The following information was adapted from the Addiction-Free Pain Management® Recovery Guide© and is used with permission—The TFUAR concept is part of the Gorski-CENAPS® Model.  Below are some basic principles that can help you to better understand how the TFUAR (thinking, feelings, urges, actions, and reactions of and to others) process works.  Understanding this process can help you to develop more effective chronic pain management.  The premise is:

1. Thoughts cause Feelings.  Whenever we think about something we automatically react by having a feeling or an emotion. 
2. Thoughts and Feelings work together to cause Urges.  Your way of thinking causes you to feel certain feelings.  These feelings, in turn, reinforce the way that you are thinking.  These thoughts and feelings work together to create an urge, or impulse, to do something.  An urge is a desire that may be rational or irrational.  Sometimes the irrational urge is to isolate and give into your depression.  At other times you might be tempted to use inappropriate pain medication, including alcohol or other drugs, even though you know that it will hurt you, which is also called craving.  Other times you want to use self-defeating behaviors that at some level you know will not be good for you and could worsen your depression. 
3. Urges plus decisions cause Actions.  A decision is a choice.  A choice is specific way of thinking that causes you to commit to one way of doing things while refusing to do anything else.  The space between the urge and the action is always filled with a decision.  This decision may be an automatic and unconscious choice that you have learned to make without having to think about it, or this decision can be based upon a conscious choice that result from carefully reflecting upon the situation and the options available for dealing with it.
4. Actions cause reactions from other people.  Your actions affect other people and cause them to react to you.  It is helpful to think about your behavior like invitations that you give to other people to treat you in certain ways.  Some behaviors invite people to be nice to you and to treat you with respect.  Other behaviors invite people to argue and fight with you or to put you down.  In every social situation you share a part of the responsibility for what happens because you are constantly inviting people to respond to you by the actions you take and how you react to what other people do.  Sometimes these reactions help you manage your pain more effectively, but at other times it leads to increased stress levels that cause you to making poor decisions.

To learn more about effective chronic pain management check out my article The Right to Quality 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 in recovery and want to learn how to develop a plan for managing your pain and medication effectively go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

We have a busy fall schedule and some new postings for 2009 for upcoming trainings that you can check out on our Calendar page.

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

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.

People living with complex chronic pain conditions—chronic pain with other coexisting psychological problems including addiction—need strategic, targeted, and proactive interventions, but may of these people do not get the type of treatment interventions they really need.  For example, some addiction treatment programs and pain clinics have a tendency to put people in a passive role which has proven to be counterproductive. In addition to assigning people living with chronic pain to a passive role, some chronic pain programs fall short as they lack a multidimensional approach.

There are many other pain management experts though, that believe as I do that people living with chronic pain require an active, multidimensional, approach to treatment. For example, the treatment plan might include exercises, chiropractic treatment, cognitive-behavioral strategies, and massage therapy in addition to medication approaches. This combination is becoming known as multidisciplinary integrated pain management.

The Addiction-Free Pain Management® System is based upon the concept that people living with chronic pain require an active, multidimensional approach to obtain favorable treatment outcomes.  This three part approach includes: (1) A medication management plan; (2) A cognitive-behavioral treatment plan; and (3) A nonpharmacological pain management plan.

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 Ariticles page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you live with a complex chronic pain condition and want to learn how to develop a plan for managing your pain and medication effectively go to our Publications page and check out my book the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

We have a busy fall schedule and some new postings for 2009 for upcoming trainings that you can check out on our Calendar page.

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

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.

Many people with chronic pain frequently become depressed due to living with under-treated or mistreated pain symptoms. This process starts when your thinking and emotions become problematic. This is when your thinking becomes irrational or dysfunctional and you start mismanaging your feelings; you often have urges to indulge in self-defeating, impulsive or compulsive behaviors to cope with your depression. This in turn affects your relationships with others.

One of the biggest problems in treating depression in people with chronic pain is a misdiagnosis—you or others do not realize that you are depressed. This occurs for two reasons: (1) when you live with chronic pain you often do not realize that you may also be suffering from a major depression; and (2) your healthcare provider is not looking for it. People living with chronic pain will often define their problem as strictly medical and related to the pain. Therefore, being alert to see if depression is present and being willing to develop a treatment strategy becomes a crucial component of an effective pain management treatment plan.

There are currently a variety of highly effective interventions available for the treatment of depression. The majority of depressive conditions can be treated with either psychotherapy (especially cognitive behavioral therapy) or medication, but research studies have indicated that a combination of these interventions is usually the most effective form of treatment for moderate to severe depression. There are also some types of depression that have a seasonal patterning where intensive Full Spectrum Lighting therapy is often effective in reducing symptoms. It should be emphasized that the majority of depressive conditions can be treated without hospitalization.

To learn more about depression and effective chronic pain management please check out my article The Role of Clinical Depression in 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 listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

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.