Why pain management for work is different

There are many people who have completed a pain management programme, know how to do things like breathing, working to quota (pacing), relaxation strategies, distraction and exercise - but when they are asked about returning to work say ‘I can do these things at home, but not at work’.
I have many books on pain management [...]

If you find it hard to slow down…

Self regulation is something we learn to do to achieve goals - it’s all about establishing what the goal is, find out how close we are to the goal, the gap between where we are and where we want to be, and what we need to do to get there. This is a reasonably [...]

A brief ponder

Complete opinion today…!
I’m pondering why we as clinicians can be so scared about increasing our patient’s pain levels. And why patients are so fearful of increases in pain.
I spoke with a new group of people starting a pain management programme yesterday. I told them, as I tell all the new groups, that their [...]

Fear/anxiety, pain and movement…

The best way to start this week’s series of posts is by quoting Simmonds, Moseley & Vlaeyen (2008) who said: ‘Chronic pain and its often associated movement dysfunction are pervasive, intriguing and complex problems … conceptualisation of pain and movement dysfunction has increased our understanding of both…that conceptualisation remains incomplete until it also includes the [...]

A Prospective Analysis of Acceptance of Pain and Values-Based Action in Patients With Chronic Pain

Lance M. McCracken and Kevin E. Vowles
These two researchers have been publishing more and more on acceptance and values and Acceptance and Commitment Therapy (ACT) and Contextual Cognitive Behavioural Therapy (CCBT), and this paper is another example of the type of work being undertaken.
The objective was to ‘prospectively investigate the combined processes of acceptance of [...]

Practical techniques of mindfulness

I’ve been looking around at quite a few different ways to learn and practice mindfulness. There are heaps and I realise that I’m just dipping my toe in water that has been flowing for many hundreds of years really.
If the essence of mindfulness is to be fully present, then most of us have probably [...]

Mindfulness effectiveness

One of the most delightful aspects of the ‘new wave’ of cognitive behavioural therapies is the continued adherence to test the effectiveness of therapy in a scientific way. There has been quite a flow of ACT (Acceptance and Commitment Therapy), CCBT (Contextual Cognitive Behavioural Therapy) and allied therapies in the psychological literature, and now [...]

Explaining mindfulness - doing and being

Today I worked with a person who is very analytic, and finds it quite difficult to feel emotions or experience sensations without thinking about them. He has persistent pain that he calls ‘frustrating’ or ‘unbearable’ - emotions that for me are quite poles apart!
His overall anxiety levels are quite high, and at one time [...]

Control or acceptance?

I’ve been reading a wee bit of ACT, acceptance and commitment therapy recently. I’m trying to find a relatively simple way to explain ACT to my patients, many of whom just don’t do reading, and prefer living life in a practical way, rather than an intellectual or even spiritual way. I’m not sure [...]

Truths from the past

Mindfulness, Contextual Cognitive Behavioural Therapy and Acceptance and Commitment Therapy suggest that the problem with traditional cognitive behavioural therapy is that it attempts to control the uncontrollable. These therapies work on helping us to let go of the attempt to control against difficulties, and instead, focus on being aware of, but not judging, our negative [...]