Complete Your Pain Management

By Dieter Dvorak

Chronic pain is a very common health problem and a number of natural and automatic human reactions and attempts by pain patients to help themselves, unfortunately, prolong and exacerbate their situation as patients get stuck in an endless chain of increasing pain and distress. Sooner or later, attempts to directly eliminate chronic pain sensations create an even bigger problem rather than providing a solution to pain sufferers.

Enabling chronic pain patients to recognize this counterproductive struggle and then to break the unhelpful chain reaction is the purpose of this highly structured course. Gradually, the chronic pain patient is instructed on how to reduce the negative impact of chronic pain by first recognizing and then neutralizing their natural and automatic human "Flight or Fight or Freeze" reactions to pain sensations.

Since the beginning of the 21st century, neuro-science research has found that the cognitive practices, that are suggested in this guide, are stimulating neuro-plasticity effects in human brains. These effects are necessary in order to be able to override the automatic "Flight or Fight or Freeze" chain reaction if and when needed.

This guide was written by an experienced Clinical Health Psychologist, who has been specializing in long-term pain and physical health problems for more than 30 years in his career. It represents the accumulation of many years of clinical work with people whose lives have ben upended and deeply affected by severe injuries, chronic pain and other long-term health problems such as diabetes, chronic fatigue, long Covid, stroke, MS, arthritis, asthma, chronic kidney disease and others.

The approach in this guide has proven itself as a deliberately gradual and measured way of learning how to recognize problematic reactions and how to stimulate the necessary neuro-plasticity first before eventually applying the newly built skills to chronic pain in everyday life.

This guide is filled with practical instructions and advice as well as with many metaphors and illustrative examples to create a better understanding of the suggested approach and the motivation to start and then persist with the necessary cognitive practices.

• Language: English
• Publisher: Dieter Dvorak
• Release date: Jun 17, 2022
• ISBN: 9781005512996

Dieter Dvorak

Dieter Dvorak was born in Stuttgart, Germany.He worked in the public workplace accident rehabilitation service between 1981 and 1994.In 1994 he began formal studies in Psychology at the Eberhard-Karls University in Tuebingen.In 1995 he and his family immigrated to Auckland, New Zealand and he subsequently continued his professional training with Massey University to become a Clinical Psychologist. He has been working as a psychologist in Auckland since 2001.Returning to his roots in rehabilitation, after an initial period of working for local public adult mental health services, he has specialized in interventions for long-term health and injury and chronic pain since 2005.In 2011 he created the Psychology module of a local public chronic health service and has been developing and implementing it since then.

Book preview

COMPLETE

your

PAIN MANAGEMENT

How to make the most of life

when the body keeps hurting

Dieter Dvořák

Published by Dieter Dvořák at Smashwords

Copyright 2022 Dieter Dvořák

Disclaimer

This guide is intended as a general information resource and all care has been taken in compiling the contents. This guide does not take account of individual circumstances and is not in any way a substitute for medical advice. Always consult a qualified practitioner or therapist. Neither the author nor the distributor can be held responsible for any loss, claim or action that may arise from reliance on the information contained in this book.

This e-book is licensed for your personal enjoyment only. This e-book may not be resold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you are reading this book and did not purchase it, or it was not purchased for your use only, then please return to your favourite e-book retailer and purchase your own copy. Thank you for respecting the hard work of this author.

Contents

Contents

Is your Pain Management Complete?

Phase 1: Laying the Foundations

Chapter 1: Quality of Life – Rising to the challenge of chronic pain

Chapter 2: Of Fires and Petrol – why you need to neutralise your natural reactions to pain

Chapter 3: Getting started – how to neutralise natural reactions

Summary of Phase 1

Phase 2: Pain relevant practices

Chapter 4: Working with Body Sensations

Chapter 5: Staying neutral when it really counts – challenging sensations and reactions

Chapter 6: Practice – in life and for life

Chapter 7: The final dress rehearsal – being neutral about physical discomfort

Summary of Phase 2

Phase 3: Applying the techniques and principles in daily life

Chapter 8: Horses for courses

Chapter 9: Ripple effects

Chapter 10: Re-framing your life

Chapter 11: Be kind to yourself

Chapter 12: A possibly important afterthought

Chapter 13: Going beyond pain and suffering

Summary of Phase 3

Afterword

Appendix 1: A collection of insights

Appendix 2: Practices – audio files

Appendix 3: Practices – written instructions

Appendix 4: Practice worksheets

Is your Pain Management Complete?

This seems probably like a strange question to you.

Obviously, reading this introduction of a chronic pain management guide, you are still in pain and it affects your Quality of Life on a daily basis and you want something to be done about it – so how can it be possibly complete?

You probably have had pain for quite some time now – maybe months, maybe years, maybe decades, even.

In all likelihood, you have sought out help from your family doctor, medical specialists, physiotherapists, chiropractors, nutritionists, acupuncturists, herbalists…

You have undoubtedly undergone scans, medical examinations and investigations, you have been taking medications, you have been doing exercise, you have had manipulations and interventions, you have rearranged your lifestyle and eating habits and maybe you even have had surgery. Maybe you have purchased some kind of special device that was promised to take the pain away quickly and easily.

You have done the right thing!

Looking for pain relief and improvement and seeking out the help of health care professionals is what anyone should be doing and yet…

Despite all your best efforts, you still experience pain sensations often enough and intense enough to affect you in your daily life.

The bad news is that – at this point in time – you seem to be left with pain sensations that have not responded to all those medical and alternative efforts to reduce or eliminate them. That is the very nature of chronic pain. It is bio-medical (and complimentary) treatment resistant! If it was not, it would simply not exist.

There is good news, though.

The good news is that your personal pain management is not complete unless it has also addressed the natural reactions and changes that come with experiencing long-term pain and that automatically exacerbate and prolong pain and its negative impact on your life.

This is very good news because modern neuro-science has produced evidence that it is possible for human beings to deliberately influence and even shape their own nervous system and to neutralise their natural reactions that have such detrimental effects.

This is called remedial neuro-plasticity and this ability can be harnessed by most people for changing how their central nervous system is processing pain signals.

Traditionally, pain management has always focused on bio-medical treatments. The general idea has been that pills, and potions and injections or surgery as well as certain psychological treatments (relaxation, self-hypnosis, distraction or changing your thoughts to be more positive) as well as alternative interventions can directly reduce and eliminate pain sensations.

There is nothing wrong with this approach, of course, except it does not work for at least one in five people who experience on-going pain despite all their best efforts.

Training a brain to not automatically and blindly react to pain sensations but instead being able to respond in a very different and new way, however, can have very powerful positive effects for chronic pain patients.

A greater ability to engage in meaningful activities and a subsequently increased Quality of Life have all been directly linked to remedial neuro-plasticity. Even a reduction in pain intensity is possible once such neurological changes have been achieved.

Remedial neuro-plasticity does never replace any helpful medical or alternative interventions, of course! However, it does complete the pain management of anyone who carries the heavy burden of chronic pain.

If you feel that your pain management has been incomplete then the NIP programme is here to help.

NIP stands for

Neutralise (reactions)

Integrate (sensations)

Prevent (ripple effects)

What it is and how, exactly, that you are supposed to neutralise, integrate and prevent is what this guide in front of you is all about.

It will offer you scientifically supported advice and a structured learning experience that has proven itself over many years and thousands of pain patients. You will learn how to initiate and sustain remedial neuro-plasticity so that you can experience more Quality of Life again.

This guide is an educational intervention that will equip you with the necessary skills, knowledge and motivation to get started and to keep going with the completion of your chronic pain rehabilitation.

There are three distinct phases to the NIP programme and this guide will lead you – step by step – through those phases.

Phase 1 is about the laying of the foundation. Neuro-plasticity requires a very particular set of skills needed to start re-shaping your brain’s response to pain. In this initial phase you will be introduced to the techniques and principles and the general practice of neutralising your brain’s automatic reactions.

Phase 2 will take these general neutralising skills and techniques and practices into working with your body and pain sensations. In this second phase you will be introduced to more advanced and sometimes challenging practices that are necessary for you to build a strong and reliable and helpful response to pain sensations in particular.

Phase 3 is all about how to correctly apply your new response to pain sensations of various intensity levels so that you can reap the maximum long-term benefits from your efforts in your daily life.

Complete pain management is about making sure that all aspects of someone’s pain experience are being addressed!

Completing your pain management through the NIP programme is about you becoming able to improve your Quality of Life with persisting pain sensations by being able to focus your strength and resources onto those aspects of the pain experience that you can directly control yourself!

At the time of publishing this guide, I have close to 40 years of professional experience in rehabilitation and healthcare, and during this time I have worked with thousands of people who were badly affected by injury, illness and pain and its impact on their daily life, and therefore I have confidence that following this guide will improve your Quality of Life above and beyond what it is now.

Dieter Dvořák, Clinical Health Psychologist

Phase 1: Laying the Foundations

In this part of this guide, we first will explore how chronic pain has such a negative impact on life.

A deeper understanding of how pain sensations and pain reactions feed and exacerbate each other over time will be helpful with starting your brain’s remedial neuro-plasticity training in order to overcome the automatic and natural vicious cycles that pain sets in motion.

Such neuro-plasticity requires a very particular set of skills and in this initial phase you will be introduced to the fundamental techniques and principles and the systematic practice of neutralising your brain’s automatic reactions to the world in general.

We will take a gentle and gradual approach that has proven itself over many years and with thousands of pain patients.

Do not rush ahead!

Stick with the suggested order in which the various practices are presented and explained to you.

Do not rush ahead to Phase 2 or 3 before you have laid a solid foundation of general neutralising skills first!

Chapter 1: Quality of Life – Rising to the challenge of chronic pain

Why does chronic pain have such a severe impact on the Quality of Life?

Quality of Life – above all else – is created when you are being able to do what you feel is most meaningful to you. It is also about being able to be with the people that are the most important ones to you. It is about being able to participate in life and to find satisfaction and enjoyment in what you do.

Chronic pain often cuts people off from meaningful activities and being with other people that are important to them. It also makes it very difficult to savour all that is good and enjoyable in life around pain.

In other words, chronic pain stops pain patients from creating and maintaining a good Quality of Life through participating and finding satisfaction in their lives.

What does participating mean?

Participating in life is all about being personally and actively involved and connected to people and activities. These activities can be anything YOU choose such as family, friends, local community, work, art, environment, spiritual/religious activities, sports, hobbies, politics and so forth. Your life – your choice!

Participating means: taking an active interest in life and in something bigger and different than oneself. This does not always have to be about physical activities, though. Joining a social media interest and discussion group and constructively contributing with posts, for example, is as much about participation as is playing in a competitive sports team, traveling, gardening or socialising with other people. This example of participation, however, would not involve more physical activity than hitting the buttons of a keyboard and a few mouse clicks!

Participating is as much a state of mind and commitment and giving one’s full attention to something and getting involved mentally as it is about physical activities.

Participating, therefore, should never be confused with being a passive recipient of something that is merely being consumed without too much attention and active personal inner involvement on your own part.

What does finding satisfaction really mean?

Finding satisfaction in life is also all about being actively personally involved and connected to what the world has to offer you.

It is also about – again – giving your full commitment and attention to something that will spark a sense of admiration, being inspired, enjoyment, awe, gratitude, respect, etc. in you.

It is about the art of savouring life, really.

Finding genuine satisfaction requires an active effort on your part to fully engage with the world through your senses and actions and thus allowing life to come to you and to touch you and move you.

Finding satisfaction, therefore, should never be confused with simple consumption and being merely amused, pleasured or entertained either. Being a passive recipient of something that is only momentarily pleasant or entertaining or fun is certainly a legitimate part of life. Yet mere fun – in and by itself – is not nearly enough for creating a solid and lasting sense of Quality of Life.

Finding satisfaction is mainly about being able to show up mentally, receive and truly experience beauty, your own or someone else’s achievements, relationships and whatever good and uplifting is happening around you and to you. Even just simple pleasures are more intense if you do pay proper attention. So – next time you eat that delicious slice of pizza put the phone aside and try to fully taste it.

Someone who is able to fully participate in life and find satisfaction in it, is much more likely to enjoy