In my last post (here) I gave a definition of trauma, as it is typically operationalised in research settings. I noted that Trauma (with a capital T) “… as used in DSM5 PTSD or ICD-11 PTSD/CPTSD is a more restrictive term than adversity, yet adverse childhood experiences are widely studied as contributors to some forms ..read more

It’s hard to go anywhere on the interwebs without encountering something about ‘trauma-informed’ care/therapy/treatment and chronic/persisting pain management is no exception. This is the first of a series on my thoughts (based on research!) about trauma and chronic pain. Today I’ll very briefly define trauma as it’s typically used in this context, and touch on ..read more

Showing my age, I know, but I love this song! And it asks such a fundamental question: Who are you? Our answer/s to this are pretty revealing. Do you think of your name? Your gender? Your role in a family? Your professional title? Are you just the one thing? Or many? And are you the ..read more

A commentator recently opined that: “For the record, it has long been known that people can see their pain either as a threat or as a challenge. Our role as clinicians is to encourage the latter” and as often happens I started pondering.Living with persisting pain for most of my adult life, along with working ..read more

The first time you look into your baby’s eyes is one of those moments. Driving through the Haast Pass with the grandeur of those mountains, the river, the bush…more moments. The icy plunge into a high country lake, even in summer – taking your breath away! Lying spread-eagled (starfish!) on the smooth, cool sheets on ..read more

When starting a mindfulness practice, people often turn to written scripts. These scripts can be used to guide the practice, and offer suggestions for what the mind can attend to. They often give cues that remind the listener that yes, minds do wander, and that this is normal – and how to bring the mind back to what the focus was on. There are heaps of these guided meditations available online and pre-recorded, and there’s no doubt they’re both popular and readily available. Today I want to explore scripts and why a person might choose to move away from using a script. I don’t have research to ..read more

I can’t recall how often I’ve mentioned mindfulness to people and get that eye roll and ‘It doesn’t work!’ response. Let’s dig into this a bit more, and touch on one of the groups of people who quite often think mindfulness is not for them (pssst! I’m talking to you, ADHDers!). The first question that comes to mind for me is what people mean when they say ‘it doesn’t work’. I mean, what are people expecting from mindfulness? How are they measuring whether it’s ‘worked’ or not? And I do not mean this in any negative way at all, this is a genuinely curiousity-driven question for me because I won ..read more

The first time I encountered the term mindfulness in relation to chronic pain was when I read a paper by Jon Kabat-Zinn published in 1982 in the journal General Hospital Psychiatry. This was a study describing the preliminary effects of mindfulness-based stress reduction (and relaxation) taught over 10 weeks and involving 51 people with chronic pain. The participants included people with a wide range of pain locations (we used to do this in the olden days!), and these early results showed 65% of participants obtained a reduction of more than 33% on the Pain Rating Index (Melzack, 1975). The MB ..read more

I’ve pondered this question for a very long time. The term ‘self management’ is vexed as it is, let alone me questioning what we mean by ‘pain self management’, but let’s start with the definition I intend to use. Self management, to me, is anything I can do myself to live my life alongside my fibromyalgia, or any other long-term health problem I have. It can be supported by others because I don’t live in splendid isolation, but the actions are things I do. They’re my choice. When we expand the definition to include pain, this is where things get a little tricky. Pain self management almost im ..read more

What exactly do we mean by this word? And how does it work, exactly? I don’t use the word pacing, to be honest. I use ‘activity management’ because there are times when people might want to increase their overall pattern of activity, and times when they might want to reduce it, and plenty of times when people want to be judicious about when and why they employ this approach. Activity management is, depending on your definition, about deciding when and how to undertake the things you need or want to do, and it’s been a part of pain management for a very long time. I think the earliest descripti ..read more