Sharon responded well to Maxalt, but she also was put on a preventative medication called Migranal. Ergotamine medications, such as DHE and Migranal, are used as vasoconstrictors for migraine prevention and sometimes mixed with caffeine. They are also FDA approved for migraine treatment, as is Midrin (a combination of acetaminophen, dichloralphenazone, and isometheptene). Because of these two medications, her migraines were now effectively managed.

Sharon was also prescribed an SSRI antidepressant as we began to implement a cognitive behavioral therapy treatment plan for the depression and pain-focused psychotherapy for pain management. Today Sharon is experiencing a great quality of life, but still has nightmares about her time at the treatment program. Getting back to my original three questions: Sharon’s general practitioner risked fueling an addiction, and the addiction treatment program definitely sabotaged her pain management.
It is important to work with a multidisciplinary team and get assessments to determine if you are experiencing addiction or pseudo-addiction when you have chronic pain and coexisting addictive disorders. Sharon experienced pseudo-addiction — not addiction as everyone thought. Once she was placed on an appropriate migraine medication management plan, along with cognitive behavioral therapy to address the psychological pain symptoms, Sharon’s quality of life improved dramatically and her migraine episodes lessened both in frequency and intensity.

Understanding and Addressing Chronic Pain and Addiction

Pain is the reason many people start using potentially addictive substances. Jeanie is an excellent example of what can happen when a pain condition is not managed appropriately and treatment depends only on medication.

We know that regular use of psychoactive medication, plus a genetic or environmental susceptibility can lead from pain relief to increased tolerance. Both of Jeanie’s parents were alcoholics, and she was in an abusive marriage. She developed a chronic pain condition and was prescribed opiate medication to treat her pain. Jeanie soon discovered that her pain medication also helped her escape from painful childhood memories and the trauma of an abusive relationship.

Eventually Jeanie’s medication no longer helped with the physical pain symptoms or her emotional distress, so she started taking much more than was prescribed. She eventually went to several different doctors to get the amount she believed she needed, but her pain continued to get worse. In fact, Jeanie’s medication started to increase or amplify her pain signals — this is called the pain-rebound effect.

Physical pain is the reason many people like Jeanie start using potentially addictive substances. Chronic medication use, plus genetic or environmental susceptibility can lead to increased tolerance as a result of searching for pain relief. Eventually, the addictive substance no longer manages the pain symptoms. Not only will it increase or amplify the pain signals, it can also cause an extreme sensitivity to pain, a condition called hyperalgesia. The end result is severe biopsychosocial pain and problems.

Jeanie did become addicted to her medication, which increased her pain and created problems in every area of her life: physically, psychologically and socially (biopsychosocial). Because Jeanie was experiencing both chronic pain and substance dependency problems, she needed a specialized, concurrent treatment plan for both conditions.

An effective synergistic treatment protocol for Jeanie’s chronic pain and substance addiction condition included the three following components:

• Appropriate Medication Management
• Core Clinical Processes
• Nonpharmacological Interventions

Appropriate Medication Management: Jeanie’s medication management plan included collaborating with an addiction medicine practitioner/specialist. This person made sure that her medication was needed, was recovery-friendly and was the right type, as well as the appropriate quantity and frequency, so it would not trigger relapse.
Core Clinical Processes: Jeanie also needed to deal with her irrational thinking, uncomfortable emotions and self-defeating urges and behaviors, as well as the isolation tendencies that can develop with co-existing pain and addiction. I used a cognitive behavioral therapy approach using the eight clinical processes in the Addiction-Free Pain Management® Workbook as a starting point, which worked well since her health care provider was experienced in the concurrent treatment of chronic pain and substance dependency.

Nonpharmacological (Holistic) Interventions: I supported Jeanie to search out alternative non-pharmacological/holistic pain management modalities such as hydrotherapy, physical therapy, acupuncture, chiropractic, prayer, meditation, hypnosis, self-hypnosis and so on. I also suggested she read Managing Pain Before It Manages You (2001), a book by Margaret Caudill, which was very helpful for her. Jeanie also used both a 12-Step group and a chronic pain support group, which greatly enhanced her recovery.

Knowledge Is Power

Developing an effective treatment plan also required that Jeanie understand which stage of the addiction process she was in. It was also important for her to know how much damage had been done by her inappropriate use of pain medication. As Jeanie progressed, she learned how to identify which stage of the developmental recovery process she was in, and then implemented appropriate treatment interventions.

As you can see, the road to recovery can be a difficult one for someone with both chronic pain and a coexisting addictive disorder. However, most of the chronic pain research I have reviewed over the past two decades has been very clear about treatment outcomes. The best prognosis is when people are proactive in their own treatment and recovery process. One way they can do this is to learn as much about their pain and effective pain management as they can.

As the title of this section stated, knowledge is power. Once people understand what is really going on with their body and mind, they can take action to effectively manage their pain. In fact, the most important shift they can make is to stop believing that pain is their enemy and accept it as their friend.

Jeanie looked at me like I was crazy when I suggested that she make peace with her pain and that pain is her friend; she had a very difficult time accepting that. Even so, it is true. It was very important for Jeanie to stop seeing herself a victim of her pain condition and empower herself by developing a pain management and chemical dependency recovery program. Fortunately, Jeanie adhered to her treatment plan and remains clean and sober, as well as effectively managing her chronic pain.

The Relapse Intervention Plan

While walking the tightrope of pain management and addiction, it’s important to make sure patients have a safety net in case they fall. I call this the relapse intervention plan, which must be developed with the patient before moving into the three-part treatment process explained above.
This is their insurance policy. People don’t buy auto insurance because they plan to crash into other vehicles. They have it just in case. The relapse intervention plan should be a mandatory component of a treatment plan for anyone with chronic pain and coexisting disorders; especially addiction.

In its simplest form, developing a relapse intervention plan consists of writing out a specific plan for the following three questions.

1. What is your healthcare provider supposed to do if you relapse, stop coming to sessions or fail to honor your treatment or medication management contract?
2. What are you going to do to get back in recovery if you start inappropriately using pain medication (including alcohol) or other drugs or other ineffective pain management so that you can stop using before you hit bottom?
3. Who are three significant others who have an investment in your recovery? What is each of them supposed to do if relapse occurs? Make sure you have their day and night phone numbers accessible and they have a copy of this plan.

The premise here is simple: Those who fail to plan, plan to fail. I believe that positive treatment outcomes are possible if people have a three-part, multidisciplinary treatment plan, are committed to being active participants in their treatment process, and they develop a relapse intervention insurance policy — especially when walking the tightrope of pain management and addiction.

Healthcare providers often become confused and frustrated when their treatment interventions are ineffective.  Also, we must warn people living with chronic pain not to be fooled by health practitioners who claim to do pain management, yet only do one major thing for your pain, such as medication management, or chiropractic adjustments or acupuncture.  True multidisciplinary pain management involves interventions such as physical therapy, massage, medication management, counseling or therapy, biofeedback, occupational therapy, exercise physiology, an anesthesiologist or pharmacologist, and a case manager all at one site, at a minimum.  It may also involve some type of movement therapy such as Tai Chi, classes on spiritual wellness, yoga or meditation.

I believe a multidisciplinary team is crucial in order to address the specific biopsychosocial needs of people living with chronic pain.  In addition, the physical, psychological, and social implications of chronic pain and any coexisting disorders—including the impact on family systems—must also be adequately dealt with.

I believe it is essential to implement a collaborative three part approach such as the one I developed for the Addiction-Free Pain Management® System: (1) A medication management plan—in consultation with an addiction medicine specialist if abuse or addiction are an issue; (2) A cognitive-behavioral treatment plan—addressing pain versus suffering, treating family system issues and changing self-defeating behaviors; and (3) A nonpharmacological pain management plan—developing safer medication-free ways to manage pain.  Recovery and avoiding relapse is possible if patients are willing to do the footwork and utilize a collaborative multidisciplinary treatment team.

Using a multidisciplinary team is crucial in treating the synergistic problems people and their families’ face that have been severely impacted by chronic pain, especially when addiction, and other psychological disorders are present.  When these conditions coexist it creates a major challenge that must be addressed by utilizing a collaborative treatment approach. The inclusion of Addiction, Mental Health and Medical is vital to this process.

When these coexisting conditions occur, the family problems increase synergistically.  Effective treatment can be challenging and confusing for counselors, therapists and other healthcare providers, but especially for patients and their families.  I believe it is important to utilize the strategic three-part approach outlined above that can improve treatment outcomes and give people living with chronic pain and their families new hope.

To learn more about developing an effective chronic pain management plan, especially when coexisting disorders are a factor, please check out my article Overcoming Obstacles for Effective Chronic Pain Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are once again presenting my Addiction-Free Pain Management® Certification Training in Sacramento on November 11-13, 2010 this time in our new office space. To learn more about this and my other upcoming trainings you can check out our Calendar page.

You can learn about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Below you will have an opportunity to gain more insights about your personal pain relationship. The main purpose is for you to gather daily written feedback regarding your internal perception (insights) of your pain condition and how you manage your pain. You will be looking for triggers (both physical and psychological/emotional or stress related) and patterns for your pain. This is your starting point for have an improved relationship with your pain.

Pain journaling is a common tool in chronic pain management and many of you have probably already been exposed to this concept. In the exercise below I’m showing you one of the pain journaling assignments I used effectively with many of my chronic pain patients. Remember, this is just one way of pain journaling—not the only way.

Please Follow the Six Steps Below

• In your journal at least two times per day list the type of pain—also note whether it is more physiological or psychological/emotional—and the highest level of pain (using the 0 to 10 pain scale) that you are experiencing and why you rated it that way.
• Note what you do for your pain (i.e., medication, stretching, exercise, massage, etc) and how well it works (on 0 to 10 scale with 0 meaning not at all and 10 meaning totally).
• Identify what you were doing (that day or earlier) that may have triggered the pain and make note any ways you could avoid those situations (triggers) in the future. Be sure to include both physical triggers and stress or emotional triggers.
• Identify any negative (self-defeating or addictive) thoughts you are having because of your pain.
• Identify any uncomfortable feelings you are having because of your pain.
• At the end of each day identify the most important thing you learned about your pain and commit to one thing that you will do differently to improve your pain management.

To learn about the imporance of using a multi-faceted approach to chronic pain management please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you’d like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I’m very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in our new office in Sacramento on November 11-13, 2010. To learn more about this 3 day 20 hour training and my other upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, especially if you’re in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

When you live with chronic pain it can become very frustrating when you aren’t getting the pain relief you want. I know that when I experience a pain flare up my first reaction is I want it to stop—now! Many of the pain medications were developed for acute pain conditions. It can soon become very problematic when you use an acute pain plan on a chronic pain condition. Some people have a need for instant gratification (I want it and I want it now). Unfortunately, some of the acute pain medication leads people into this instant gratification trap—looking for the quick fix.

Telling the difference between appropriate and effective use of pain medication and the beginning of medication abuse can sometimes be difficult for you or your healthcare providers to determine. There are progressive stages of problematic use including medication dependency, medication abuse, pseudo-addiction, and finally addiction. The confusion and uncertainty of this progression is a challenge for both you and your treatment provider.

Some people living with chronic pain are afraid to take their narcotic (opiates, benzodiazepines, etc.) medication because they have heard horror stories of people getting hooked on pain pills. This leads to a decision to under-medicate and to suffering as a result. If you happen to be in recovery for alcoholism or any other drug addiction the problem is even worse. If you under-medicate it could trigger a relapse. Of course the other side of the coin is overmedication; which could lead to rapid tolerance building and finally reactivation of your addiction.

It is crucial to take an honest look at your relationship with pain medication.  Differentiating between appropriate use of pain medication and the beginning of abuse can sometimes be difficult for you or your healthcare providers to determine.  There are progressive stages of problematic use including medication dependency, medication abuse, pseudo-addiction, and finally addiction.  The confusion and uncertainty of this progression is a challenge for both you and your treatment provider.

To learn more about the quick fix mentality in chronic pain management, please check out my article Chronic Pain Management Needs More Than a Quick Fix that you can download for free on our Article page.

If you’d like to receive training for helping people with relapse prevention, I’m very excited to announce that the Gorski-CENAPS Corporation is presenting The Relapse Prevention Therapy44 Hour Certification Training in Ft. Lauderdale October 18-22, 2010. To learn more about this 5 day 44 hour training you can check out our Calendar page.

You can learn about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Our pain system is a crucial component of our makeup and essential to our ongoing survival.  Could you imagine how bad it could get if we didn’t have pain receptors and kept putting ourselves in situations that could seriously damage our body?  Imagine that you’re in the kitchen talking on the phone and you put your hand down on a hot burner.  Without pain receptors your first indication that something was wrong would be your flesh burning.

Impaired Pain System Can Lead to Chronic Pain

As with any sensory system, pain receptors and circuits can become impaired, resulting in chronic pain that cannot be attributed to any identifiable physical problem. The greatest challenge with regard to understanding the biological aspects of pain is not knowing why the pain sometimes continues even after a painful stimulus has been removed.

Recurrent Acute Pain

There is also another classification of pain that is called acute recurrent pain which is when the individual suffers from pain episodes with pain free periods in between. The pain episodes are usually brief (e.g., lasting from minutes to an hour or so) and are often associated with an identifiable physical process (such as migraine headaches, sickle cell anemia, back sprain, etc).

Anticipatory Pain

When you live with chronic pain you hurt.  Doing certain things can make you hurt worse. So you come to believe that these things will always cause you to hurt. In other words, you associate those things with your pain. You believe that every time you do those things, you will have pain.

Because you believe that you are going to hurt, you can activate the physiological pain system just by thinking about doing something that you believe will cause you to hurt. This is called anticipatory pain.  You anticipate that something will make you hurt, which in turn activates your physiological pain system. You often start hurting even before you begin doing whatever it is that you believe will cause you to hurt. All you have to do is to start thinking about doing that thing. This process is what often leads to suffering.

Pain versus Suffering

The psychological meaning that you assign to a physical pain signal will determine whether you simply feel pain (“Ouch, this hurts!”) or experience suffering (“Because I hurt, something awful or terrible is happening!”). Although pain and suffering are often used interchangeably, there is an important distinction that needs to be made. Pain is an unpleasant signal telling you that something is wrong with your body. Suffering results from the meaning or interpretation your brain assigns to the pain signal.

Many people irrationally believe that: “I shouldn’t have pain!” or “Because I have pain and I’m having trouble managing my pain, there must be something wrong with me.” A big step toward effective pain management occurs when you can reduce your level of suffering by identifying and changing your irrational thinking and beliefs about the pain, which in turn decreases your stress and overall suffering.

Because of these two components—pain and suffering—pain management must also have two components: physical and psychological. The way people sense or experience pain—its intensity and duration—will affect how well they are able to manage it. It may be an unrealistic goal to become totally pain free but I can promise that if you are willing to follow through and complete the work required—you will never have to “suffer” with your chronic pain again.

To learn more about pain and suffering for more effectivce chronic pain management please check out my article Pain versus Suffering that you can download for free on our Article page. In addition, please take a look at a more recent article along similar lines Moving Beyond Anticipatory Pain for Effective Chronic Pain Management that you can also download for free.

If you’d like to receive training for helping people with relapse prevention, I’m very excited to announce that the Gorski-CENAPS Corporation is presenting The Relapse Prevention Therapy44 Hour Certification Training in Ft. Lauderdale October 18-22, 2010. To learn more about this 5 day 44 hour training you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, especially if you’re in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

It is very important when you are confronted with a decision to make a significant lifestyle change that you carefully weigh the pros and cons (i.e., benefits and disadvantages) of making that transition. It is easy for many people who have been eating addictively to see the disadvantages or negative consequences of that behavior (i.e., obesity, heart problems, joint problems, etc.). Therefore, it is often difficult to admit that they mistakenly believe there is a benefit to eating addictively—in this case to help cope with their chronic pain condition.

Some people use eating to cope with uncomfortable emotions or to deal with the consequences of having poor social skills and lack of friendships. Others use eating to avoid intimacy by making food their best friend. There must be some benefits to your eating inappropriately or you wouldn’t have started eating to cope instead of for fuel. These benefits are sometimes called secondary gains. Being open to seeing that this may be a problem is the first step toward change.

To read a bit more about this topic that includes a review of the Eating Addiction Relapse Prevention Workbook please check out my article Eating Addiction Needs a Strategic Relapse Prevention Protocol that you can download for free on our Article page.

If you’d like to receive training for helping people with relapse prevention, I’m very excited to announce that the Gorski-CENAPS Corporation is presenting The Relapse Prevention Therapy44 Hour Certification Training in Ft. Lauderdale October 18-22, 2010. To learn more about this 5 day 44 hour training you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, and are experiencing problems with using food to cope or other eating addiction problems please go to our Publications page and check out my book; the Eating Addiction Relapse Prevention Workbook. Many of my patients have found benefit from completing this workbook.  To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.