Freedom from Suffering

Posted on Friday, December the 28th at 7:03pm

By Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II

The following article briefly describes the important steps of effective pain management. This is a brief overview a book I’m working on Freedom from Suffering: Seven Strategic Steps for Achieving Successful Pain Management. You will review a brief description of each of the seven steps that people living with chronic pain need to learn to apply in order for them to move from “suffering” with chronic pain to learning to manage their pain more effectively. It is intended to give people a road map of what they need to accomplish as they embark on a personal journey towards successful pain management.

Step One: Beginning the Pain Management Journey

It is important for people living with chronic pain to have a healthy support network in place as they begin this pain management process. There are two crucial components of an effective pain management support network; (a) professional healthcare providers and (b) appropriate family and friends. Next people living with chronic pain need to objectively examine their current pain management program. They need to explore both their medication management plan as well as which non-medication types of pain management activities or procedures they are utilizing—if any.

Step Two: Looking At Your Pain Objectively

People living with chronic pain need to increase their understanding of pain and how to use that knowledge to improve their pain management.  In this step people explore the different aspects of pain—acute and chronic—and the bio-psycho-social components of pain as well as the difference between pain and suffering.  They also need to recognize the stress-pain connection and how to rate their stress and pain levels accurately.  Finally they need to explore how their thinking, emotions, behaviors, and social relationships change when they’re having a “bad” pain day and start looking at better ways to cope.

Step Three: Understanding and Managing Psychological Problems

In this step people will be exposed to information about depression, sleep disorders, or trauma disorders that frequently affect people in chronic pain and what constitutes effective psychological management. For example people will learn how to accurately rate the type and level of depression symptoms they experience and then start developing their own personal six-step depression management plan.

Step Four: Exploring Effective Medication Use

This step starts with defining some common, and possibly misunderstood, terms like medication abuse, dependency, pseudo addiction, and addiction. People who take prescription pain medication need to learn how to use a Red Flags checklist to see if they might have a problematic, or even dangerous, relationship with their pain medication. They also need to learn the role of denial and finally explore the benefits and disadvantages of continuing to use pain medication the way they have been.

Step Five: Developing an Effective Pain Management Plan

In this step people are exposed to the concept of a Pain Management Agreement and how to deal with urges/cravings that could tempt them to use pain medication in an inappropriate manner. They need to learn how to develop a non-pharmacological (non-medication) pain management plan and how to utilize a pain journaling process to increase their pain management skills.

Step Six: Exploring Biological versus Psychological/Emotional Symptoms

This step focuses on explaining ascending versus descending pain signals and exploring and scoring people’s biological and psychological/emotional pain symptoms. People living with chronic pain need to look at how their TFUARs (thinking, feeling, urges, actions, and social reactions) change on a bad pain day and how to manage those TFUARs more effectively.

Step Seven: Finalizing the Pain Management Plan

This step ties everything together by helping people identify and rate their bio-psycho-social-spiritual pain management goals. Then they will learn how to improve their existing pain management foundation and test this new plan to make sure it is as effective as possible.

Achieving freedom from suffering is possible if people are willing to stop being passive recipients of treatment and become proactive in their healing process. I have seen many of my patients come back from severe hopelessness and helplessness to become high functioning and enjoying a much improved quality of life. Most importantly they report they no longer see pain as their enemy and are not suffering anymore. They are past just surviving—they are thriving.