Whose Pain Is It?

Having recently arrived in Oregon, studied diligently for (and yes, passed) my ethics exam, and at long last, received my license, I had a few months in which to explore the clinical issues prevalent in my new environment. Chronic pain kept popping up in conversation, sometimes right after "oh, you do hypnosis," and sometimes before.

What I gleaned from my participation in clinical groups and meetings was that the chronic pain treatment pendulum has swung once more. In short, and without citation: Long ago, MDs prescribed heavy doses of medication for pain patients, chronic or acute. The pendulum then swung to a fear of creating addicts. This was not entirely unfounded, as overprescribing of serious pain medication was rampant, and addiction was up. (When my children left a dentist with Vicodin for the removal of wisdom teeth, I knew something was not right). So docs lived in fear of government repercussions for overprescribing, and, as with most pendulums, now it had swung too far, and even deathly ill patients were constrained from receiving comfort, by over-regulation. Back it went, and back came too many addicted patients along with, guess what? too much chronic pain.

Vexing Illnesses!

I am just back from presenting at the American Society of Clinical Hypnosis Annual Meeting with my colleagues, Julie H. Francis, GCFP, and David C Flemming, MD. We presented our fascinating workshop on uncovering the reasons for puzzling medical problems such as intractable chronic pain, migraine, IBS, interstitial cystitis, and autoimmune disease. The blanket term I use for these problems is "medical disorders of dysregulation."

These illnesses are vexing to physicians because they do not follow the rules. Medications tend not to work, there is no surgery that fixes them, and even the cause is elusive.

These problems are even more vexing to those of you suffering with such a condition for those same reasons. No one seems to be able to help. Now and then something seems as if it is helping and then you are let down when your symptoms return.

The work I have done in my office, and the work I have shared with various colleagues, leads to some interesting conclusions with the potential to help many of you. First and foremost, we know that you are not pretending, faking, or, worse, crazy. You have symptoms, some of which are visible or measurable, others of which are subjective--you hurt, but it cannot be seen by others.