Chronic pain has been correctly described as the invisible crisis at the heart of contemporary life. Despite stunning advances in other areas of medical science, no similar breakthrough in the treatment of chronic pain has resulted from an exclusive focus on the body. Dr James Alexander's young life was redefined by a tragic car accident in his late teens, and the chronic physical and emotional trauma inspired him to become a psychologist. Now pain-free, Dr Alexander has dedicated the last three decades of his life to helping others overcome similar challenges, specializing in the treatment of chronic pain and psychological trauma. His success is proof that recovery from chronic pain is possible, and this guide offers a valuable resource for working toward that goal. The recovery from chronic pain requires that we revisit and challenge the outdated attitudes and practices that have been used with little result. With the proliferation of medical and psychological research, for the first time we are at a point in history where these notions of pain recovery can be validated by research-based evidence. For too long, Dr Alexander feels, we have been looking in all the wrong places. Specifically, the problem lies at the core of our culture, which still treats the physical and nonphysical aspects of the human as separate experiences. This innovative program involves a journey of self-discovery, a new way to approach medical and psychological care of chronic pain, and advice on the most effective types of help to pursue.

The HIDDEN PSYCHOLOGY of PAIN

The Use of Understanding to Heal Chronic PainBy JAMES ALEXANDER

Balboa Press

Copyright © 2012 Dr. James Alexander
All right reserved.
ISBN: 978-1-4525-0680-7

Contents

ACKNOWLEDGMENTS................................................................................................xiiiINTRODUCTION...................................................................................................xvEpidemic of chronic pain.......................................................................................xviiiPain Questionnaires............................................................................................xxivChapter 1: PSYCHOLOGY & PAIN...................................................................................1Chapter 2: PHYSICAL PERSPECTIVES ON PAIN.......................................................................20Chapter 3: BIO-PSYCHO-SOCIAL MEDICINE..........................................................................34Chapter 4: CHRONIC PAIN MISUNDERSTOOD..........................................................................47Chapter 5: THE PHYSIOLOGY OF CHRONIC PAIN......................................................................76Chapter 6: CONSCIOUS & UNCONSCIOUS FACTORS.....................................................................96Chapter 7: THE DEPTHS OF THE UNCONSCIOUS.......................................................................113Chapter 8: GETTING BETTER......................................................................................140Chapter 9: SELF-HELP STRATEGIES................................................................................174Chapter 10: PSYCHOLOGICAL TRAUMA & DEPRESSION..................................................................195Chapter 11: THE HEALING POWER OF DREAMS........................................................................208Chapter 12: THE PROMISE OF ENERGY PSYCHOLOGY...................................................................236Chapter 13: IMPROVING YOUR SLEEP...............................................................................262Chapter 14: EFT, ANXIETY & STRESS..............................................................................283Chapter 15: PSYCHOTHERAPY FOR PAIN.............................................................................299Chapter 16: EYE MOVEMENT DESENSITIZATION & REPROCESSING........................................................317Chapter 17: MINDFUL AWARENESS OF THE PRESENT MOMENT............................................................333APPENDICES.....................................................................................................367Appendix 1: Pain Questionnaires (I)............................................................................367Appendix 2: A neurological understanding.......................................................................370Appendix 3: Anatomy of the spine...............................................................................384Appendix 4: Standard medical treatments for chronic back pain..................................................386Appendix 5: The value of physical therapies?...................................................................389Appendix 6: The evolution of psychology........................................................................397Appendix 7: Sample of research demonstrating structural pathology in pain-free populations.....................405Appendix 8: EFT on a Page......................................................................................409Appendix 9: Process for staying in the present moment..........................................................411Appendix 10: Testimonials from the Hidden Psychology of Pain clients...........................................412Appendix 11: Pain Questionnaire (II)...........................................................................418Appendix 12: Placebo treatment?................................................................................421BIBLIOGPRAPHY..................................................................................................425

Chapter One

Psychology & Pain

I was first alerted to the true nature of chronic pain from the experience of a friend whom I had known since my early teenage years. As a young man, he had suffered for months from such intense back pain that a surgeon had advised him to undergo a fusion of what were believed to be the offending vertebrae. Nothing else had helped up to that point. Desperate for relief, he made arrangements for the surgery. I rang him a few days later to see how he was after the operation. He told me he ended up not having the procedure at all. On the day of the surgery, he simply woke up with no back pain, and had concluded that it was not necessary. He experienced a spontaneous remission, and has remained largely pain-free ever since. Many years later, now a middle-aged man, this friend regularly trains for and runs half-marathons.

What had happened here? Was he a malingerer who, having achieved the sympathy he figured he deserved, simply decided to drop the issue? This explanation simply did not hold with my knowledge of his character. Something else had happened to remove his pain, but at the time I had no idea that psychology could be part of the answer.

Years later, a similar thing happened with a different friend who complained of chronic rhinitis, asthma and food allergies. I saw her after shehadjustcomebackfromaweekendof"spiritualdevelopment"ataquasireligious workshop. Over the weekend, she had simply realized that she no longer "needed" to have these respiratory complaints or the associated food allergies. From then on, she was symptom-free. As with my other friend, I had no way of understanding this experience at the time, but nor could I deny the reality of it. It was not until several years later that I was able to make any sense of these two puzzling reports.

Let's look now at another sufferer—this time, experiencing a chronic groin pain. At its worst, the pain in his left groin was excruciating, barely allowing him to walk normally. At other times, he was able to run and even play tennis, but the pain could return without any notice or warning. As an otherwise fit and healthy young man, being stuck with a limiting pain was inevitably depressing. Fortunately, his occupation did not require heavy lifting or vigorous movement, as that would have left him unemployable around 50% of the time. Regardless of its fluctuations, the pain was a constant in his life for eighteen years.

A physiotherapist tried manipulation and traction to treat him. She diagnosed that a lower back nerve was being pinched as a result of a car accident he'd had a few years earlier, producing a referred pain in his groin. She placed him in traction a couple of times a week, which according to the bio-mechanics, would stretch the offending vertebrae apart, allowing more room for the nerve and thereby reduce the pain.

The traction helped to alleviate the pain, but it usually returned immediately after the treatment—often, as soon as he got into his car in the physiotherapist's car park. Then he tried a highly regarded chiropractor who said the pain came from a twist in his hips, again sending a referred pain into his groin. Like the physiotherapist, the chiropractor viewed the physical trauma from the car accident as the likely cause of the problem.

In addition to vigorous manipulation, the chiropractor had him lay flat and placed blocks under one hip and the opposite buttock....