Pain Management

By Bud Perschek

In the spring of 2014 while living in Oregon, I was recruited for and asked to participate and help pioneer a new program. At that time, more emphasis was being placed on the negative and long last effects that opiates were having on patients. Physical dependence on opiates affected all who were placed on them. Psychological addiction was also becoming prevalent. Physicians, who had been previously encouraged to prescribe pain medications, were now being instructed wean their patients with chronic pain off of them.

This proved to be a dilemma for those who had been on these medications, sometimes for years. In response it was suggested that much of the perceived physical pain may be able to be addressed with a more natural and effective behavioral approach.

I remember when I went in to discuss the program. I said to them: “But I don’t know anything about Chronic Pain.” They all said “Yes you do.” I know now that the skills they were looking for had nothing to do with medications or traditional medical treatment. It had to do with an approach that would address the additional psychological pain many chronic pain sufferers endure. There was a mandate to get chronic pain sufferers off of opiate medication, but how we going to do it? Given this I agreed to help establish a pain management program that covered the Northwest portion of the state.

We did have an initial model to draw from on the structure of the Program. It would be conducted in groups of 5 to 10 clients. It would run weekly for 10 sessions. I remember that there was a lot of initial tweaking to the program to help make it educational, informative and effective for the participants. My learning curve was never so steep.

I must admit, I had my doubts. Why would I say that? It seemed like an insurmountable task. Deep breathing; restructuring the way you think; laughter; diet; sleep hygiene; body movement? What? Body movement for a person in pain??? No one was more surprised than me when we started getting good results. 95% of the participants reported that the program was “very helpful” to them and I was tickled pink. I don’t think we cured their chronic pain, but it was successful in helping them perceive pain differently.

As the program progressed, we began noticing something else. We had a number of participants who were also in mental health treatment. Their therapists began noticing that their psychological symptoms had improved, and a lot of the improvement was attributed to their participation in the pain clinic program. I guess it makes sense, physical and psychological pain have a lot of the same characteristics. So, we began to expand the program to include and address those with psychological pain.

I really hated to leave the program, but it was time to relocate back to Iowa. After moving I contacted the director of The Wellness Center in Cedar Rapids. I had heard that they were interested in a pain management program. I volunteered my time and we successfully graduated two classes. Then Covid hit.

Since doing the pain management program, I have become a firm believer in a more holistic approach in working with our clients. The pain clinic opened my eyes to explore other more natural ways to address the whole person.

I am trying to incorporate the principles I have acquired from the pain clinic to individual therapy. I do believe, however, that a group model is more conducive primarily because of peer interaction. I hope soon to re-establish a pain management group at Family Psychology Associates in Cedar Rapids. We shall see.

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Couple Counseling

By Don Damsteegt, PhD • September 20, 2023

By Don Damsteegt, PhD Relationships are the greatest source of joy in our lives and the greatest source of pain. When couples come to Family Psychology Associates for assistance with their relationship, they experience caring counselors whose goal is to create a safe environment in which to talk to one another, to improve communication, and to improve problem-solving. A specialized technique for couple counseling is Imago Relationship Therapy. This counseling approach emphasizes the importance of listening to one’s partner and validating what is heard for the purpose of one’s own and the other’s growth. When people come for counseling they will be encouraged to practice dialogical communication, which means not immediately responding, but first listening and then acknowledging what was heard. This makes it safe for the speaker to speak and it allows the listener to understand the speaker at a deeper level. For example, a common pattern is for Partner A to say, “I’m frustrated about X.” Partner B may then say, “Why are you frustrated?” or “Just get over it.” or “What did you do to make the other person react that way?” All of these responses invalidate what the speaker has said. We might say this is normal communication, but it is not helpful communication. In couple counseling, the counselor emphasizes listening and validating what the speaker has said. For example, if one partner (the speaker) says, “I’m frustrated about X,” the other partner (the listener) seeks to respond with empathy and understanding. “So you are frustrated about X. Did I get that right? Is there more to that?” Then the listener will seek to validate and empathize with the speaker. “If I were in your shoes I would feel frustrated too. It makes sense that you would want X not to do that. I can imagine that makes you feel hurt.” This is called “Mirroring, Validating and Empathizing (MVE)” This style of communication is rare. One of the gifts that couple counseling offers is a chance to be able to express yourself in a vulnerable manner and to know that your partner will receive the communication with empathy and without judgment. This style of communication allows for safety and opens the possibility of more emotional intimacy. This is a tool that partners can use in situations where emotions run high, such as hurt feelings or feeling very grateful. Research has shown that learning to understand your partner’s inner world and communicating one’s understanding in an empathic way improves relationships. If you are struggling with frustration in a relationship, please feel free to call Family Psychology Associates (319-378-1199) to set up a counseling session with your partner.

What to Expect from Counseling

By editor • June 9, 2014

So, what is counseling? Counseling is a focused conversation about things you want to change in your life. Counseling is most effective when it occurs in a relationship in which trust and care are established. Friends and relatives provide a type of counseling, as do clergy, teachers and many others. Psychotherapists are different from others […]

Listening to Teenagers

By editor • March 12, 2014

By Ken Fate I recently started a book study with some parents. We were discussing the book “How To Talk So Teens Will Listen And Listen So Teens Will Talk”, written by Adele Faber and Elaine Mazlish. In this edition I will share some gleanings from Chapter 1 which addresses the issue of feelings. Teenagers […]