Why consider visiting a pain psychologist when you have back pain

Almost anyone is likely to experience back pain at some point in life. However, some sufferers of chronic back pain who have not found medications and surgeries too helpful are likely to suffer emotionally as well. These patients find it hard to go to places with their families, they can’t enjoy the occasion as much as everyone else seems to enjoy. They often report not being able to work the regular 8-hour day jobs; some can’t even work at all. They say their sleep has turned into one strenuous ordeal and they also say they are not as happy and satisfied with their romantic relationships. On top of all this, they take pain medications that often leave them feeling groggy, sleepy, and unable to concentrate, they notice various negative side effects from those medications. That’s the time to refer to a licensed pain psychologist (other names of this specialty are: Medical Psychologist, Health Psychologist, and Behavioral Medicine Specialists) who understands pain both from physiological and psychological perspectives. A pain psychologist can help in figuring out how to get back to enjoying life with friends, how to pace your daily activities to where you don’t over do or under do it. Pain psychologists can help in sorting out depressive feelings that arise because of being in pain, how to find a way to enjoy your romantic relationships once again and how to find a way to work and feel productive again. Pain psychologists can also help in sorting out your medications and figuring out the best ways to get the most mileage out of your pain medicine. Prescribing physicians often are happy to refer their pain patients to a trained pain psychologist. This is because it really takes both the care of a physician and the care of a pain psychologist to manage the pain and keep it from getting worse. If you are a chronic pain sufferer, ask your physician about being referred to a pain psychologist.

This is Dr. Dashtban. write your questions regarding health and habits to me directly at [email protected]

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

What is your pain fear number?

Most people are familiar with the pain scale. It is a subjective way of measuring one’s pain level at a given moment. There is no medical device or medical test that can objectively measure one’s pain level and so health care providers rely on the patients’ own report. The pain scale asks patients to rate their pain level somewhere between 0 (no pain at all) to 10 (the worst pain you can imagine). But it is not unusual for patients to feel frustrated when asked to rate their pain level on this scale. Patients sometimes report numbers higher than 10 on a scale that has a maximum level of 10. Why is that?

It turns out that pain is often anxiety provoking and sometimes down-right scary. Even most health specialists, when faced with high levels of pain, wonder if the pain will ever go away and if they will ever be all right again. The fear of staying in that much pain, the fear of body parts being damaged or at least loss of function at that part can begin to feel so real and so threatening. So when asked by health care providers what their number on the pain scale is, patients are reporting their fear number as well as their actual pain number, and that leaves little wonder as to why a maximum of 10 is not enough to capture what their true experience is.

There is no magical way to foresee what exact message pain has. While translating the exact message of pain can be tricky, pain should be taken seriously because it is always the body’s way of saying something to us. It is perhaps most helpful to trust that once medical work ups have been done and a “no threat” bill of health has been issued by the treating physician, then the fear level be tested separately from the pain level. The fear level often stems from catastrophic thoughts, images of being disabled, seriously harmed. While being on the lookout and perhaps a bit pessimistic can sometimes save future disasters, but often such thoughts prove to be debilitating. At times like this a bit of reality check can save a lot and be very useful.

Ask yourself questions like:

  1. Am I fearful of my pain because it resembles the pain of a relative or friend which ended up being disastrous?
  2. Are my treating physicians concerned that the higher my pain the more damage I am receiving which will lead to further disability?
  3. As difficult it is to deal with it, am I actually going to die from this pain?
  4. Can I just concentrate on this hour and not think of how I am going to live the rest of my life?

So, what is your fear number?

Call or write to me at 831-621-1150 or [email protected]

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

It Takes a Village to Manage Chronic Pain

Dear Readers,

An idea just came to mind that I thought might be worth sharing with you. Have you heard the saying: “It takes a village to raise a child?” Well, I think the same concept applies to successful management of chronic pain. By the time your pain condition has changed from acute (imminent, only has been around for less than 6 months) to chronic, then you probably need as many disciplines as is necessary to manage the pain effectively.

We used to think that the pain physician was the only source to receive help for pain management. However, over time we learned that physical therapy and psychotherapy are the other two important components of successful pain management. Some people also incorporate acupuncture as a very helpful adjunct to the trio mentioned above. Also, for those people who have ended up taking large doses of narcotics or other pain meds and are now finding that the meds are not really helping them as much, then what might be needed is a successful game plan of how to titrate off of those meds or at least reduce them back to a therapeutic dose. In these cases, a pharmacist’s expertise might be super helpful, where they begin a titration program to easily and gradually wean you off of those meds without too much trouble with withdrawal symptoms.

So, while “raising the child in a single parent home as opposed to with the help of the village” is possible, but often people find it very frustrating and in fact sometimes unsuccessful when only relying on their physician to manage their chronic pain.

The other question that forms in some people’s minds is which discipline helped them the most. Was it the new meds their physician prescribed, was it the new movements they got into at physical therapy that eased their muscle tension, or was it the cognitive changes brought about at psychotherapy which helped reduce their anxiety and depression that helped them get back on their feet? And the answer to that question my friends would be: “ALL OF THE ABOVE.”

Visit me on my new face book and Twitter accounts, or our website at http://www.medicalpsychologyservice.com

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Pacing is the name of the game

Hello readers,

If you are a chronic pain sufferer, you have probably noticed that pain level goes up and down seemingly by itself, some days it is worse, other days it is better. If you are one of those who has a tendency to “make up for the lost times” during your “good days”, read on…..

It is quite understandable how big a toll being in pain takes. Often people report that they’ve put their lives on hold while looking for a cure or a way to reduce their pain. As it turns out, pain has some built-in ups and downs associated with it. If you over extend yourself on a day that your pain is a bit better, you might find that on the next day, or a few days later you are experiencing a flare up. What is the solution? PACING…..

Here is the key to successful pacing. You first need to learn what feels like a high impact, and what feels like a low impact activity for YOU. Naturally people would name different activities as high and low impact for them. For example, for most people sorting out their mail is considered a low impact activity while vacuuming is typically reported as a high impact activity. The key is knowing the difference in your particular case. Once you develop this knowledge about yourself, then all you have left to do is mix and match your day with alternatively low and high impact activities. For example, here is a well balanced way to spend a morning: wash dishes 5 minuets, sit on the couch and watch TV for 3 minuets. Dry dishes and put away in cabinets for 5 minuets, sit or lay down for stretches for 5 minuets. Load up one load of laundry for 10 minuets, sort out the mail for 4 minuets. Tidy up your room for 10 minuets, sit down for a cup of tea for 5 minuets.

By pacing you are likely to find that you have taken your life from hold to actually living it while you have not activated a flare up.

As always, please call me at 831-621-1150 Ext 100 or write to me at: [email protected] if you have any questions or want to share a success story with me.

Peace,
G. Katie Dashtban, Psy.D.
Licensed Clinical Health Psychologist, PSY22256

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Who is the “owner” of the chronic pain I feel?

It is easy to confuse ownership of your pain with blaming yourself for it. Taking ownership of the pain means 1) exploring exactly in what ways has the pain affected your personal and professional life, 2) recognizing ways that you have been successful in taming the pain, 3) and of course recognizing the ways that pain gets worse and turns into a flare up. Blaming, on the other hand, means looking for where you went wrong, how you could have and should have prevented it, or how someone else, for example a physician, has “caused” the pain. The trouble with finding blame is that it only makes you feel more angry and less in charge of controlling your pain. In fact many people feel sad and anxious about the whole disruption they feel in their lives as a result of pain and get tempted to put their whole lives on hold waiting for others such as their physicians, their families, and their life circumstances to take away the pain. It is as if they are giving the responsibility of coping with the pain to someone or something outside of themselves, which clearly makes them feel even more powerless.

Two things to do in order to “own” your pain and therefore exert more power on controlling it:

1) Keeping a pain diary: It is very important to learn of your own various physical sensations and their paired unpleasant emotional experiences. Examples of physical sensations are stabbing, burning, aching, tightness, and pounding pain. Unpleasant emotional experiences associated with various physical sensations are measures of suffering and include: frustration, anxiety, anger, fear, despair, and hopelessness. Keeping track of your specific physical sensation and its level of intensity as well as your associated emotional suffering gives you a clue as to times and circumstances when your pain is easier to handle and times that it is the most uncomfortable. The pain diary is intended for your exploration. You can begin to notice the pattern of your pain, begin to trace flare ups, begin to notice how and when your pain experience is least bothersome, etc. Not only this information will give you a strong sense of control over your pain, it is a much appreciated tool for your health care providers in terms of your responses to treatments and ways to treat your flare ups.

2) Setting Goals: It is very common for people with chronic pain to feel scattered, unfocused, unable to make commitments, and unsuccessful in meeting their own needs on a steady basis. Naturally, when you don’t know how to predict your pain level and your emotional suffering, you are less inclined to make any type of meaningful plans. But having that pain diary can be your most effective tool to change some of that chaos into organization. In addition: setting goals in the following manner can most likely result into positive outcomes: A) You must be able to measure it: (I’ll feel good by next summer is poorly measured, but I’ll have one load of laundry done by the end of the week is measurable). B) It should be humanly possible not superhumanly possible: (I’ll have my bathrooms renovated in 2 weeks is not that likely to happen, but I’ll have the magazine and newspaper clutter cleared by next Tuesday is more like it). C) Your goal is best to be in the form of some action not some intangible concept (I’ll do really good in school next semester is more of a concept, but I’ll have pages 31 to 50 read by next Friday is a specific action). D) The word “I” will have to be the most essential part of your goal: (once my neighbor has her lawn mowed, I’ll plant by cucumbers is all about the neighbor, but I’ll have my cucumbers planted by the end of next week is all about the “I”). E) Must make sure you really want the outcome of that goal: ( is it even worth your while to volunteer in an organization you have no emotional connection to? )

Keep me posted on your journey through managing chronic pain and if you need to consult with me, I’ll be happy to hear from you. My number is 831-621-1150, my website is www.medicalpsychologyservice.com Keep an eye on the website for various seasonal workshops that might just be of much help to you.

Stay well,
G. Katie Dashtban, Psy.D.
Licensed Clinical Health Psychologist

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Sleepless with pain?

Hello readers!

I’d have to tell you, of all the complexities I hear about from my chronic pain patients, the most disturbing of all is lack of adequate sleep which by itself causes all kinds of health problems, even if you did not have chronic pain. So, let’s talk about how to get to bed!!

Think of sleep as a train that passes by your station every 90 minuets!!!. You have a chance to get on board only when the train is at your station, not before and not after. It means you need to prepare for sleep before you are sleepy, and you need to be in bed ready to fall asleep when you first feel that drowsy sensation. Staying on the couch, watching TV and dosing off until wee hours and then at last making your way to bed around 2,3,4 a.m is a no no !! That is like hanging around the parking lot of the train station, but not on the actual platform where the train makes its stop.

If you don’t already, develop a sleep ritual. For most people the sleep ritual consists of changing into PJ’s, flossing & brushing teeth, washing face, brushing hair, maybe even a warm shower or bath. It could also include a light book (none of those page turners that keep you up all night, certainly nothing horror or provocative). A slow melody of music can be helpful too. Take a moment and find out what type of sleep ritual you’d like to have and begin preparing for bed by doing the ritual.

Now, you must make sure that your bedroom is designed for sleep, and yes sexual activity too!! I know some people don’t mind the street noise, but hear this: back in the day of our ancestors, dark meant no activities, no cars, no stimulations, nada. So, once sleep came about, nothing would wake the creature until the first rays of the morning sun. Well, though we don’t live in that day and age, but we are still the same creatures. So, if you must have some sound, obtain a sound machine that makes nature sounds, enough to mask the street noise, or just put in some ear plugs.

Too much light is also counterproductive to sound sleep. Remember, our ancestors had no light until the morning sun or perhaps the moon light. So, see if you can only suffice to low emission emergency lights or just no light in the bed room.

Taking work related activities, lap top computers, even TV to the bedroom takes the idea of the bedroom being your sanctuary to it being your hanging out spot in the house. But it is much better to get into the habit of preserving the bedroom as a place to sleep.

Last, but certainly not the least, if you find your mind going around like a monkey jumping from one branch to the other, stop the process in the following ways. First do get out of the bed, go outside of the bedroom, maybe into your living room. Sit down with a writing pad and just jot down those thoughts. Say to yourself, “I know these thoughts are very important or they wouldn’t be occupying my mind now. I need to attend to them in the morning, so I am writing them down before I forget about them.” Then trust that the thoughts are recorded for your future attention and then hit the sac again, this time without the worry of those thoughts.

And oh one more thing: if you have been prescribed sleep medications, do be sure to take them prior to getting ready for bed. It usually takes somewhere between 20 to 40 minuets for most sleep medications to get you drowsy. So, be mindful of keeping track of the timeliness of your meds.

Remember, you can write to me at [email protected] to chat or ask questions. It is a free call!!!

Best regards,
G. Katie Dashtban, Psy.D. PSY 22256
Licensed Clinical Health Psychologist

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Managing chronic back pain doesn’t have to be a pain

Managing chronic back pain reminds me of the chicken and egg story. Got to get up and get moving so you can keep flexible and keep the back strong, on the one hand!! On the other hand, the pain gets in the way of moving all together. Sleeping poorly at night, taking lots of pain meds, and looking for that one doctor who might finally have the cure for your pain is perhaps the story of your life right now. Well, it does not have to be. Quite often, the anxiety around being in pain causes you to embrace your body in such a tight way that makes the pain even worse. Also, depression and a sense of helplessness makes it much harder to cope with the pain. No matter how difficult it seems, the key to effective management of chronic pain is keeping the anxiety down and digging in with yourself, asking yourself some questions about your own beliefs and assumptions. For example: “Should I stay away from all fun things because I might have extra pain the next day?” Quite likely you have formed certain black and white assumptions that are in need of modification.

Just keep in mind that while pain might be inevitable, suffering is optional.

Write me at [email protected] or go to www.medicalpsychologyservice.com and let me know how I can help.

G. Katie Dashtban, Psy.D.

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.