When you experience a bad pain day your TFUARs (thinking, feelings, urges, actions, and reactions of others) often change. The purpose of the following exercise is to explore your personal accounts in each of the above TFUAR areas when you experience pain on a bad pain day and then take corrective action.

Please take a brief timeout to breath and center yourself. Then when you are ready, complete the following exercise designed to help you to identify, challenge, and change the thoughts, and manage the feelings, urges, actions and social reactions that can lead you towards using self-defeating behaviors and experiencing negative consequences that lead to worsening your depression and/or chronic pain symptoms.

Thinking

First draw a line down the middle of a page so you have two columns. Title the left hand column PROBLEM and the right hand column SOLUTION. Thinking of your pain on a bad pain day please list three of the self-defeating or negative thoughts that you experience. Now in the right hand column come up with as many positive challenges or affirmations that you can that you can use to challenge those self-defeating thoughts.

Feelings

Again draw a line down the middle of a page so you have two columns—if you have room under the thinking section just continue from there. Title the left hand column PROBLEM and the right hand column SOLUTION. Thinking of your pain on a bad pain day thinking the self-defeating thoughts you listed above; please list three of the uncomfortable feelings or emotions that you experience and rate them on a 1-10 scale. Now in the right hand column come up with as many positive ways you can think of to manage those feelings in a way that moves you out of the problem and into the solution.

Urges

Continue the line down the middle of a page so you keep two columns. Again the left hand column is the PROBLEM and the right hand column is the SOLUTION. Thinking of your pain on a bad pain day with those self-defeating thoughts and uncomfortable emotions please list three of the self-defeating or negative urges or impulses that you experience. Now in the right hand column come up with as many positive ways that you can think of that you can that you can use to challenge those self-defeating urges.

Actions

Continue line down the middle of a page so you keep two columns. Again the left hand column is the PROBLEM and the right hand column is the SOLUTION. Thinking of your pain on a bad pain day with those self-defeating thoughts, uncomfortable emotions and self-defeating urges, please list three of the self-destructive or negative actions or behaviors you use. Now in the right hand column come up with as many positive ways that you can think of that you can that you can use to challenge those self-destructive actions or behaviors and what are your new healthy behaviors that you can implement.

Reactions

Continue line down the middle of a page so you keep two columns. Again the left hand column is the PROBLEM and the right hand column is the SOLUTION. Thinking of your pain on a bad pain day with those self-defeating thoughts, uncomfortable emotions, self-defeating urges, and self-destructive actions, please list three of the ways your behavior causes negative social reactions. Now in the right hand column list as many guides, helpers or coaches that can help you move out of the problem and into the solution. Then list as many ways that you can think of that you want each of these healthy support people to say or do, that will aid you.

To learn more about my views on how to cope with chronic pain without suffering, please read my article Pain is Inevitable but Suffering is Optional when Living with a Chronic Pain Condition 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 living with chronic pain, especially if you’re in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively, please 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.

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.

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.

Some of you reading this Blog have friends or loved ones who are experiencing depression as a result of living with chronic pain. Maybe you’ve asked yourself How can I help? Some of you may have become frustrated, afraid, anxious, or even angry with the depressed person and maybe you even wanted to escape or avoid them. If someone you care about is struggling with depression, you can be a valuable resource.

A depressed individual can be emotionally withdrawn, isolated, lethargic, self-critical and, sometimes, suicidal. If you talk candidly with the individual regarding your concerns for his or her wellbeing, it will often bring the problems out into the open. Emphasize that your primary objective is to convey feelings of concern and assist them in receiving appropriate, professional help. If the person expresses thoughts of suicide, but refuses to seek assistance, you should consult with a mental health professional.

If you are the one with depression you can share this information with a friend that is willing to learn how to be more supportive. Below is a brief ten-point checklist of ideas for being part of the solution; not part of the problem.

Suggestions for Helping a Depressed Friend

1. Be empathic and understanding
2. Don’t try to cheer up a depressed person
3. Avoid critical or shaming statements
4. Challenge expressions of hopelessness
5. Empathize with feelings of sadness, grief, anger and frustration
6. Don’t argue about how bad things are
7. Don’t insist that depression or sadness are the wrong feelings to be experiencing
8. Don’t become angry even though your efforts may be resisted or rejected
9. Advocate and push for their recovery from depression
10. Emphasize that depression is treatable

To learn more about dealing with depression associated with chronic pain 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 or living with chronic pain yourself and want to learn how to develop a plan for managing the 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 radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to listen 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.

I was very interested in a posting on www.medicalnews.com
titled “Prescription Opioid Abuse, Addiction Less Common Than Many Believe.”  While some of the information was very interesting I do not agree with the way they minimize the problem.  In fact, I submitted my comments that I hope they will post. To read the Medicalnews.com article please Click Here.

I do in fact agree with some of observations and findings from this article.  However, I do not think their 3.3 to 3.7 percent numbers are an accurate total picture of the extent of the problem.  One reason may be the way problems are screened by different pain management providers.  Many of the patients I’ve dealt with over the past 26 years in pain management have a great track record of fooling healthcare professionals.  Fortunately, we are getting better at detection and intervention. 

The other factor I believe needs to be explored is the rate of prescription medication abuse/addiction when the patient has a personal history or family history of any addictive or mental health disorders.  I have seen many research studies indicating that the problem is much higher than the rates their research found.  In some studies the rates are as high as 40 percent.  I myself use a conservative (for me) 10 percent estimate that includes prescription medication abuse, pseudoaddiction, or addiction.

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 medication 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.

To learn more about my views of how to address this problem, please read my article Addressing the Problem of Prescription Drug Abuse/Addiction 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 living with chronic pain, especially if you’re in recovery or believe you may have a medication problem and want to learn how to develop a plan for managing your pain and medication effectively, please 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.

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.

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.