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Case Study

Reversing Chronic Pain: Ten steps to reduce suffering

By Maggie Phillips

Chronic pain often has a clear physiological cause, arising out of an accident, an injury, an illness, or a surgery. But these days, more and more people are being referred to therapists with pain conditions that persist for months and years beyond the time when damaged cells, muscles, and tissues show every appearance of having healed and medical practitioners have pronounced that the initial accident, injury, or illness has been "cured." At this point, when traditional medicine seems to have done everything possible, people come to our offices hoping to find another way to understand why they're still in pain and—more important—what to do about it. Amy, a successful commercial artist in her late thirties, was such a client.

In our first session, she looked at me warily over the rims of her reading glasses as she clutched a thick folder in her lap. She was eager to tell me her story. "I've had five surgeries now for endometriosis," she began. "The first one was in 1990. I was having terrible, shooting, pelvic pain during my periods. They found a cyst on my ovary, and I had laser surgery to remove the cyst and some of the endometrial tissue. I felt immediate relief. But then slowy the symptoms came back again. In the next two years, I had more pain and two more surgeries, which helped temporarily. And then several years later, I started having bladder symptoms and two more surgeries, including a full hysterectomy.

"I'm worried about depression, yet the antidepressant I'm on has caused weight gain. I've been on medical disability from my job for the last six months, and though I'm practicing yoga, meditation, and walking one and a half miles per day, I feel no better and no closer to coming off disability. Do you think you can help me?"

When I see pain patients for consultation, it's all too common to hear this type of litany, in which the person describes becoming worse and worse, in part because of the interventions intended to repair the problem. At this point in the interview with Amy, I asked my standard questions.

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