Migraine and Chronic Pain

MIGRAINE AND CHRONIC PAIN

    • Do you suffer from migraine or chronic pain?
    • Have you tried medication or other methods to stop your pain, but it doesn’t work?
    • Do you have a history of trauma, abuse or unresolved anger?
    • Do your doctors often look at you as if they don’t know what to do?

 

Migraine and chronic pain typically have a biological or medical explanation for their origin, yet many people who suffer from the pain of migraine and chronic pain from other areas in their body do not ever find relief from traditional or alternative medicines. Even though many doctors will look at their patients like they are “crazy” after tried a combination of preventative and rescue medications, very few will ever recommend from the beginning to include psychotherapy as part of their treatment regimen, so when they do the patient then becomes angry and confused as to why their doctor thinks they need to go see a “shrink”. The message that the patient would like to scream out to the doctor is, “No doc, my pain is not all in my head; it’s real.”

It can be a devastating and degrading experience to be treated like that by a doctor that you placed your trust in and had hope that your migraine or other chronic pain would be reduced or eliminated. Many in the medical and mental health professions lack so much understanding about migraine and chronic pain that they can actually do more harm to their clients who are already suffering. Many of the so-called expert neurologists who are referred to as headache specialists and other pain management specialists including chiropractors and alternative medicine doctors who cannot find a way to treat you according to everything, they know may refer you to an insurance-based mental health professional who most likely suggest a few visits of cognitive-behavioral therapy or eye-movement desensitization and reprocessing (EMDR) therapy. While some people report that they experience some benefit from these types of therapy for their chronic pain and I even use cognitive-behavioral therapy when appropriate, there are limitations to these methods and the one-size fits all approach is a major concern.

MIGRAINE IS THE SECOND MOST DISABLING DISEASE IN THE WORLD

If you have experienced migraine, you are not alone. When people hear the word “migraine”, they often think of a really bad “headache”, but it is much more than that. Migraine is a neurological disease and it can begin at any age. Headache specialists will often probe you with questions about your family history because an estimated 80-90 percent of those who are afflicted with migraine have a family history of migraine and there are a number of genes that have been associated with a higher risk of developing migraines. However, twin studies and other studies have shown that genes may only account for fifty percent or less of the cause of migraine. Other factors such as hormonal changes, co-morbid neurological disorders, unconscious conflicts, overexertion, and environmental stimuli may be equally responsible.

I believe that’s why headache specialists should be incorporating psychotherapy into treatment for migraine from the beginning. They briefly talk about SEEDS for Success, which are all lifestyle change that are behavioral in nature that they promote for their patient to do while under their care, but then they focus on the rescue medications such as triptans and DHE combined with preventative treatments such as Botox, Nerve blocks, and other medications such as blood pressure, anti-seizure, anti-depressants, and CGRP monoclonal antibodies.

If you experience chronic migraine that means that you have 15 or more headache days per month with at least 8 days having migraine features. Anything less, is considered episodic migraine. Migraine attack features vary from person to person, but include one or more of the following:

    • With or without aura
    • Blurred vision
    • Pulsating or throbbing pain, starting gradually and building up in intensity
    • Sensitivity to light, sound, smell, or touch
    • Nausea and vomiting
    • Fatigue
    • Mood changes
    • Lightheadedness, sometimes followed by fainting
    • Weakness

 

Note: Untreated migraine can last for hours, days, or months. For some people, migraines progress through four stages: prodrome, aura, headache (migraine attack), and postdrome. It’s also important to note that some people who experience migraine may not actually even feel pain, but they do experience other symptoms consistent with migraine and that not everyone who has migraine will experience all four stages (e.g. aura).

CHRONIC PAIN IS AS COMMON IN THE UNITED STATES AS MENTAL ILLNESS AND IT EFFECTS YOUR MENTAL HEALTH

If you have struggled with chronic pain, you are not alone. 1 in 4 Americans currently live with chronic pain. The four most common causes of chronic pain include back pain, headaches (tension headaches, migraine, eye strain headaches, and cluster headaches), joint pain (arthritis, repetitive motion injury, bursitis, and tendinitis), and nerve pain (sciatica, diabetic neuropathy, carpal tunnel syndrome, post-therapeutic neuralgia, and trigeminal neuralgia). Chronic pain can affect your mood, ability to function in normal activities of daily living including work and self-care, and your relationships with others if it is not properly treated and if you do not get the help and support that you need from a psychological perspective as part of your other treatments. While poor body mechanics, injury and genetics are common medical explanations, which may be correct, the treatment options do not work for everyone. Pain medications, physical and occupational therapy are often used, and while some people report that they get results, many others suffer from chronic pain and either need more medication because they build up a tolerance or choose not to use pain medications because of the fear that medication overuse can cause an addiction. Some people do become addicted to these pain medications and as their doctors try to reduce the dosage after surgery because physical therapy has been completed and the wound is “healed”, now have a new problem with no way to control their pain experience the other effects that the pain medications provided them. People, who never used illegal drugs, may seek out synthetic opioids such as fentanyl, which are 50-100 times more potent than morphine and approximately 43% of the pills sold on the street have a lethal amount in a single pill.

PSYCHOTHERAPY FOR MIGRAINE AND CHRONIC PAIN CAN HELP YOU RECLAIM YOUR LIFE

While I do believe that medical and even some alternative medicines such as chiropractic medicines work and should be used in combination with psychotherapy, research shows that psychotherapy techniques can help reduce migraine and chronic pain even when nothing else seems to work. If you are committed to the therapeutic process and willing to acknowledge the psychological impact that migraine or other chronic pain has on your life, there’s a lot of hope that your life can get better. In session, we will first work towards understanding how your pain is impacting your life and how you would like your life to be different. Next, we will work towards identifying and understanding any unconscious psychological conflicts that may need attention. Psychotherapy techniques can help you to put new language and meaning to things that you were not able to do on your own, but we will work together to help you to so and to find new, healthier ways of seeing your situation and living so that your pain is no longer having so much control over you.

My approach is carefully designed to promote healing and wellness. I have been able to help a lot of clients overcome unconscious conflicts, some of which result in physical manifestations of their distress. Some clients who have had migraine or chronic pain that started in childhood or after a trauma, stop having pain after their first session with me simply because I have been able to identify the source of their unconscious anger, but they have continued treatment to experience psychological healing and ultimately stopped receiving medical treatments for migraine or chronic pain. In some cases, I may include treatment methods which include making changes in your lifestyle and integrating practices that promote physical and mental exercise that are different than how you are living now.

I believe that psychotherapy should be highly personalized based upon your unique and specific needs. I will work in collaboration with your medical professional if you choose, however we will need to discuss the limits of confidentiality if choose that approach. At this time, all of my clients who have migraine and who have not already been provided access to a special educational course created by specialists and advocates from around the world, which has a value of $99, are provided this at no additional charge.

ALTHOUGH YOU MAY SEE THE BENEFITS OF PSYCHOTHERAPY FOR MIGRAINE AND CHRONIC PAIN, YOU MAY STILL HAVE SOME QUESTIONS OR CONCERNS ABOUT THE PROCESS…

My migraines or chronic pain ARE real. I am not faking it. I doubt that you can help me.

A small percentage of people “fake” or “exaggerate” their pain and this is called “malingering”. The mere suggestion that psychotherapy can help you heal or respond to medical treatments or that there may be an underlying psychological reason for your pain does not mean that I believe that you are someone who is faking or exaggerating the effects of your medical condition. My belief in psychotherapy being beneficial in treating migraine and chronic pain is based on research and personal experience in treating clients who have experienced both. I understand that it adds an additional layer of pain, not just psychologically or emotionally, but even physically when a person, especially someone who is a professional or otherwise should be trusted because of your personal relationship with them, does not to believe you. Even our understanding of pain and the current definition of pain that the medical field is using demonstrates the real lack of empathy, compassion, and understanding that a person who experiences migraine and chronic pain feels when they hear it. I can make no guarantees that the work that we do together will work, but I can tell you that I have helped many people experience less pain and feel more at peace even when they are in pain as a result of our work together.

What does trauma have anything to do with migraine or chronic pain?

Pain is unique and specific based upon each person, so the correlation between trauma and pain is not universal. Physical trauma can cause headaches and other chronic pain to start, as an example, and there can be unconscious conflicts related to the original physical trauma that are unresolved, which can exacerbate the pain. Clinicians may only begin to experience migraine or chronic pain, as another example, when working with victims of trauma if they are reminded of their own trauma (e.g. childhood sexual abuse) that was left untreated. Psychotherapy can help work towards understanding these wounds and even provide a reduction in pain or complete relief for some people. Medical treatments may need to be used in combination with psychotherapy during treatment and thereafter, but the person’s ability to respond to medical treatment is typically enhanced by their participation in psychotherapy.

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