Memo 1: Why Your Client Has Chronic Pain and Others Do Not

Long-term or chronic pain is nothing like “acute” pain. These two distinct types of pain have different causes, and use different nerve paths. This is an article about chronic pain, not acute pain.

If your client is struggling with back pain, or post-surgical pain, or other pain that just won’t go away, you’ve probably already observed that medication does little if anything to take the edge off, that physio makes no difference, and that while your sessions may or may not be helping your client to cope, they are not making much difference to the pain itself. It’s still there. You may even have told your client that there is no actual cure, and that their suffering is at least partly caused by their thoughts or attitude.

In the rest of this series of articles about working with chronic pain clients, I’ll write more specifically about the high failure rate of current treatment (medication, physical therapy, CBT and/or mindfulness) and what kinds of things the client can do to reduce pain, and how you can actually teach the client to switch off chronic pain completely, but for today I just want to explain why your client has pain and other people don’t.

You see, true chronic pain always starts somewhere. It could have been an injury, surgery, disease, trauma, or even something as mundane as a rash or an insect bite. But it always starts with some kind of initial “insult”. It doesn’t ever come from nothing.

Luckily for most people, around 80% in fact, they go through an acute pain stage, heal up, and return to normal life without pain. The overwhelming majority of people don’t develop chronic pain.

However for about 20% of people, much higher for those over 70 years of age, they also go through an acute pain stage, and heal up, but the pain doesn’t go away. In fact not only does the pain remain, but it can even get worse, can become quite weird (like feeling like your arms are on fire and all you’re doing is putting on a shirt) and can become even more weird, experiencing not only physical pain, but also other physical symptoms like heat, inflammation, and swelling.

This is what we mean when we say that the pain isn’t accounted for by pathology, or is inadequately explained by pathology. And this is the experience of some 1.5 billion people world wide. And we have no evidence that anything currently in use is making any difference.

So why your client? Why is your client one of those 1.5 billion people?

The only answer we have right now in regard to reasons, is that it’s looking a lot like random bad luck. It’s possible that hypersensitivity could play a role, but basically it is plain bad luck. Their body has quite literally learned to produce pain signals as conditioned learning, and the pain is now being triggered by their brain. Current studies, showing that chronic pain is mediated via the amygdala region of the brain, back up this claim, and other clinical researchers are also moving in this exact direction.

This is exactly what happened to Brian. Brian worked for a major telecommunications company and had a bad accident that left him hanging upside down on a telegraph pole with a severely damaged back. Many months later, instead of experiencing reduced pain as he healed, his pain got worse. Medication and physiotherapy had not made any difference, and his sessions with a psychologist had not helped his pain either.

On the basis that this kind of chronic pain is “learned” by the brain and body working together in a very unhelpful way, we used a new psychological technique (called SDR Therapy) to “extinguish” the learning, so that his brain very quickly “forgot” how to trigger old pain signals. He was able to completely eliminate his pain and go back to work within 2 weeks.

Margaret is another example of pain persisting long after healing has occurred. Many months ago Margaret had had an incredibly severe sinus infection that proved difficult to eradicate but nevertheless was treated successfully and she was now completely clear of infection. However her pain not only persisted, it also developed into shooting pain, and not just in the sinus area, but also out to her ear. Multiple tests showed complete healing and no sign of anything at all that could be causing her current chronic pain so long after healing had occurred.

As with Brian, we proceeded on the basis that her brain had learned to trigger pain signalling as a learned response, and used SDR Therapy to treat that learned pain signalling. We were able to completely switch off her pain even in the first session of her program.

Patricia was a cancer patient who had surgery 6 months previously, but even after healing and being in complete remission, she still had strong pain along her jaw, down her neck, and into her shoulder. Using SDR Therapy this pain also “switched off” in the first session of her chronic pain program.

In the next article I’ll talk about what kind of triggers your client’s brain may have developed, that cause it to produce that awful and unwanted pain signalling.