How Counselling Can Help You & Your CRPS & Chronic Pain
Living with Complex Regional Pain Syndrome (CRPS) or chronic pain can leave you feeling depressed, vulnerable, desperate and in need of answers or help with coming to terms with your condition. This is where and how general counselling (Counseling in US) can help you and your CRPS and chronic pain.
General counselling for CRPS and chronic pain is a psychological treatment and this is seen as a ‘talking therapy’ that can either be on a 1-2-1 basis or in a group session. It is used when those living with CRPS or chronic pain need help in coping not just with their condition but also in adapting to their new way of life. Counselling is a helping approach rather than psychotherapy which is different.
HOW CAN COUNSELLING HELP YOU?
There are many forms of counselling which includes Cognitive Behavioural Therapy (CBT), Person Centred Approach Counselling and EMDR. This blog is dealing with general talking counselling. Just talking to a counsellor can help you keep your psychological state in as good a place as it can possibly be when also dealing with a condition like CRPS or chronic pain in general. Your body is receiving treatment so why shouldn’t your mind receive a helping hand as well? The IASP guidelines have recommended that if you have suffered from pain for less than 2 months, then they don’t recommend you have any psychological treatment (Stanton-Hicks, M et al 1998). Over 2 months they recommend that patients should receive psychological intervention.
The Counselling Directory (See below) say:
“Maintaining a positive mindset and lowering stress levels can improve your quality of life and can even help to reduce your pain.”
General talking or supportive counselling where you talk to an individual counsellor about your problems can help you not only explore your feelings but also may be able to help you find ways of dealing with your CRPS or chronic pain. There tends to be less intervention by the counsellor and more listening instead. This allows you the time to talk through your own thoughts and feelings. You are encouraged by the counsellor to talk about any feelings you have about your CRPS or chronic pain such as disability and pain that comes from the condition and in return you are taught some coping strategies to help you cope with every day life.
According to an article from The Huntley Centre (2006):
“… the therapist attempts to make the individual able to bear their problems better, especially if the underlying cause of the problem (for example, chronic back pain, due to injury or due to degenerative disease of the spine) is chronic and continuous.”
There are a few research studies for psychological treatments for CRPS and chronic pain and 1 such article Karakaya, I. et al (2006) stated that:
“The individual and family psychotherapeutic treatment with a multidisciplinary approach has important and positive effects on the prognosis of RSD…”
Having sessions with a counsellor to seek help for your psychological side of CRPS and chronic pain doesn’t mean that it is the only treatment to help you overcome your condition. In many research papers it is suggested that multi-disciplinary treatment is important to help you and your pain. In the research paper Ghai, B. & Dureja, G.P. (2004) they say:
“A close collaboration amongst professionals of multiple disciplines i.e. psychologist, physical and occupational therapists, oncologist, neurologist and pain medicine consultants is helpful in achieving optimal treatment effects. The treatment goal is pain relief, functional recovery and psychological improvement. No one therapeutic modality achieves this goal in all patients, and a scientifically proven cure does not exist. “
Also an important point to remember is that according to Morley, S. et al (1999)that counselling and other forms of psychological treatment for chronic pain:
“… is complex and lengthy and provides variable results.”
WHAT HAPPENS IN A COUNSELLING SESSION?
During your 1st session of counselling, your counsellor will ask you some questions about you and your life, questions such as:
Your current situation – This may have more of an impact on your CRPS or chronic pain than you realise.
Personal and family history – The details you give at this point may have some impact on what you’re going through at the moment.
Symptoms – The counsellor is trying to ascertain if there are other underlying symptoms other than the reason why you’re there.
Why did you want counselling – By answering this the counsellor (therapist) will try and understand not just the immediate problem but deeper issues that may be connected.
When you get asked questions from your counsellor it’s not because they are being ‘nosey’, but they are trying to get as full a picture about you, your life and your problems so they can treat you in the best way possible. Try to answer their questions as fully as you can so they have enough detail and information to help you deal with your reason for wanting to see a counsellor.
At the end of your first session the counsellor will make a diagnosis based on the information you have given them, however this diagnosis may evolve further over some more sessions. They will then develop a treatment plan that is particular to you. Counselling is not seen as a “one size fits all” treatment, because everyone is an individual. Treatment plans often include teaching you relaxation techniques, learning new distraction techniques, challenging and altering any beliefs you may have about pain, learning and building up your coping strategies as well as dealing with any mental health issues you may be having along with your pain such as depression, PTSD or general anxiety. Psychologists or counsellors can help make changes to your lifestyle to enable you to continue or start recreational activities or going back to work. They can also help you learn new ways to help you with your poor sleep patterns that you may have because of living in constant chronic pain.
One of the most important point about counselling is that everything is confidential and professional counsellors will tell you their policy on confidentiality. However the only time that counsellors may need to speak to another professional about you, as the Skills you Need website says:
“… they may, however, be required by law to disclose information if they believe that there is a risk to life.”
WHAT DO YOU NEED TO DO BEFORE & DURING THE COUNSELLING SESSIONS?
The first most important thing you need to do is to talk to your counsellor, there isn’t any point in just sitting in the room and answering the counsellor’s questions in very short sentences. Other things you need to do during the sessions are:
Relax! Don’t get tensed up – You may feel more comfortable the more sessions you have with your counsellor
Ask any questions you may have – If you don’t understand something then ask your counsellor or ask them to repeat something
According to Bressert, S (2013) You need to:
Be open – Therapists are trained to ask the right questions, but they’re not mind readers. The therapist can do his job more effectively if you answer the questions openly and honestly
Be prepared – Before you get to the session, know how to describe “what’s wrong,” and to describe your feelings about your problem.
Be open and honest about your feelings – A lot will be going through your head in this first session. Listen to your own reactions and feelings, and share them with the therapist. You’ll both learn from these insight
Be sure to go to your first session with realistic expectations. Therapy is not a quick fix for your problem, rather it is a process.
I'm a barrister, advocate & sufferer of Complex Regional Pain Syndrome (CRPS).
I am also a bilateral (double) above knee amputee due to aggressive symptoms of CRPS.
However I want to help all those affected by this devastating condition which includes those living with CRPS, their loved ones, families, carers and friends.
Please help spread awareness of this debilitating and life-changing condition - CRPS. We need your support!