Pain clinic and psychiatrists

I’ve read the letter the pain clinic sent to my GP and he mentions many times that he wants me to see psychologists and psychiatrists. Has anyone else gone through this with the pain clinic?

[desquinn Partner Volunteer FMAUK Trustee]

Different pain clinics have different services available but psychologists etc are very common. Possibly CBT will be one of the options, but also if they are thinking of antidepressant drug options that can help with pain they may look at mood to see if a dosage is relevant to address more than just the pain.

[Hidden in reply to desquinn]

I’ve already been to numerous therapists and done CBT. I’ve tried all the antidepressants and I’m currently on one now. So I’m not sure why they would send me to them?

[Hidden]

Hi BigCat,

I also have the same from my Pain Management Clinic, they said they wanted me to see a psychologist, I asked why they thought that appropriate and apparently and this is their words "to prepare you with living with chronic pain". I said that I really did not feel that this was necessary as through various stages of my life I have been involved with counsellors and the last one actually said "to be honest you should be sitting in my chair".

I think that was the only logical answer apparently the referral is about 6 months behind so at least it wont be a phone call or visit next week.

Panda

🐼

[Hidden in reply to Hidden]

I’ve already been to many others like you. So I don’t get why they would try to send me to a psychiatrist of all things?

[Hidden in reply to Hidden]

I personally don’t get it either 🤷‍♀️

[Hidden]

Ajay575 I completely agree with you and the reason I have been seen by both physiatrists and psychologist was because life traumas and events meant my mental health suffered tremendously but as I have repeatedly told them I am not and fingers crossed never going to need to be counselled over chronic pain, I have overcome horrendous things but they still said oh just see them, i wish they would give it to someone who would need it more than I do. I would feel terrible taking the appointment.

Panda

🐼☺️

[desquinn Partner Volunteer FMAUK Trustee in reply to Hidden]

but things change both in the person and with treatments. Was hearing about EAET recently which was new to me as an option. EMDR also but not heard it used for fibro but for PTSD and cognitive interviews. These were from a German professor but just to illustrate that things change. He was also expressing that there are good psychologists for fibro/chronic pain and not so good ones. I would think pain clinic ones are more likely to be positive.

[Hidden in reply to desquinn]

So sorry desquinn, I don't know about EAET or EMDR I have PTSD and I honestly do get that things can change both in the person and treatments but honestly personally, actually I am finding it difficult to put into words what I really want to say but this may come across as flippant and derogatory to chronic pain sufferers which of course I am one of, but trust me its not that way.

I will never find chronic pain difficult to deal within my personal life I have dealt with personally a lot lot worse, which i will not go into details about, oh goodness sorry if none of this makes sense.

[desquinn Partner Volunteer FMAUK Trustee in reply to Hidden]

First of all the terms but was more to highlight there are new things from time to time just like new drugs come along.

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.

Emotional awareness and expression therapy (EAET)- pubmed.ncbi.nlm.nih.gov/311...

As to the other point yeah I can understand and was getting what you were at from the earlier post. Its a matter of perspective but I was (as I do a lot of the time) was speaking to the room so to speak as well as you. But in your situation if you are in a better place with your pain then you are then in a a better place overall.

I think they will also at the pain clinics assess people to see where they are at to then see what treatment is best. Physio and tramadol are no relative use if the patient is floored with depression for example.

[Hidden in reply to desquinn]

Unfortunately not in a better place with pain but thanks for clarifying the treatments etc

[Oshgosh in reply to desquinn]

Thanks for explaining the names of the rherapies

[desquinn Partner Volunteer FMAUK Trustee in reply to Oshgosh]

no problem but they may not be available to all but was more to encourage people to think about things change so if you have not tried this or that in 10 years then dont think it is the same as it was. And also some things are improved in how they are applied.

[Chance15]

BigCat47 I myself went through the same things that was due to mental health.I seen both both of them for 1 year each I told psychologist I will not be seeing him no more.I was going through the same torture every week and yet I was still in the same pain fatigued loseing me mom I still wake in nite watching mom putting her hands out begging any one who went past for helpe.That will haunt me till my dying day..They may help some not me.I then get told by pain specialist they have done everything they can with treatments.that there’s nothing more they can do in other words suffer in pain till you die.

Sorry I’ve gone on to much.

If I was you I would see them both at least then u av tried.

[Hidden in reply to Chance15]

chance15 this post literally breaks my heart not going to lie I shed a tear, and I totally get your post and what your saying warm hugs it won’t cure your broken heart but it may just help a teeny weenie bit 🐼🥰

[Beachcomber53 in reply to Chance15]

So sorry to hear you are suffering these PTSD dreams. I had them for a year after a car crash and dreaded going to sleep ending up exhausted. My counsellor helped me to work through them by asking what happens next? By staying asleep and extending the dream to find out and ACCEPT the next part of “the story” I was able to work through this horrible nightmare and break the cycle. It took many months and was awful but once my subconscious had exhausted expressing the trauma in my dreams the dreams just stopped. It was my “year from hell” but 9 years on I’m so glad I put in the work! Good luck Chance15

[HapaC in reply to Chance15]

Chance15, you have brought me to a place I have not been in for a bit, I am crying in my soul for you and your mum. Life is so cruel on do many levels, many of us have suffered so much, yet, here we all are. Helping each other by listening and at least sympathizing makes us feel better sometimes. As for seeing numerous therapists, I used to feel like I was being told by my PCM that he/she didn't believe me about being in so much pain, I felt they were insinuating that it was all in my head, UNTIL I began working with and really trying some of the new techniques with my latest psychologist and I recommend trying everything at least for a few weeks, who knows, you might actually find some helpful tools. Sending out big hugs to all of my pain suffering family, hope you find something to help. Xoxo

[Themanwithnoname]

Firstly id say you have nothing to loose in giving it a try. I had a few sessions with a pain psychologists and found it useless. Tried telling me to try working in a garden centre as i used to be a farmer. My defences went up and safe to say she never understood as garden centre to me involves a lot of lifting of heavy bags of composs. She did put me onto a pain clinic and i think you will prob always take something away with you but dont go in expecting miracles as on the 2 ive done the first sentance is we cannot take away your pain.

Been offered CBT but involved going out somewhere and i rarely go out. Been pretty depressed recently and today is the first time ive been out in 3 weeks. Went for a nice walk down by the river.

[Hazel_Angelstar Administrator FMA UK Staff]

when it comes to psychological support - i think it depends very much on the relationship you have with the individual psychiatrist/psychologist. I've seen a few over the years - some were connected to my depression; others for pain management/fibro support - although they would generally overlap. Some were a great help - others a waste of space.

For me, psychological support helped me to look at my perspective on living my life with a chronic health condition ... and i realised that (at that time) I was letting fibromyalgia and depression rule my life and what I was doing .... with support I was able to turn that around and learn coping mechanisms and ways of living my life with fibromyalgia and depression.

it might not take away your pain, but it may help you to learn ways of living with it. xxx

[Hidden]

I have had some amazing experiences with regard to my mental health and some where I was like very questionable as to what they were trying to achieve both privately and on the NHS.

I have had CBT and I have never been in a room with so many angry people, I left at the tea and biscuits stage. One lady next to me was there because she had punched her boss 😳

It’s like everything give it a go, nothing ventured nothing gained, if it’s not for you then tick that box and explore other alternatives (I would just like to point out Ajay I have not once mentioned beans ☺️👍🏻

[Hidden]

Yes, for many years treated like a mental case. A hypochondriac a liar and an attention seeker.

[Cat00]

I've seen masses of psychiatrists, psychologists etc they were never able to deal with what was then undiagnosed chronic pain (despite seeing many doctors) one very nice psychologist eventually said that they couldn't help me with my 'existentialist' problems!

[Beachcomber53]

Pain and treatment aside - if you need to apply for early retirement or benefits (or to increase them) getting all the recommended treatments will help provide the evidence you need to fight your case more effectively and could really help you. Xx

[MaggieSylvie]

It sounds as if some inexperienced civil servant has decided it would be a good idea to send everyone to see a psychiatrist/psychologist. It can feel patronising. However, you never know - it will be a legitimate way of leaving the house and meeting someone to talk to if you've been shielding and it might distract you from the pain for a while (distraction being something pain clinics suggest as useful, and it can be). That is unless walking to the clinic causes you extra pain. If you can bear it, you might get something out of a visit.

[Medical61]

When I attended the pain clinic I got the distinct impression they believed some of the pain is psychosomatic.

[desquinn Partner Volunteer FMAUK Trustee]

One thing I was watching recently was talking about neuroplasticity when the brain adapts and changes over time. And that our fibrofog may be an example of that and the cognitive changes are a result of our constant pain. But it is conceivable that by using cognitive techniques that some of that pain could be helped at some point. A lot of current techniques like CBT are to help us deal with pain rather than reversing it. This can help it from becoming worse but interesting to think about non drug approaches helping to push things back the way.

Examples of this can be found with phantom limb pain and the mirror approach for example.

[Oshgosh]

Did CBT when I was first diagnosed.I found it useful,but it was hard work.

Now 2 years on,Ian having another course,it’s much harder this time,but the issues are different.

Also a big problem emerged,which I managed to work through.

I was nearly taking antidepressants,but havemanaged to improve my mood and sleep by different means.

Have done both courses online.i for nd it good.

Didn’t have o go out and could concent rate properly, o visual/ verbal distractions.

I don’t think there’s 1 answer to any thing,sometimes lots of small changes can make a difference.

Take care

[Freddie20]

Hi bigcat47. Yes I have had some amazing counselling through the pain clinic. I found it really hard to come to terms with having fibromyalgia and other health issues which have had a severe effect on my life . It was very helpful and Lorna was so kind and understanding. I would recommend this help. X

[Hidden in reply to Freddie20]

Thank you for your comment! I am struggling with a few things but I’ve tried counselling before and it didn’t help x

[Freddie20]

I know it's really difficult. They know about people dealing with living in pain, and the affect it has on us. I guess at the end of the day its help. I wish you luck. Take care. X

[Chloe_x]

Hi, my pain clinic also offered me a psychologist/psychiatrist. I ultimately declined for several reasons, but my point is that perhaps they have more experience dealing with chronic pain patients. I don't know if the CBT you've done in the past was with a therapist trained and experienced in that area, but the psychologist at my pain clinic was particularly involved with chronic pain, so perhaps it's something similar for you.

Whether you decide to take them up on the therapy or not, I hope you find the pain clinic helpful

[22pagets22]

Helo all I was reading about people being told to get used to living with chronic pain i had phone call from a gp telking about withdrawing my pain relief when I questioned why as iam on slow release zomorph and it took 15yrs of trying different meds and acupuncture etc to get to something that helps this is when said gp said its all psychological to me I asked to speak to anyher doctor to go over my medication as in a review and this is when they said they are worried my medication will shorten my life I said living with chronic pain without pain relief would shorten my life more than any medication iam taking also said gp and the pharmacist who I talked to didn't know why I was taking meds this is what happens when only have locums at moment cant get anything other than a phone call no appointments etc so maybe that is why phycologist was mentioned sorry bit of ramble but got so angry when gps who don't know your medical history and see your on opiates and straight away want to withdraw them without any other alternatives

[JayCeon]

I've done quite a bit of one-to-one CBT in my life and it all helped me. When it comes to fibro-pain management I was thinking I'm doing it quite well, but what have I to lose, went to 2 recommended psychologists. It was a bit fun, a bit boring, because they didn't have any ideas, one just supported one idea I had (relaxing my muscles more), which I implemented in five days, without it helping. In the rheum./fibro clinic I could talk with a pain clinic psychologist, which I hoped could help more, it was nice, but he couldn't do much either. He had several images, which haven't stuck tho. One was to think of the pain as a nerve-wracking relative O.o! I pondered on this a few days and decided to give it up and go more for even more focused self-care instead, which has helped. I've also read 2 books, Jon Kabat-Zinn and Peter Levine which didn't tell me anything new, because I already use autogenic training, self-hypnosis etc. and that doesn't help that much apart from doing something sensible when I can't sleep properly ;-), and often it does get me to sleep, if I've sorted everything else out.

[WFBA]

I would urge anyone who is offered a place on a Pain Management Programme to take it. I was very sceptical it would make a difference. I would not say it is life shattering, but even if you only find one or two new ideas that work for you then your life will be slightly better. It effectively gives you a forum to consider your situation with other people who are suffering with chronic pain. For me what helped was understanding pacing, and knowing it was safe to exercise. For one participant who was struggling to do his exercises, as he was so stiff, and enjoyed taking baths, as it eased the stiffness, I suggested he tried doing his exercises in the bath, and that worked for him.

It is like the Olympics, we all need to find small incremental changes that make our life a little better, because 1% here, 2% here etc can through the multiplier effect make our lives just a little better.

As for psychologists and psychiatrists, it is again part of the jigsaw, as dealing with pain 24/7 is challenging; and again one small reframing exercise might make a difference to you. Distraction works to an extent for me, 4 pages of evening puzzles from the newspaper helps me to relax. Meditation the worst for me, all I was left with after I cleared my mind was the pain!!

But what I saw was different things work for different people in the pain management clinic, not to cure but to gain marginal improvement.

I was wondering if anyone had tried and had any success with hypnotherapy or virtual reality hypnotherapy in their management of pain? And if so who was the practitioner they saw?

Hope that helps.