Experience Chronic Pain Management without Suffering

Whenever you are experiencing pain, it’s helpful to ask: What is my pain trying to tell me? Pain is the signal that says something is wrong; that you need to find out what is it, and then learn how to manage it. Sometimes it can be difficult if not impossible to pinpoint the pain generator, and as human beings we want to know why something is happening and we want to know “right now.” But when we’re in pain the more important question is: What can I do, right now, to manage my pain in a healthy way that supports me physically, emotionally and spiritually? The answer will be different for each person.

But what if you can’t answer that question because your chronic pain has become unmanageable, no matter what you try? This brings us to a discussion of 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 (This pain is awful and will just keep getting worse; this is terrible and why is it happening to me!). Although pain and suffering are often used interchangeably, there is an important distinction that needs to be made. Pain is a physical sensation, a warning signal telling you that something is going on in your body. Suffering results from the meaning or interpretation your brain assigns to the pain signal.

Many people 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 chronic pain management occurs when you can reduce your level of suffering by identifying and changing your thinking and beliefs about your pain, which in turn can decrease your stress and overall suffering. Because of the two parts—pain and suffering—chronic pain management must also have two components: physical and psychological. The way you sense or experience pain—its intensity and duration—will affect how well you are able to manage it.

To learn more about how to effectively address chronic pain and suffering please check out my article Pain Versus Suffering in 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 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.

Chronic Pain Management and Antidepressants

Not everyone with chronic pain and depression will need antidepressant medications. However, this class of medication may be indicated for several reasons; one is that many people living with chronic pain disorders become clinically depressed. The Addiction-Free Pain Management® System suggests a full biopsychosocial evaluation to determine the severity of the problem before any medications are prescribed.

Situational depression responds best to cognitive behavioral therapy and in those cases medications are not necessary. Other types (bipolar) may need a medical intervention in addition to psychotherapy. There are many different types or classifications of antidepressants to choose from, therefore a specialist should be consulted to determine the most effective medication for each person.

Pain reduction is another key factor to consider using an antidepressant. For example the use of tricyclic antidepressants has been an effective tool in pain management for years. The tricyclic medication Elavil (amitriptyline) is frequently used to treat and help prevent migraine headaches. These antidepressants have been able to provide relief for nerve pain and often result in lowering the dose of opiate medications. Since sleep disturbances often accompany both chronic pain and depression some healthcare providers use this type of medication as a sleep aid.

Another class of newer antidepressants is the SSRIs (selective serotonin reuptake inhibitors). Many pain management specialists utilize this type of medication for chronic pain treatment particularly for people who live with constant debilitating chronic pain, as their serotonin system becomes depleted. This type of medication is good for both depression as well as improving pain management.

SSRIs like Prozac, Effexor, Lexapro, or Celexa, improve mood as well as help relieve pain, reduce fatigue and improve sleep problems. There have been reports about SSRIs being helpful for some types of neuropathic pain symptoms. Some studies also suggest that using an SSRI and a tricyclic antidepressant (such as amitriptyline) together may be more successful at breaking the cycle of pain, depression, and sleep problems caused by fibromyalgia than using just either one alone.

In addition, these three antidepressant medications can also be very helpful; Cymbalta and Effexor, which block the reuptake of serotonin and norepenepherine and Wellbutrin, which alters the levels of norepenepherine and dopamine. Cymbalta is a versatile medication that is FDA approved to treat depression and certain types of neuropathic pain. Norepenepherine, serotonin, and dopamine are neurotransmitters that not only affect depression but also pain management. Many pain management specialists recognize that combining different medications creates a synergistic effect for both pain management and improving depression.

The good news is that there are many different management and treatment options for depression. Try to remember that overcoming depression can take time and someone living with chronic pain and depression will need to stay strong and focused when faced with tough pain days. They will also need to reach out for support to keep them from becoming isolated. The important thing to remember is that overcoming depression is achievable with the right team and the right plan!

To learn more about the importance of identifying and treating depression for more effectivce chronic pain management please check out my article Depression Management with the Chronic Pain Patient 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 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.

Effective Chronic Pain Management Using Phone/Cyber Coaching

Many people living with chronic pain with coexisting psychological disorders including addiction, are unwilling or unable to go into a structured treatment program. Sometimes this is due to not having quality programs in their immediate area. Other times it can be due to the financial commitment some of these inpatient or residential programs require. While for others it is not wanting to be stigmatized or pathologized (sick, bad etc.). This is where phone or cyber coaching can fit in.

Addiction-Free Pain Management® (APM)
Coaching Program

The purpose of APM™ Relapse Prevention Coaching is to guide people who are living with chronic pain and may be struggling with pain medication issues to become active participants in their healing process. They will learn a strategic set of new pain management protocols that will help them to recover their health and regain their independence, thereby improving the quality of their life. Most importantly, participants will discover a light at the end of the long dark tunnel their life of pain has become.

With the assistance and the support of a Certified Coach, clients will experience the seven clinical processes that help them to quickly identify and manage high-risk situations that cause relapse. They will receive expert guidance in setting powerful recovery goals and implementing specific actions plans to facilitate their continued recovery.

The foundation of our Relapse Prevention Coaching Program is the evidence-based work and 40 years experience of Terence T. Gorski's Developmental Model of Recovery. As an Advanced Relapse Prevention Specialist and Director of Training and Consultation for the CENAPS® Corporation, my expertise in denial, relapse prevention and co-existing disorders underlie his biopsychosocial, multidisciplinary approach utilizing an ongoing continuum of care that incorporates strategic, cognitive-behavioral skill building exercises in conjunction with powerful solution-focused and strength-based coaching methodologies.

If people knew they could participate from anywhere using their phone and/or a computer, and that they could become active participants in their healing by participating in our coaching program, we feel confident that their feelings of helplessness and hopelessness would disappear.

Check out our Coaching Questionnaire which is the first step of deciding if you or someone you know is ready for APM or Relapse Prevention Coaching, or call Ellen at 916-575-9961f or a confidential interview.

If you want more information on relapse prevention for chronic pain management please check out my article Relpase Prevention and Chronic Pain Management, that you can download for free on our Ariticles 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 Sacramento on August 5-7, 2010. 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 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.

Moving Beyond Anticipatory Pain in Chronic Pain Management

I believe it is important for people living with chronic pain to understand that sometimes what you most fear you actually create. 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 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 actually activate the physiological pain system just by thinking about doing something that you believe will cause you to hurt. This is called anticipatory pain.　

Once the physical pain system is activated, the anticipatory pain reaction can actually make your pain symptoms worse. Whenever you feel the pain, you interpret it in a way that makes it worse. You start thinking about the pain in a way that actually makes it worse. You tell yourself that the pain is "awful and terrible," and that "I can't handle the pain." You convince yourself that "it’s hopeless, I’ll always hurt, and there’s nothing I can do about it."　

This way of thinking causes you to develop emotional reactions that further intensify or amplify the pain response. The increased perception of pain causes you to keep changing your behavior in ways that create even more unnecessary limitations and more emotional discomfort. This can make you feel trapped in a progressive cycle of disability.　

In 2007 I wrote published an article titled Coping with Anticipatory Pain that is on our Article Archive. A couple of months ago I decided to publish a new article titled Moving Beyond Anticipatory Pain for Effective Chronic Pain Management, that you can download for free on our Ariticles 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 Sacramento on August 5-7, 2010. To learn more about this 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 http://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.

Chronic Pain Management with Neuropathy

Neuropathic pain is a complex chronic pain state that is usually accompanied by tissue injury. With this type of pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send erroneous signals to other pain centers in your brain. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.

According to the Neuropathic Pain Network, somewhere between five to twenty-three million people (that’s between 2 to 8 percent of our population) are living with neuropathic pain in the United States. Unfortunately, it is a syndrome that is often under-diagnosed and under-treated.

Some of the symptoms of neuropathic pain including shooting pain, burning pain, tingling, and numbness. An example of neuropathic allodynia—a non-harmful stimulus perceived as painful—is rough clothing rubbing on your skin which you feel as if it were sandpaper; another example would be someone shaking your hand in what is really a gentle grasp but you feel it as crushing or excruciating.

Another striking example of neuropathic pain is called phantom limb syndrome. This occurs when a limb like an arm or a leg has been removed because of illness or injury. The brain still receives (or perceives) pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.

As anyone living with neuropathic pain knows the treatment can be frustrating and often ineffective. While acute short-term pain is usually easy to manage and most chronic pain management conditions can be treated effectively, neuropathic pain can be a major treatment challenge for both patients and their healthcare providers. Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability.

The capsaicin patch could be a much needed tool for many people experiencing neuropathic pain symptoms and find that other pain management medications (e.g., opiates or SSRI’s and SNRI’s) are not helping or have too many side effects. Of course medication management is only one component of an effective pain management treatment plan.

I believe that people also need to be developing nonpharmacological interventions as well as learning to better manage the psychological/emotional components of their pain. For those symptoms cognitive behavioral and rational emotive therapeutic interventions give the best outcomes.

To learn more about effective chronic pain management 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 Sacramento on August 5-7, 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.

Positive Chronic Pain Management Outcomes Require Coping with Denial

Two Antidotes for Denial:

1. Peaceful Acceptance and

2. Problem Solving with Authentic Action

Acceptance is a peaceful acknowledgement of the truth. If you can calmly face the problem, acknowledge the truth about what is going on, and accept that it is happening to you, you can then develop a way for handling the situation. The person who has accepted the truth of a serious problem has the ability to honestly affirm to themselves: "I have a serious problem! I am responsible for dealing with it! I'm willing to learn how!"

Problem Solving is a system for finding solutions to your problems. Effective problem solving systems involve identification and clarification of your problems, identifying and projecting the logical consequences of alternatives, deciding which alternative to use, taking action, and evaluating the outcome. By recognizing and accepting the problem and developing an effective problem solving plan, your need to use denial will go down because your ability to manage your problems will go up.

This was the reason I teamed up with Terry Gorski and Jennifer Messier to write the Denial Management Counseling (DMC) for Effective Pain Management Workbook that could be a helpful resource for some of you reading this Blog. I believe that learning to identify and manage denial is a necessary first step for people living with chronic pain who want to learn how to develop and implement an effective pain management plan.

The DMC/Pain Workbook is 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 decisions and behaviors are undermining what could be an effective pain management plan. It can be one important tool to help someone identify and learn to manage their inner saboteur.

To learn more about chronic pain management and denial please check out my article From Denial to 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 presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this 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 http://www.addiction-free.com/ If you are working with people in chronic pain or are undergoing chronic pain management 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.

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 May Lead to Long-Term Opiate Problems

According to researched published in Pain Physician Journal (2006), 90 percent of people in the US receiving treatment for pain management are prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. Unfotunately, this is not the only problem with prolonged use of opiates.

Neuroplasticity (variously referred to as brain plasticity or cortical plasticity or cortical re-mapping) refers to the changes that occur in the organization of the brain as a result of experience. 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.

According to research published in Annals of the New York Academy of Sciences 933:175-184 (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. Since so many people living with chronic pain are using opiates these neuroplastic changes need to be better understood.

Learn more about the down side of long-term opiate use in chronic pain management by reading my 2009 News and Research Post titled Long-Term Opioid Use May Increase Sensitivity to Chronic Pain that you can read by going to this link and scrolling down the page to that title.

To learn more about effective 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 Sacramento on August 5-7, 2010. 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 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.

To see an online overview of a Web-Based Delivery of Addiction-Free Pain Management® please go to this Link for a free demo.

The Suboxone Controversy

Last month I posted a new article on our website on Suboxone. I'm including a few paragraphs below.

There is a difference of opinions on whether patients should be maintained on Suboxone (buprenorphine) or go through a total detoxification for opiate addiction. A similar debate has been going on for decades about another medication used for opiate addiction treatment—methadone. I would like to propose a third option: using the medication as a transitional treatment intervention with eventual discontinuation.

Unlike methadone physicians are more likely to prescribe Suboxone in their offices for people who are dependent or addicted to opiates such as opiate pain medication, heroin, or methadone. Buprenorphine (the active treatment medication in Suboxone) is a more convenient maintenance medication for opiate addiction because it does not require daily or weekly visits to a clinic. Buprenorphine blocks the effects of other opiates; it reduces or eliminates cravings and prevents withdrawal symptoms such as pain and nausea.

Subutex and Suboxone are the brand names that buprenorphine is being marketed as for the treatment of opiate dependence. Both medications contain the active ingredient buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence. Subutex contains only buprenorphine hydrochloride which was developed as the initial product.

Please check out this entire article titled Revisiting Suboxone: Maintenance versus Total Detoxification that you can download for free on our Article 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.

To see an online overview of Cognit delivering Addiction-Free Pain Management® please go to this Link for a free demo.

To learn about my upcoming trainings you can check out our Calendar page.

Telephone Coaching for Relapse Prevention

People undergoing chronic pain management need all the support they can get. If they also experience some of the common coexisting problems such as addiction or other mental health conditions relapse prevention is crucial. The Addiction-Free Pain Management® (APM) Relapse Prevention telephone coaching may be the missing piece for ultimate success for effective chronic pain management. Our coaching programs are also for anyone in recovery from any addictive disorder and will help people develop essential tools for avoiding future relapse.

Our Relapse Prevention Coaching services are individualized coaching sessions for anyone who is in recovery from an addiction and the use of self-defeating, self-destructive behaviors and wants to learn how to recognize and effectively manage situations that put their recovery at risk. It is especially helpful for individuals who have had relapse episodes, but anyone in recovery will find it useful. We combine the Gorski-CENAPS® relapse prevention methodology with personal empowerment coaching strategies to create a powerful foundation for long-term stable sobriety.

The Relapse Prevention Coaching Programs can assist individuals leaving treatment and support those people who cannot or chose not to go into traditional treatment programs. They are also invaluable for people who have had limited success with outpatient treatment, or for those who want to enhance their current program and learn how to put these powerful relapse prevention tools to work in their lives.

With the assistance and the support of a Certified Coach, clients will experience the seven clinical processes that help them to quickly identify and manage high-risk situations that cause relapse. They will receive expert guidance in setting powerful recovery goals and implementing specific actions plans to facilitate their continued recovery.

The foundation of our Relapse Prevention Coaching Program is the evidence-based work and 35 years experience of Terence T. Gorski's Developmental Model of Recovery. As an Advanced Relapse Prevention Specialist and Director of Training and Consultation for the CENAPS® Corporation, my expertise in denial, relapse prevention and co-existing disorders underlie his biopsychosocial, multidisciplinary approach utilizing an ongoing continuum of care that incorporates strategic, cognitive-behavioral skill building exercises in conjunction with powerful solution-focused and strength-based coaching methodologies.

If people knew they could participate from anywhere using their phone and a computer, and that they could become active participants in their healing by participating in our coaching program, we feel confident that their feelings of helplessness and hopelessness would disappear.

Check out our Coaching Questionnaire which is the first step of deciding if you or someone you know is ready for APM Relapse Prevention Coaching, or call Ellen at 916-575-9961for a confidential interview.

If you want more information on relapse prevention for chronic pain management please go to our website and on the articles page archive click on my article Relpase Prevention and Chronic Pain Management, that you can download for free on our Ariticles page.

To learn more about effective chronic pain management check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Articles page.

You can learn 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.

To see an online overview of Cognit delivering Addiction-Free Pain Management® please go to this Link for a free demo.

To learn about my upcoming trainings you can check out our Calendar page.

Check out a Free Demo of Addiction-Free Pain Management®

We now have an overview of the Addiction-Free Pain Management® System Powered by Cognit. To see an online overview of Cognit delivering APM please go to this Link for a free demo.

Cognit is a powerful web-based recovery tool using Terence T. Gorski’s 40 years of expertise in addiction recovery and relapse prevention as well as my 27 years of work with people living with chronic pain management conditions including coexisting psychological problems including addiction.

Cognit provides individuals, treatment centers and other organizations who offer addiction and/or mental health treatment with web-based educational and self-awareness tools. Cognit supports and enhances all stages, as well as modalities, of treatment and recovery for people who suffer from addiction and related mental health issues. The Cognit process combines educational content, self application E-Workbook exercises, session quizzes as well as self-awareness inventories that were developed by Cognit co-founder Wayne Blampied.

The Cognit system acts as a support umbrella from pre-treatment, to the earliest stages of treatment and all the way through late recovery. No matter what course recovery takes, Cognit supports the entire process. The true value of Cognit is in its ability to assist in the treatment process by offering effective, consistent, science-based, easy to use educational content and its ability to assess and quantify a patient’s progress.

You can learn 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.

To learn about my upcoming trainings you can check out our Calendar page.

Personal Impowerment for Effective Chronic Pain Management

I believe an important part of effective chronic pain management is understanding everything you can about your pain and then learning some effective tools that will allow you to respond in an appropriate way so that you can improve the quality of life. Whenever you experience pain, it is always appropriate to ask: "What is my pain trying to tell me?" Remember, pain is trying to tell you that something is wrong, that you should find out exactly what it is, and find a way to address it—not mask it.

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.

Knowledge is Power

To effectively manage a pain condition it is important that you understand exactly what is going on with your body. When you are in pain you experience both physical and psychological symptoms. To understand the language of pain, you must learn to listen to how the pain echoes and reverberates between the physical, psychological, and social dimensions of your human condition. Pain is truly a total human experience that affects all aspects of human functioning.

Personal empowerment is the best—and only—way out

When you are in pain for a long period of time you can begin feeling victimized by your pain. You hate your pain. You want to escape from your pain and are willing to do anything to obtain relief. Unfortunately, the way out for many people leads to self-defeating behaviors, including abusing pain medication.

To learn more about effective 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.

To learn about my upcoming trainings you can check out our Calendar page.

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

We Need To Improve Chronic Pain Management

Reducing the burden of uncontrolled chronic pain is a societal necessity, a medical challenge and an economic requirement. Chronic pain, if not recognized and treated as a chronic illness, takes an enormous personal toll on millions of patients and their families, and leads to increased health care costs.

Chronic pain can also compromise the productivity of the U.S. workforce. Although the impact of pain on patients and on society is among the most serious of public health concerns, chronic pain has been largely left out of the current national debate on health reform. The nation must take the necessary steps to re-define chronic pain as a unique chronic illness and must immediately address this public health crisis.

To learn more on the need to improve both access and quality of chronic pain management please check out our News & Research post this month on Chronic Pain Management Must Improve.

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

To learn about my upcoming trainings you can check out our Calendar page.

An Attitude Gratitude - AKA Counting My Blessings

As we begin a new year I always look back at the past year to remind myself of all that I’m grateful for. This is a simple process for me as I complete a daily gratitude journal of 5-10 specific things I’m grateful for each day. At the end of each month I review all of the days and pick my top 20 Gratitudes for that month. Now as the year ends I review each month’s top 20 and pick the top 20 things I’m grateful for that year.

You may be wondering; what does gratitude lists have to do with chronic pain management? A LOT! When people live with chronic pain on a daily basis they can become discouraged, frustrated, and very depressed. One of the tools I use and teach to my patients is to look at what they're grateful for in every situation.

I also want to encourage people to focus on what they want—not what they don’t want. So instead of the focus being I don’t want to hurt or live with this unbearable pain; I encourage people to instead focus on enjoying what they have and what they are grateful for.

Of course chronic pain management is not that simple but I believe that focusing on gratitude is a necessary component for any one living with chronic pain. To learn about some roadblocks for effective chronic pain management and ways to overcome adversity please read my latest article Overcoming Obstacles for Effective Chronic Pain Management that you can download for free on our Ariticles 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 and want to learn how to develop a plan for managing their pain and coexisting psychological disorders including depression or addiction effectively please go to our Publications page and check out my book the Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.


To learn about my upcoming trainings you can check out our Calendar page.

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.

Nine Sleep Hygiene Tips for More Effective Chronic Pain Management

I’m often asked by patients and people at my trainings "when someone has chronic pain and addiction, what can they do for sleep problems because they can’t safely take many of the sleep medications." Well first of all I don’t think it’s a good idea for anyone to become dependent on sleeping pills. If you look at the patient education information on most sleep medications you will see that it tells you that they are not intended for chronic use.

So what do you do when you live with chronic pain and need to sleep? Do you give in and use potentially dangerous sleep medications or just suffer? Most authorities recommend practicing good sleep hygiene, along with becoming very familiar with their sleep deprivation problem (i.e. understanding the cause). Sleep hygiene refers to the habits, environmental factors, and practices that may influence the length and quality of your sleep. These include bedtime, nighttime rituals, and disruptions to one's sleep. These are typically represented by simple guidelines meant to effectively promote a good night's rest.

If sleep problems persist after implementing sleep hygiene practices, it may then be the time to seek medical help. But what is sleep hygiene? Below I’m putting 9 sleep tips that I found on About.com , a website devoted to educating people about back and neck pain. If you want to see more about sleep hygiene please go to that website and type in “Sleep Hygiene.”

1. Relax before bedtime


2. Make sure your bedroom is quiet, dark, cool, and comfortable


3. Make sleep a priority: don’t sacrifice sleep to do daytime activities


4. Get up and go to bed at the same time every day, even on weekends


5. Avoid caffeine and other stimulants


6. Don’t smoke - in bed or at all


7. Exercise every day, but avoid doing it 4 hours before bedtime


8. Bedrooms are for sleeping and sex, not for watching television or doing work


9. Don’t take naps

I’ve been helping people with this problem for a long time and have actually used most of interventions listed above. One of the tools I also recommend for many of my patients is to use headphones with relaxation techniques, soothing sounds or music to help them to sleep. I also teach people relaxation response techniques that take about 7-10 minutes and one of the positive side effects is a reduction in their sensation of pain.

If you want more information on chronic pain management and sleep problems please go to our website and check out my article Chronic Pain Management and the Role of Sleep Disturbances , that you can download for free on our Ariticles 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.

To listen to a radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

Chronic Pain Management and Addictive Disorders

According to researched published in Pain Physician Journal as recently as 2006, 90 percent of people in the US receiving treatment for pain management were prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. The research also stated that 16 percent of pain management patients experienced illicit drug use along with their prescribed medication, and as high as 34 percent in other research they reviewed. These numbers give a picture of the overall problem of chronic pain abuse/addiction problems in the general population. What is harder to quantify is the extent of this problem in the recovering community.

Whenever I asked the following question at trainings, “How many of you know someone in long-term recovery who has relapsed over pain management issues?” most of the audience raises their hands. The reasons vary, but more often than not they either take the wrong medication or too much. Others try to tough the pain out and end up relapsing back to their original drug of choice.

Living with chronic pain is difficult for anyone, but especially for someone with coexisting abuse, addiction or other psychological disorders. They can become severely depressed and discouraged. Healthcare providers often become confused and frustrated when their treatment interventions are ineffective and frequently blame their patients. The problem of managing pain and medication in recovery continues to grow and healthcare professionals are left with the challenge of how to effective address it. Given the biopsychosocial nature of addiction and chronic pain, it is imperative to understand both conditions and implement a multidisciplinary treatment plan.

To learn more about the need for teamwork for effective chronic pain management check out my article The Need for Multidisciplinary 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 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 Addictive Disorders

People with chronic pain who develop substance use disorders due to taking medication present a difficult challenge to treatment professionals. Many health care providers see no difference in treatment outcomes when these people are treated either in a pain clinic for their chronic pain condition or at an addiction treatment center for their substance use disorder issues.

In either case the prognosis ranges from poor to fair at best. However, I believe it is possible to increase the probability of a more successful treatment outcome by creatively combining existing chemical dependency and chronic pain treatment methods using a multidimensional, non-traditional approach I’ve named the Addiction-Free Pain Management® (APM) System.

The APM™ system is a treatment approach that uses a biopsychosocial model to integrate the most advanced pain management methods developed at the nation’s leading pain clinics, with the most effective treatment methods for addictive disorders developed at the nation’s leading chemical dependency treatment programs. The result is a unique integration of treatment methods that combine proper medication management with non-medication techniques to insure both chronic pain management and addiction treatment. This leads to relief of pain while lowering or eliminating the risk of addiction or relapse.

People with a chronic pain and addiction diagnosis have specific needs that are different from the typical chemically dependent person or the person who suffers only from a chronic pain condition; therefore, a specialized APM™ approach needs to be formulated and implemented. In addition to the pain and substance use, abuse and/or addiction screening, this approach assesses for the psychological issues present before any prescription medication abuse, new psychological problems arising from the pain and subsequent addiction, as well as finding innovative treatment modalities for this particular population.

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.

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 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.

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.

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.