picture of worried sketch dummy sitting in a wooden chair

EMDR and Chronic Pain

By
Mary French, BSN, MSW, LCSW-C, Center Faculty and Lead Trainer

Do you ever feel completely overwhelmed working with clients who have trauma and chronic pain? 

 

Trauma and chronic pain go hand and hand.  

 

It is one of the places where the mind and body meet (or collide) in our fragmented healthcare system.  It can be an overwhelming experience for the client and the therapist.   

 

My own chronic pain experience was a great teacher 

Even though I had a prior career as a nurse working with many people with chronic illness and pain, it wasn’t until I had my own experience with chronic pain, which started during my first pregnancy, that I could begin to unpack this difficult experience. 

 

During my first pregnancy, I developed what was later diagnosed as interstitial cystitis, a chronic and painful inflammation of the bladder.  After consulting with many specialists in my hometown of Boston, I realized that traditional medicine had little to offer me at the time.   

 

Unfortunately, when you can’t be cured you often feel there is no hope.   

 

The pain was so intense at times I feared I wouldn’t be able to raise my child. On my journey, I realized that I could find ways to cope with the pain and facilitate my own healing.  Pain may not be an option, but suffering is optional.  

 

One of the ways I manage and still manage pain is by deconstructing pain and working on my perception of pain. 

 

And that is the tool I would like to share with you, unpacking or deconstructing pain prior to EMDR reprocessing. 

 

Why would I want to approach my pain? 

 I sadly still see the effects of Reneé Descartes philosophical understanding of the mind and the body as separate entities.   

 

We need to help clients reconnect to the body, which is very hard, and we can start by unpacking or deconstructing pain.   

 

Honestly, when I was first asked to approach my pain in early 1990s, I thought Jon Kabat-Zinn’s’s work around this in his book Full Catastrophe Living, was crazy.  Why would I want to approach my pain?  

 

 

Deconstructing pain is the first step in reconnecting to the body 

When we deconstruct pain, we can see that the experience involves images, emotions, cognitions, and body sensations.   

 

Sound familiar?  

 

Yes!  It is the components of memory we are all familiar with in EMDR training.  When we deconstruct pain, we see that these components of pain are “workable.”  These components of memory can be reprocessed, often resulting in a decrease in the intensity of our pain experience. 

 

Reconnecting to the body is BASIC  

I want to share a model of reconnecting to the body, which has helped me: 

 

B- Breathing (pausing in the present moment) 

  • This reminds us to pause and breathe. Bringing in oxygen is important as we tend to constrict around pain. 

A-Attitude (caring) 

  • This reminds us of bringing a compassionate stance to our experience, as American Tibetan-Buddhist Pema Chodron states, “Staying with pain without lovingkindness is warfare” 

S-Sensations (direct experience of the body)  

  • See sensations as purely this; tugging, burning, pulling, twisting, tightening, throbbing, stabbing.  

I-Inner sight (look closely and clearly)  

  • See the thoughts and the emotions we link with the sensations - emotions of fear, anger, frustration, despair, hopeless, grief, blame, and depression to name a few. Thoughts of ‘my life is over’, ‘I will always be in agony,’ ‘ I am going to die,’ ‘ I can’t live with this,’ ‘I am a burden,’ are common. 

C-Choices (reacting vs. responding)  

  • In reacting through trauma responses, we increase stress response, muscle tension, contraction, avoidance, and more pain.  By responding through mindfulness, relaxation, awareness, and memory reprocessing, we have choices. 

 

Helping clients reconnect to the body in this BASIC way can help us begin to relate to our trauma and pain differently. 

 

Want to learn more about EMDR Therapy Training and chronic pain? 

Look for my upcoming programs on EMDR training online at The Center for Excellence in EMDR Therapy. 

 

Remind clients that a cure might not be possible, but healing is.  

 

There are always choices. 

 

Notes: 

Descartes and the Discovery of the Mind-Body Problem 

The MIT Press Reader, August 8, 2019 

 

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn 

 

Comfortable with Uncertainty: 108 Teachings on Cultivating Fearlessness and Compassion, by Pema Chodron