How to combine emotional and cognitive work to help chronic pain patients?

Dr. Schubiner and Dr. Abbass talk about how they each learned from each other's clinical experience and theoretical underpinnings, wrote a book together, and made changes to their own practices to incorporate each other's insights.
Presented by the International Experiential Dynamic Therapy Association & This Might Hurt film:
00:00 - welcome and intro of panelists
07:04 - Dr. Schubiner, how has the treatment evolved since we finished filming?
12:41 - Dr. Abbass, can you talk about what you learned while working on the book and how you've seen treatment change over the past few years?
16:41 - When you added a psychologist, did they do one-on-one work with people who might otherwise drop out or become distressed from the peer-to-peer work?
19:05 - Dr. Abbass, can you tell us why the "unconscious mind" is an important part of your theory?
22:00 - Howard, can you talk about how a therapist can integrate some of these ideas from the psychophysiologic world with the emotional work they're already doing?
26:16 - When doing peer-to-peer work, how do you select people to help each other?
27:45 - Howard, how do you use mindfulness in your work and how is that different from how it is typically used?
29:45 - Dr. Abbass, is there an understanding in your framework of ISTDP and experiential therapy, for what's going for somebody whose symptoms move and shift when they engage with this work?
32:02 - What's the most important task in the simpler version of ISTDP, to deal with fragile patients with some meditations and other permanent defenses?
35:11 - Dr. Abbass, what kind of advice do you have for a therapist who wants to integrate this very powerful form of emotional processing but is feeling unsure?
38:18 - Can you talk about how Pain Reprocessing Therapy and ISTDP framework might be combined, or how they make sense together?
40:16 - Dr. Abbass, can you talk about the concept of "bracing" and how you use it with people who have chronic pain?
42:22 - Howard, can you talk about the two research studies published just last week about this therapy?
47:41 - Allan, do you have a sense of whether ISTDP could work in a group format?
49:46 - Is the NIH getting interested in your work?
51:15 - What about families working together in this work?
53:42 - I’ve heard from some therapists that sometimes when you’re doing emotional work, a patient's physical symptoms will just sort of slough off. Even if you weren’t even working on that specific chronic pain issue. Has that happened in your experience?
PANELISTS:
Howard Schubiner, MD - Co-author of "Hidden From View: A clinician's guide to psychophysiologic disorders," professor, Michigan State University College of Human Medicine
Allan Abbass, MD - Co-author of "Hidden From View: A clinician's guide to psychophysiologic disorders," president of the IEDTA, founder and director of the Centre for Emotions and Health at Dalhousie University in Halifax, Nova Scotia, Canada
Kent Bassett - Director of This Might Hurt film (w/ Marion Cunningham). An 80 minute documentary about a radical cure for chronic pain. Stream the full film here: www.thismighthurtfilm.com
Kent is a pain recovery coach at Mind-Body Insight Coaching:
www.mindbodyinsight.net
Buy the Book "Hidden From View": www.amazon.com/Hidden-View-cl...
Both the film, the book, and this conversation are creating a bridge between two distinct but powerful treatment paradigms for helping chronic pain patients.
One is ISTDP (Intensive Short-Term Dynamic Psychotherapy), which was founded by Habib Davanloo, MD in the 1970s. Allan Abbass, MD has spent decades practicing, recording videos, and training clinicians on how to use ISTDP to help patients with chronic pain and other symptoms that derive from emotional conflicts, normal childhood stress, or even severe trauma or abuse.
The other paradigm is the one founded by John Sarno, of which Howard Schubiner, MD has done a lot of research and clinical innovation. This framework has been furthered by the Pyschophysiologic Disorders Association and goes by several names depending on the practitioner - Psychophysiologic Therapy, TMS, EAET (Emotional Awareness and Expression Therapy), or PRT (Pain Reprocessing Therapy).
An important component of the psychophysiologic work is to investigate whether there is structural damage explaining the chronic pain. If no damage is found, then a lot of work is done around a patient's beliefs that they are damaged, which is typically reinforced by many doctors, MRIs, and common mistaken beliefs that are prevalent in society.
Thanks to the IEDTA for sponsoring the screening! Websites for more info:
Psychophysiolgic Disorders Association: ppdassociation.org/
ISTDP: iedta.net
Howard Schubiner, MD: www.unlearnyoupain.com
Allan Abbass, MD: reachingthroughresistance.com/...

[@IntuitiveCoachTheresa]

Thank you and God bless you for producing this film, one and all :)

[@kent.bassett]

@praising servant Thanks so much!

[@hew195050]

so it CAN get worse when you start doing this work! Ah, I kinda wondered because mine has. Unbearable So it's calming to know this may be part of the process. Whew. I literally was getting my things in order to check out. I figured, see! nothing works for me!

[@ThisMightHurt]

Yes it often and "up and down" process with a overall positive trend. And sometimes symptoms getting worse because of starting emotional work can be further evidence that pain, fatigue, etc are driven by fear and emotions. If they were structural-damage based they usually wouldn't change quite as much. We are wishing you well on your journey. Take care.

[@Truerealism747]

You will be ok been doing this stuff 18 month slow job ft or me had tmd got 25 years last few days pain felt same as before but I was 30 percent better for few months losing the fear in pain I'sdo hard

[@aliciatolentino7577]

9

[@FortheBudgies]

I'd really just like to find a doctor to help actually find the cause of the pain instead of figuring out how to cope with the pain the medical community refuses to put in the work to diagnose.

[@ThisMightHurt]

@FortheBudgies If you're looking for a mind-body-informed physician to help you differentiate mind-body causes from structural-injury causes, we can recommend Rebecca Kennedy MD and John Stracks MD. Wishing you luck! -Kent

[@ThisMightHurt]

It's worth mentioning that according to the literature, about 80% of chronic pain conditions are not caused by structural injuries... Most doctors just look for some kind of physical injury that could possibly explain symptoms, and if they don't find anything, they have nothing helpful to offer unfortunately.

[@FortheBudgies]

@@ThisMightHurt I went to a chiropractor 2x a week for 6 months. They did soft tissue work that did help some issues but none of the adjustments did anything and they gave me zero ideas of what was causing my pelvic pain. That was my reason for referral and my 6 month assessment was all about how my neck was different. Zero assessment of what I came in for was changed. Never went back.