Memo 2: What Your Client Can Do about Chronic Pain – and What Only You Can Do

After decades of research into chronic pain, we now have very convincing evidence around what works and what doesn’t, and therefore what will give your client the best possible chance of eliminating their pain not only for good, but usually relatively quickly and easily.

According to an important study published in the eminent journal “Pain” none of the current treatments, from medication, to physiotherapy, to psychological strategies, help the majority of chronic pain sufferers.

There is now an answer, but first let’s look at what your client can do for him/herself, based on the best possible evidence, to dramatically reduce or eliminate chronic pain.

Exercise, Sleep, Nutrition, Fun

While physiotherapy is incredibly important (even critical) in the recovery stage after injury or surgery, study after study demonstrates no benefit for chronic pain, with any improvement being extremely temporary.

However increasing the client’s activity level, despite the fact that they struggle with chronic pain, definitely has benefit, and even if all they do is go for a gentle, slow and very short walk each day, they will have an excellent chance that they will reduce their pain, or even eliminate it altogether in a couple of weeks, even without medication.

So even if their back hurts with every step, and they need to go very slowly, their pain is likely to reduce to nothing quite fast.

There is no such thing as food that causes pain (unless your client has a rare disorder) and neither is there food which decreases pain (again, unless they have a rare disorder). However what we do know is that when people have good nutrition they optimise their health and that includes the issue of pain signalling. It is highly likely that their pain levels may improve if they improve their diet.

If you client isn’t getting enough sleep, or not getting good-enough quality of sleep, this is going to make their stress levels worse and their pain worse as well.

It’s very stressful having pain, especially if the suffering has been relentless over a long period of time. This stress causes high levels of cortisol which in turn end up making pain signalling worse. This is exactly why you need to investigate every aspect of your client’s quality of life, resolving issues which detract from their well being, getting the most fun possible, engaging with other people socially, even if they don’t feel like it because of the pain.

So those are things some clients may be able to attend to themselves, or may need some professional help to resolve.

Now let’s look at what your client most definitely will require your help with in order to switch off pain signalling altogether.

Switch Off Pain Signalling

It’s highly likely that your client will present with a number of co-morbidities quite apart from the life/health issues described above. Depression, anxiety, trauma, serious sleep dysfunction, and many others are very common and need to be addressed.

If there are identity issues which could slow or sabotage the switching off of pain signalling, it will be the life issues and co-morbidity that must be addressed first.

We already know that CBT and other approaches have very small effect sizes in the treatment of psychological problems. In the case of chronic pain there is no evidence for improvement of pain at all. That is why therapists who use those methods will never claim to be able to reduce or eliminate chronic pain. They know they cannot.

What definitely does reduce or eliminate chronic pain is a completely new approach to psychological therapy, and that is SDR Therapy (which stands for “sensory disruption of reconsolidation). This is a way of getting your brain to permanently “forget” how to trigger fake pain signals that cause such agony and distress. It is strongly evidence-based, and we need to train all psychologists and counsellors to use SDR Therapy so that they can provide more effective help to their clients, not just for chronic pain, but for all other issues as well.

It takes considerable time and supervised practice for an experienced psychologist or counsellor to complete their training and be able to help people with SDR Therapy, so this isn’t something that the client could realistically be expected to do alone.

As an SDR therapist, you’ll investigate both direct and indirect triggers to your client’s pain signalling, because they are different for everyone, and work with them over the course of a comprehensive program to switch that pain signalling off permanently.

In the next article, we’ll look at “What Is SDR Therapy?” and following that will explain how you can work with your clients as an SDR therapist to achieve freedom from pain as quickly as possible.