The Patient was upset

This article was first published in the Herbal Collective in 2004.

After her visit to the family physician, the patient was upset. “Counselling? Why counselling? My pain is real—doesn’t my doctor believe me?”

Why, indeed? Does a referral to a counselor for chronic pain mean that the pain is “all in one’s head”, imaginary? And isn’t this adding insult to injury, when, after all the medical tests and interventions available, the person is still in pain?

Actually, the idea that pain is either in the body or in the mind is one of Western society’s more damaging and wrong-headed prejudices, and it is no longer believed by most doctors. Technically, all pain is a product of the nervous system—without nervous system activation, we would feel no pain even in the face of grievous bodily injury. The nerves signal the brain of damage or illness for a very good reason; pain is an important message that tells us when, and how, to take care of our bodies. People without the ability to feel pain (a rare condition) live short lives.

But communication within the nervous system is affected by many things, including not only the condition of the body, but also emotional states, fatigue, competing sensory input, and even our thoughts. Far from being a straightforward experience, pain is affected by literally everything in our lives. In return, as anyone living with chronic pain will attest, pain affects everything else that we are experience. It’s a full-circle deal.

The role of counselling in the management of chronic pain is not to take the place of more body-centered treatment (conventional and/or complementary medicine), but to enhance its effectiveness in two ways. First, counselling can help to identify and alleviate conditions that tend to exacerbate pain. Negative emotions, unhelpful beliefs and thought patterns, stress-producing behaviors and muscle tension can be reduced, thus “turning down the volume” of a pain-activated nervous system. Second, counselling can help us to manage better within the limits of our health. Prioritizing what is most important, focusing on our strengths, and restoring a sense of control and choice in our lives are some of the ways that counselling can help to bring joy and fulfillment back to a life that has been negatively affected by pain.

Physicians know that the majority of people who feel limited, frustrated, angry or very sad about living with chronic physical pain can be helped by a qualified and skillful counsellor. A physician who refers a patient with chronic pain to see a counselor is not expressing doubt about the reality of your experience. Instead, she or he is expressing faith in our ability to live fully even when all the medical options have failed to stop the hurting, and to transform a pain-filled life into one with room, once again, for joy.

Monika Grünberg is a Registered Clinical Counsellor who specializes in individual and family counselling for adults and children experiencing life stresses, including illness, injuries and pain. Dr. Serena Patterson is a Registered Psychologist who specializes in psychological assessment and treatment of adults experiencing difficulties in living, including chronic pain and challenges to physical health. To contact them, they can be reached directly in the Comox Valley at 339-3269, or toll free at (877) 339-3269.