There was a discussion last year that led to a document called “The Five E’s of Chronic Pain.”   They are:

• Empathy
• Evaluation
• Education
• Encouragement
• Engagement

All of these are geared towards enabling and motivating the patient to take charge of his or own care.

One E that I want to emphasize in particular is education   it’s critical for several reasons.  If a given patient is willing to immerse him or herself in learning about all of the variables that affect his or her pain, the chances of them eventually improving is extremely high.

Conversely, if they are not willing to read, listen, and learn, then they cannot and will not get better.  They must be willing to take on that responsibility.  Otherwise they are choosing to remain in a victim role and will remain angry.  It is also difficult to work with them, which also makes progress unlikely.  I think it is important for those working in chronic pain to set personal boundaries while still “keeping the door open.”  If you are attached to getting that resistant patient better in spite of their wishes, you might get yourself into a very unhappy, energy-draining situation.  You need to let them go.

I just put on a mini-seminar called “Enjoying the Management of Your Chronic Pain Patients.”  Once a given patient decides to fully engage, it is like opening the door of a caged wild animal.  You cannot stop them from regaining their life.  It does not matter how long they have been in pain. Working with these patients has become the most rewarding and enjoyable part of my practice.

NH, BF

The post The “Five E’s” of Chronic Pain first appeared on Back in Control.

The post The “Five E’s” of Chronic Pain appeared first on Back in Control.

“Happy”

We all want to become better, happier people, and we work pretty hard at it. The marketing world keeps reminding us that we are not even close to our potential and holds up endless images of perfection that reinforce that idea. The solution advertising offers is a better appearance, more friends, accomplishments, public recognition, power, etc. We are programmed into being defined by external factors.

Additionally, self-help resources are everywhere. There are seminars, healers, books, lectures, and retreats, much of which can be helpful. The message is “if I had more of  ‘___________’ I would be a happier person.”  This includes wisdom, the tools on this web site, less pain, etc.

What we really mean when we say that we want to be happy is that we would like to experience less anxiety.

The “Abyss”

Many, if not most, of my patients would test out just fine on a psychological test. But chronic pain will still take you down anyway. It creates extreme anxiety and frustration. I define “The Abyss” as:

Anxiety x Anger x Time

The Abyss represents an unspeakably dark area of your brain. My patients can’t express it with words. I spent over seven years in a severe burnout. My experience also included chronic pain in several areas of my body. I experienced an intense burning sensation in both of my feet, tinnitus, multiple areas of tendonitis, migraine headaches and crushing right-sided chest pain.I didn’t know why I was having all of these symptoms and all the testing was normal. I eventually lost all hope. I “pre-tested” every millimeter of the pathway outlined on this website, mostly by trying multiple approaches that didn’t work. Suffering from chronic pain is far removed from happiness.

 Paradoxes

• The DOC process is paradoxical. The harder you try to get enough of the tools to “fix” yourself the less likely you are to be successful in becoming pain free (or happy). It is critical to understand that you have to enjoy your day with the idea that your pain or your life circumstances may never improve. In other words you must learn to enjoy life with what you have—NOW!
• If you are waiting for more wisdom, more re-programming tools, more money, a nicer spouse, better-behaved kids, or less pain before you can fully engage in your life, it’s never going to happen. It is life’s ultimate paradox. The harder you try to “fix” your life and yourself, the less likely you are to enjoy it.
• We also forget how illogical it is to think that all of the variables in our lives are going to align so well that we are going to finally be fulfilled. And if it could happen, how long do you think it would last?  Think how much energy we spend trying to control so much. Yet, we don’t give up trying.

The Reverse Paradox

Then there is the other side of the paradox. The more you can enjoy your day in light of your current life circumstances; you will then possess more energy and creativity to create a life that you desire. The Eye of the Storm

An Exercise

I often do an exercise with my patients. I look at my watch and point out that the time is X and you have Y number of hours left in the day. I ask them to make a decision to enjoy the next number of hours regardless of their circumstances, including the pain. A major key to solving your pain is to step fully into the life you want, with or without the pain.

When I was in the middle of my own intense burnout about 10 years ago, I had to make ongoing decisions to just enjoy the next 15 minutes. I’m serious. I had to make a conscious effort every 15 to 30 minutes.

My ongoing challenge to myself and to my patients is, “Enjoy your day—today.”

Listen to the Back in Control Radio podcast Enjoy Your Day – Today

The post Enjoy Your Day-Today first appeared on Back in Control.

The post Enjoy Your Day-Today appeared first on Back in Control.