Managing Chronic Pain So It Doesn't Manage You

My name is Susan Farber and I am a licensed Marriage Family Therapist in private practice. I specialize in helping clients manage, reduce, and eliminate chronic pain using a mind/body approach to treatment. I look at how denied emotions, tension, and stress contribute to the development and maintenance of chronic pain.

Let’s start with the issue of denied emotions. An individual internalizes unpleasant emotions (i.e. anger, guilt) when they are too painful and threatening at a conscious level. The work it takes to keep the emotions below consciousness creates ongoing tension which can eventually results in physical ailment. In my work, I teach clients to use their body as a barometer to gain valuable insight into their psyche. By making unconscious emotions conscious, pain diminishes and the individual develops a sense of hope and personal empowerment. The client learns to take responsibility and ownership of their physical selves and develops the ability to free themselves of pain allowing them to achieve a sense of peace and fulfillment.
Secondly, stress magnifies pain levels. Stress results when a person believes that their safety and well being are threatened. The body undergoes a fight or flight response and tension develops. The weakest areas of the body are then affected, putting the individual at risk for developing pain or having flair up in physical symptoms.

Most treatment models take an exte
al approach to stress management. For example, an individual is taught coping strategies to manage their internal state of tension and stress. Relaxation and guided visualization are examples of two exte
al techniques. In my treatment approach, I integrate exte
al and internal stress management techniques. I utilize cognitive behavioral therapy techniques to identify and modify an individual’s core beliefs and internal dialogue that create stress. Pain levels decrease with the elimination of internal stress.

Meet Jill
Jill came to therapy feeling depressed. She talked about suffering from chronic low back pain that prevented her from doing what she loved, running. An MRI she had taken was normal and she found little relief from a combination of physical therapy, acupuncture, nerve pain medication, and epidural injections. Our work soon revealed Jill’s unhappiness stemming from her needs not being met in her six-year relationship.

Treatment focused on providing education about the mind-body connection, in particular the relationship between unacknowledged anger and low back pain. Jill had grown up in a family believing that children are to be seen not heard. This led to Jill internalizing her anger about her relationship which developed into depression and chronic back pain. Our work involved Jill connecting to her anger and underlying feelings of hurt and disappointment. She was able to embrace her anger by seeing it as a legitimate response to being invalidated and criticized by her partner. Her inability to run was seen as a metaphor for not being able to leave the relationship. With supportive counseling, Jill used her anger to motivate herself to take action. Within two weeks of ending her relationship, Jill’s back pain disappeared, leaving her free to run once again.