1. Developed & Presented By:Dr. Stephen F. GrinsteadDeveloper of the Addiction-Free PainManagement System Dr. Stephen F. Grinstead, 2012, 1996

2. Its a Right and A Responsibility Dr. Stephen F. Grinstead, 2012, 1996 3. Chronic pain is a major public health problemin AmericaChronic pain management costs the nation anestimated $560 to $635 billion each year inmedical treatment and lost productivity This equals about $2,000 for everyone living in the United StatesChronic pain affects an estimated 116 millionAmericans This is more than the number of Americans Dr. Stephen F. Grinstead, 2012, 1996 4. Dr. Stephen F. Grinstead, 2012, 1996 5. Developing a support system Professional Guides and Coaches Personal Guides and Coaches Your Current Pain Management Plan Dr. Stephen F. Grinstead, 2012, 1996 6. Exploring the chronic pain trance Looking at the depression barrier Identify & manage your inner saboteur Exploring TFUARs Dr. Stephen F. Grinstead, 2012, 1996 7. What is the chronic pain trance? Automatic and unconscious coping styles Developing a hopeless/helpless mindset The quest for the FIX Breaking the chronic pain trance Recognition is the first part of the solution You cant think your way out of a problem you behaved your way into Dr. Stephen Covey Using cognitive-behavioral restructuring (TFUAR) Dr. Stephen F. Grinstead, 2012, 1996 8. Theres a difference between depression and situational triggered feeling down or blue Depression is very common for people in chronic pain Depression and isolation: The deadly duo Understanding depression symptoms Common depression management tools Developing a depression management plan Dr. Stephen F. Grinstead, 2012, 1996 9. Dr. Stephen F. Grinstead, 2012, 1996 10. Dr. Stephen F. Grinstead, 2012, 1996 11. The Monkey Mind Dr. Stephen F. Grinstead, 2012, 1996 12. Your MistakenThoughts, Beliefs, Opinions &The Committee ConclusionsThe Inner SaboteurMonkey Mind 13. Dr. Stephen F. Grinstead, 2012, 1996 14. Is an automatic & unconscious reaction that operates as a defense against the pain of recognizing serious problems Its A Normal Part of the Human Condition Dr. Stephen F. Grinstead, 2012, 1996 15. Lack of Information Wrong informationaboutpain and/or pain management.Conscious Defensiveness Know thatsomething is wrong but dont want to face thepain of knowing.Total Denial Unconscious defensemechanism to guard against pain andhelplessness.Delusional Deeply entrenched mistakenbeliefs held in spite of overwhelming evidenceto contrary. Dr. Stephen F. Grinstead, 2012, 1996 16. Avoidance I will do anything to not talk about my pain management problem. Types of Avoidance include distraction, saying nothing, uproar, & playing dumb.Total Denial No not me! I dont have a problem with pain!Minimizing My pain is not that big of a deal! Dr. Stephen F. Grinstead, 2012, 1996 17. 1How Bad Does It Have To Get Before You TakeAuthentic Action? 10 Pounds100 Pounds51000 + Pounds10 Dr. Stephen F. Grinstead, 2012, 1996 18. Blaming If I can prove that my problems with pain management arent my fault, then I wont have to deal with them!Rationalizing If I can find good enough reasons for my problems with pain management, I wont have to deal with them! Dr. Stephen F. Grinstead, 2012, 1996 19. Dr. Stephen Covey Dr. Stephen F. Grinstead, 2012, 1996 20. Comparing If others are worse off than me,it proves I dont have serious problem!Compliance I pretend to give you what youwant so youll leave me alone!Manipulating I play the game to convinceothers to do all the work.Flight Into Health Feeling better means thatIm cured! Dr. Stephen F. Grinstead, 2012, 1996 21. Fear of Change OR Recovery By Fear If I dontfocus on having a problem with my pain I wontknow how else to relate!Diagnosing Myself as Beyond Help Sincenothing I have done has ever worked for my painmanagement, I shouldnt have to try anymore.I Have the Right to be This Way Its My Body I have the right to do whatever I want to do ordont wantto do with my body and for my chronic painmanagement. Nobody has the right to tell medifferent! Dr. Stephen F. Grinstead, 2012, 1996 22. Review All The Denial PatternsPick The Pattern That Troubles You MostWrite Down That Pattern NowWrite Down Why You Picked ItWrite Down What This Pattern Means ToYouThink Of A Time This Denial Pattern CausedYouNegative ConsequencesBe Ready To Write Down Your TFUARs Dr. Stephen F. Grinstead, 2012, 1996 23. Thoughts (T) cause Feelings (F)Thoughts plus Feelings cause Urges (U)Urges plus Decisions cause Actions (A)Actions Cause Social Reactions (R) Dr. Stephen F. Grinstead, 2012, 1996 24. ProblemSolutionThinking ThinkingFeelingFeelingUrgesUrgesActionsActionsReactionsReactions Dr. Stephen F. Grinstead, 2012, 1996 25. Understanding pain and the pain system The Bio-Psycho-Social components of pain The spiritual aspects of chronic pain management Ascending versus Descending pain signals Dr. Stephen F. Grinstead, 2012, 1996 26. Acute Pain Chronic Pain Recurrent Acute Pain Anticipatory Pain Neuropathic Pain Dr. Stephen F. Grinstead, 2012, 1996 27. BiologicalA signal that something is wrong PsychologicalMeaning individual assigns to pain signal Social/CulturalRole assigned to the person in painFamily & cultural beliefs about pain Dr. Stephen F. Grinstead, 2012, 1996 28. Pain Physical sensations that tell ussomething is wrongSuffering Psychological interpretation thatthe sensation is awful, terrible, or unbearablePain is inevitable, but suffering is optionalFreedom From SufferingIts Your Right and Your Responsibility Dr. Stephen F. Grinstead, 2012, 1996 29. Spirituality versus religion Religion prepares for the next life Spirituality prepares for this life Spirituality is a complex and multidimensional part of the human experience. Spirituality involves beliefs, perceptions, thinking, feeling, experiential and behavioral aspects. Dr. Stephen F. Grinstead, 2012, 1996 30. Low Stress Zero To ThreeModerate Stress Four To SixHigh Stress Seven To Ten Pain Scale 01234 5 6 7 8 9 10No Pain Distressful Pain Agonizing Pain Dr. Stephen F. Grinstead, 2012, 1996 31. 20 Psychosis / CollapseTrauma Reaction 15 Dissociation10 Loss of Control9Over ReactStress Reaction 8Driven / Defensive7Inability to Focus - Spacey6Function With EffortFunctional Stress 5Function With No Effort4Focused & Active3Relaxed Focused Relaxation 2Relaxed Not Focused1Relaxed Nearly Asleep 32. In a designated pain journal at least two timesper day list the type of pain, the highest levelof pain that you are experiencing and why yourated it that way.Using the stress thermometer also identify thehighest level of stress you experienced andwhy you rated it that waywhat were yourstress triggers?Note what you do for your pain (i.e.,medication, stretching, exercise, massage,etc) and how well it works (on 0 to 10 scale Dr. Stephen F. Grinstead, 2012, 1996with 0 meaning not at all and 10 meaning 33. Identify what you were doing that may havetriggered the pain or stress and make note anyways you could avoid those triggers in thefuture. Be sure to include both physicaltriggers and emotional triggers.Identify any negative thoughts because of yourpain.Identify any uncomfortable feelings you arehaving or poor decisions you are makingbecause of your pain.At the end of each day identify the most Dr. Stephen F. Grinstead, 2012, 1996 34. What is effective chronic pain management?Safer medication management plansDeveloping a pain flare up planUsing a pain management checklistNon-medication pain management plan Dr. Stephen F. Grinstead, 2012, 1996 35. Defining misunderstood termsThe Addiction-Pain SyndromePrescription drugs of abuseRed Flags for abuse/addictionMaking a medication management agreement Dr. Stephen F. Grinstead, 2012, 1996 36. TolerancePhysical DependenceAddictionPseudo Addiction Definitions developed by the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine. (Savage, Covington, Heit, et al., 2004) Dr. Stephen F. Grinstead, 2012, 1996 37. A state of adaptation in which exposure to adrug induces changes that result in adiminution of one or more of the drugs effectsover time.Earth Language: When you first used yourmedication it only took one or two pills to getrelief and now it takes four or five. Dr. Stephen F. Grinstead, 2012, 1996 38. Physical dependence is a state of adaptationthat is manifested by a drug class specificwithdrawal syndrome that can be produced byabrupt cessation, rapid dose reduction,decreasing blood level of the drug, and/oradministration of an antagonist.Earth Language: When your body gets usedto taking a medication on an ongoing basisand your brain adapts to that being the normalstatthen when you stop taking it suddenlyyoull get sick or go into what is calledwithdrawal. For example a diabetic who is Dr. Stephen F. Grinstead, 2012, 1996 39. A primary, chronic, neurobiologic disease, withgenetic, psychosocial, [spiritual] and environ-mental factors influencing its development andmanifestations. It is characterized bybehaviors that include one or more of thefollowing: impaired control over drug use,compulsive use, continued use despite harm,and craving.Earth Language: When you are taking themedication for reasons other than physicalpain relief and wont or cant stop taking it evenwhen experiencing bad problemsthen youre Dr. Stephen F. Grinstead, 2012, 1996 40. Behaviors that may occur when pain is notbeing adequately addressed. Patients withunrelieved pain may become focused onobtaining medications, may "clock watch," andmay otherwise seem inappropriately "drugseeking." Even behaviors such as illicit druguse and deception can occur in the patientsefforts to obtain relief. Dr. Stephen F. Grinstead, 2012, 1996 41. Earth Language:Pseudoaddiction looks a lot like addictionYou may appear to be Drug-SeekingYou may need frequent early refillsThese behaviors are caused by under-treatment or mistreatmentProblematic behaviors disappear when yourpain is adequately managed Dr. Stephen F. Grinstead, 2012, 1996 42. Dr. Stephen F. Grinstead, 2012, 1996 Dr. Stephen F. Grinstead, 2012, 1996 43. AddictionAddictive PainPainDisorderDisorderSyndromeZoneZoneZone Dr. Stephen F. Grinstead, 2012, 1996 44. Hopeless to HopefulDemoralized to RevitalizedVictim to VictoriousPowerless to EmpoweredSurviving to Thriving Dr. Stephen F. Grinstead, 2012, 1996 45. Positive Self-TalkAppropriate Emotional ExpressionHealthy Support NetworkSpirituality/HumilityEffective Pain Management Dr. Stephen F. Grinstead, 2012, 1996 46. Please answer these questions:What is the most important thing that youlearned in this presentation?What are you going to do differently as aresultof what you learned?What could stop you from followingthroughand how can you overcomeany obstacles?Giving feedback and Dr. Stephen F. Grinstead, 2012, 1996 47. www.freedomfromsuffering.netwww.drstevegrinstead.comwww.chronicpainanonymous.orgwww.addiction-free.com Dr. Stephen F. Grinstead, 2012, 1996