The Role of Phone Coaching in Chronic Pain Management

Today I would like to inform you about the telephone Addiction-Free Pain Management® (APM) Coaching services we offer. If you’re not sure if coaching is for you (or your clients) please go to our Coaching page and click on the Coaching Questionnaire link near the end of the page. If you’re interested in receiving free information and an overview of these services go our Contact page and send a request for this information. Below I want to cover why we believe APM™ Coaching works and the benefits you can receive from coaching.

Why APM™ Coaching Works

The main reason APM™ coaching works is that you’re hiring someone with greater experience than you in pain management and relapse prevention. Your APM™ Certified coach can quickly identify patterns that may not be clear to you. Then your coach can help you devise and implement solutions. When this works well, it’s a very high-leverage relationship. It’s one of the fastest ways to solve challenging problems. Similarly, a good coach will have superior knowledge and experience in the area(s) in which you want to improve.

A coach can use all of this expertise to help you solve specific problems efficiently. This is essentially a variation on the principle of overwhelming force. A pain management or relapse prevention problem that may seem daunting to you might be a fairly simple matter for an experienced APM™ coach.

The real challenge of APM™ coaching is for your coach to help you implement the solutions to your specific problems. Coming up with solutions is easy. Implementing those solutions is the hard part. That’s where good APM™ coaching really performs. Your APM™ coach can work as a guide to help you stay on track, leading you safely through the quagmire of mistakes, blind alleys, and delays.

Benefits of APM™ Coaching

Achievement means the delivery extraordinary results and individual goals achieved, strategies, projects and plans executed. It suggests effectiveness, creativity, and innovation. Effective APM™ coaching delivers achievement, which is sustainable. Because of the emphasis on learning and because your confidence is enhanced ('I worked it out for myself!') the increase in performance is typically sustained for a longer period and will impact on areas that were not directly the subject of coaching.

Fulfillment includes learning and development. To achieve the result is one thing, to achieve it in a way in which you learn and develop as part of the process has a greater value - to you and your coach, for it is the capacity to learn that ensures your going quality of life. Fulfillment also includes the notion that going through coaching you begin to identify goals that are intrinsically rewarding. With fulfillment comes an increase in motivation. That the APM™ coach respects you, your ideas and opinions, that you are doing your work in your own way, that you are pursuing your own goals and are responsible - all this makes you much more inspired and committed.

Joy. Enjoyment ensues when people are achieving their meaningful goals and when learning and developing is part of the process.

These three components – achievement, fulfillment, and joy – are synergistically interlinked and the absence of any one will impact and erode the others. Learning without achievement quickly exhausts your energy. Achievement without learning soon becomes boring. The absence of joy and fun erodes the human spirit.

To learn about the my views on quality treatment please go to my article The Right to Quality Chronic Pain Management that you can download for free on our Ariticles page.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

You can learn more about the Addiction-Free Pain Management® System at our website http://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.

Chronic Pain Management and Neuroplasticity

A surprising consequence of neuroplasticity is that the brain activity associated with a given function can move to a different location as a consequence of normal experience or brain damage/recovery. In the case of chronic pain this can mean that pain signals keep occurring despite lack of a trigger or tissue damage.

According to research published in Annals of the New York Academy of Sciences (2001) titled Spinal Cord Neuroplasticity following Repeated Opioid Exposure and Its Relation to Pathological Pain; convincing evidence has accumulated that indicates there are neuroplastic changes within the spinal cord in response to repeated exposure to opioids. Such neuroplastic changes occur at both cellular and intracellular levels.

Unfortunately, most pain conditions in this country are treated with opiates—some research shows as high as 90 percent of people undergoing pain management are prescribed opiates. With so many people living with chronic pain and using opiates, these neuroplastic changes need to be better understood.

I like to use simple language and metaphors or visual images when educating my patients. Many people may not understand the term Neuroplasticity so I use the metaphor of the hijacked brain. I tell them the reality of neuroplasticity science is much more complex, but in essence what happens is that the brain forms pathways (called neuro-networks) that eventually become super highways—in other words the new neuro-network becomes more complex and elaborate. Another major problem is the deeper the trance goes the less obvious it becomes. In fact, our inner saboteur (AKA denial) often surfaces at this point and our problem can get even worse.

To learn more about neuroplasticity please go to our 2008 News and Research Archive and scroll down to the posting The Role of Neuroplasticity in Chronic Pain Management that you can download for free.

To learn about the inner saboteur and chronic pain management please check out my article From Denial to Effective Chronic Pain Management that you can download for free on our Article page.

You can learn more about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people in chronic pain or if you are someone living with chronic pain and think you may have any resistance or denial and want to learn how to develop a plan for identifying and managing denial please go to our Publications page and check out my book the Denial Management Counseling for Effective Pain Management Workbook. To purchase this book please Click Here.

To learn more about my upcoming trainings check out our Training News Update by Clicking Here. You can also go to our Training Calendar to sign up for any or all of these great training opportunities.

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.

Resistance And Denial in Chronic Pain Management

For over 26 years I’ve worked with patients living with chronic pain who also developed coexisting psychological disorders, including addiction, as a result of living with debilitating chronic pain. One of the tools that I was able to adapt was Terence T. Gorski’s Denial Management Counseling for Addictive Disorders. I modified his denial management system to work with other coexisting disorders including chronic pain.

In my early pain management recovery I often set myself up for setbacks. I have the personality type of “more is better” and always pushed the envelope. It took me a while to see how this was self-defeating behavior. The first thing that often happened after my setback was a feeling of hopelessness and frustration—“I’m always going to be this way.” This second self-defeating mindset is one of the 12 common denial patterns—Strategic Hopelessness; AKA Diagnosing Myself as Beyond Hope.

Unfortunately, unrecognized denial can lead to severe consequences. For example the population I work with is people with chronic pain and many of them have coexisting additive disorders but are in denial about what the addiction is doing to them and those they love.

My first publication in this area is the Denial Management Counseling for Effective Pain Management Workbook. This workbook was designed for people who have experienced significant problems related to living with chronic pain, but who honestly don’t believe—or don’t want to believe—that their self-defeating decisions and behaviors are undermining what could be an effective pain management plan. This process is an important component of the Addiction-Free Pain Management® System.

To learn more about chronic pain management and denial please check out my article From Denial to Effective Pain Management that you can download for free on our Article page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people in chronic pain or are living with chronic pain and have any resistance or denial and want to learn how to develop a plan for helping to identify and manage denial please go to our Publications page and check out my book the Denial Management Counseling for Effective Pain Management Workbook. To purchase this book please Click Here.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

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.

Chronic Pain Management and the FDA Panel Recommendations

A Federal Drug Administration (FDA) panel voted narrowly (20 to 17) in June 2009 to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver.

I have mixed thoughts about the efficacy of this proposed ban. On one hand, I have seen the quality of life improve for many people who received adequate pain relief from this type of medication. But I have also worked with people who abused them. Understandably many healthcare providers don’t understand the logic behind banning a drug which, when taken as prescribed, won’t harm a patient.

The FDA's Drug Safety and Risk Management Advisory Committee said in their report that the agency should ban the two prescription painkillers, Percocet and Vicodin, due to their high levels of acetaminophen and the ease with which patients can become addicted to them. Acetaminophen is also combined with different narcotics in at least seven other prescription drugs, and all of these combination pills will be banned if the Food and Drug Administration heeds the advice of this panel.

One of the reasons I am taking this issue so seriously is the impact this proposed ban will have on pain management. Not just for acute pain situations like serious bone breaks, major dental procedures etc., but also in the chronic pain management arena. Many healthcare providers have traditionally prescribed medications like Vicodin and Percocet to address breakthrough pain for people undergoing cancer treatment or other serious types of chronic pain conditions.

Whatever the outcome from the FDA, I believe it is important that anyone undergoing chronic pain management should develop a safe and effective medication management plan if they are on any medications that have serious risk factors, as well as looking at the psychological factors that accompany a pain condition, and what non-medication approaches can be implemented.

I Recommend This Three Part Approach To Developing
An Effective Chronic Pain Management Plan

1. Medication Management which includes a medication management agreement;


2. Cognitive-Behavioral Treatment that addresses pain versus suffering by learning how to managing thoughts and feelings, as well as changing self-defeating behaviors and problematic social/family reactions; and


3. Nonpharmacological (non-medication) Interventions which supports the development of safer ways to manage pain.

To learn more about how to developing a medication management plan please check out my last month’s article 12 Personal Action Steps for Chronic Pain Management that you can download for free on our Ariticles page.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

You can learn more 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.

Avoidance by Distraction in Chronic Pain Management

When necessary I have learned—and taught many other people—that avoidance by distracting myself will help take the focus off the unpleasant sensation of pain. Earlier this week I traveled to Palm Beach Florida to present at the Moment of Change Interventionist Conference and had a very long travel day due to mechanical problems and weather delays. I was only able to get four hours of sleep and then I woke up with the start of a migraine headache. I had to "practice what I preach" and used avoidance by distraction.

The pain didn’t magically "go away" but it was much less problematic when I focused on something more interesting and exciting for example. In this case I used being fully present to my workshop audience to take the focus off of my pain. When I’m out teaching or training people I can put my entire focus on them. At other times I shared with my friends there about what was going on with them. Then I went for a walk in by the beautiful beach right outside the conference center.

Dose this always work? Of course not. But it does help take the edge off while I implement other nonpharmacological pain management tools or take appropriately prescribed medication in rare instances. My pain management is not a rigid approach but it first and foremost must always protect my recovery. I’m always looking for new ways to live with pain flare ups because sometimes they come at the most inconvenient times.

A final word of caution: Using distracting or avoidance techniques should not be used until you are sure that it won’t make your overall situation worse. I’ve made that particular mistake many times and ended up causing myself more pain than I needed to have. Remember, pain is a signal that something is wrong and needs attention. Unfortunately though, sometimes pain signals get turned on or amplified when no actual damage or danger is present. Telling the difference is a very important part of ongoing chronic pain management.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

You can learn more about the Addiction-Free Pain Management® System at our website http://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.