Women in Pain Conference Draws Top Psychologist

Women in Pain Conference Draws Top Psychologist

By Ed Coghlan

Dr. Kristen Slater is a licensed clinical psychologist specializing in chronic pain management.  She will be speaking at the Women in Pain Conference on Friday, September 23rd in Los Angeles.

She is an Adjunct Clinical Instructor at Stanford University School of Medicine and works as pain psychologist in the Bay Area in private practice as well as in an interdisciplinary pain clinic.

She agreed to a short interview with the National Pain Report about what she plans to tell the 100-plus persons in attendance and thousands more who will watch online.

National Pain Report: “What will you be talking about?”

Dr. Slater: “I will be discussing why distraction from pain is so difficult, what types of distraction work for pain (and what don’t), how distraction works from a neurological and biological perspective, why distraction is so important and how the right kinds of distraction from pain can change your life.

I want to make it very clear that the implication here is not that all people with chronic pain need to do is to think about something else and all their problems will go away.  I can guarantee you, if you’ve had chronic pain, you’ve tried that approach many times.  Chronic pain is very real and very consuming.

It is normative, rather than aberrant, for pain to become the main focus in life for those that have this condition.  When this happens, chronic pain can easily start to take over one’s life.  For the sufferer, it may begin to feel as if the pain is in charge and is now the driving force behind their thoughts and decisions.

This is why it is critical for those with chronic pain to be intentional about ensuring they are participating in internal and external experiences that make them feel vital and purposeful.  I feel it is important to think about distraction not as little breaks in an otherwise miserable life, but rather as the choices we make to live a life that is deeply meaningful and fulfilling. This is the difference between suffering and existing or thriving and living.”

National Pain Report: “We hear and feel a lot of frustration and isolation in the chronic pain community. Do you agree? If so, what do you recommend they can do to address it.”

Dr. Slater: “I absolutely agree.  In fact, I don’t know that I have met a person with chronic pain who has not experienced these things to some degree.  As if having constant pain wasn’t a big enough obstacle in and of itself, sometimes the secondary effects of pain can be as (if not more) distressing that the physical sensation of pain.  With a chronic disease comes considerable loss.  Loss of friends, physical abilities, function, sleep, self-esteem and sometimes even loss of identity.  For those in pain, they are often trying their best to just to manage things moment to moment.  Comments or actions of others that may have been easy to brush off in the past can become intolerable and people may snap at others when they don’t mean to.  Some people can start to become someone they may not like or even recognize.  They may worry that others won’t like this version of them so they stop putting themselves in social situations.

For others, people in their life simply don’t understand what life with chronic pain can be like.  One immense challenge with chronic pain is that it is invisible to others.  Although they may be suffering on the inside, those with chronic pain can get very good at “putting on a mask” when they are in the presence of others.  People see them smiling or think that because they look good on the outside (if they only knew how much energy it took to wash that hair!) they must be getting better.  Others may even start to question the validity of the person’s pain or think that they are not doing things because they are “lazy”.  This is just yet another example of one of the many challenges those living with an invisible disease face.  These may be some of the reasons why isolation may seem like a favorable alternative to dealing with these hurtful and erroneous judgments.

While it is easy to see how one may be tempted to isolate, it is important to be conscious of this and make efforts to find positive sources of social support.  Staying connected to others is critical for a number of reasons.  Interestingly, a study by Novenbre, Zanon and Silani in 2014 showed that social pain (loss or strain in relationships) activated the same areas of the brain as physical pain suggesting that lack of connection to others actually makes physical pain worse on a neurological level.  Conversely, those who seek out social support exhibit greater levels of individual resilience and report greater levels of life satisfaction, lower levels of depression, less severe pain and show less activation of the central nervous system even when they are in pain.  Social connectedness is one reason why organizations like For Grace are incredibly important.  Positive relationships with people that are empathic and understanding are critical in helping people with chronic pain both physically and emotionally.”

National Pain Report: “The Women in Pain Conference is always an optimistic and energetic event. How do you recommend those who attend and watch it on the internet can sustain those good feelings?”

Dr. Slater: “Stay connected with each other!  Reach out, get phone numbers, emails, connect on social media.  It is rare that those with chronic pain have the opportunity to be introduced to others that understand them on a level that only those that have experienced chronic pain can.  Encourage each other to follow through with the techniques and recommendations presented.  Don’t just be there for the day, implement the things you hear into your everyday activities and make lifestyle changes.  “You don’t have to do it all at once, set small goals that are specific, measurable, attainable, realistic and timely.  Be kind and patient with yourself and stick with it!  Keep up the conversations, share resources and ideas.  While some “venting” can be helpful and I encourage everyone to express themselves openly and honestly, remain supportive and positive for one another.

“Professionals can also be great resources.  Pain psychologists are knowledgeable about the nature of chronic pain from a physical, behavioral, cognitive and emotional level.  Work with a pain psychologist can help you learn active pain coping skills to manage pain effectively.  There are evidence-based treatments such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness, which have been shown in repeated clinical trials to be effective for chronic pain.

“My goal in working with people is to help them improve pain and quality of life by learning to control the aspect of pain they can and accept the aspects of pain that are beyond their control.  I strive to help people live more and suffer less.”

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Authored by: Ed Coghlan

There are 15 comments for this article
  1. MW at 4:05 pm

    I read where pain mgmt. doctors have not been trained on how to wean patients off of opiates. My doctor has been trained but why should I have to suffer just when I have had two major surgeries in less than 3 months – for those who are abusing them??? I was just to the point where I felt I could take a trip an airplane to visit a friend in Florida but that won’t happen now. My pain medicine is being cut back and will continue to be cut back until I become bedridden. I hope I am making a great contribution by helping the addicts find their way back into society WHY are not the black box warnings put on alcohol and cigarettes, also addictive substances? Lets put Limitations on how much of those can be consumed too!

  2. Rose Martinez at 5:44 pm

    CBT and Dr. Slater have changed my life! For the first time in years, someone is hearing me, understanding me, and not saying to me “well you don’t look like your in pain.” Let me ask you; did Robin Williams look like he was depressed? No, he was always laughing on the outside and crying on the inside, which no one recognized. That’s what people with chronic pain do as well. Trying to lead normal lives and do normal things all the while by popping opioids like candy and hoping you can make just one more step before they wear off and you crash, because when that happens you won’t be able to function or get out of bed the next day. The pain consumes you. CBT takes my mind off of my pain even if it’s only for a minute and refocuses my thought process which in turn makes me feel better. I am now opioid free and maybe not out of pain but certainly coping better and getting a little of my life back.

  3. Judy Jaeger at 2:13 pm

    I would like to know if The Women in Pain Conference 2016 was recorded in it’s entirety & is available for viewing on YouTube or anywhere else. I googled it, and only found a short little 3 minute clip…..I’d really like to watch/listen to the entire conference.
    Does anyone know????

  4. Donna Hill at 10:12 pm

    Unfortunately, no. I’m still here only worse.But I have an appointment with a last and I do mean last surgeon. If he can fix my back as well as can be expected, that’s all I want.

    The rest of my chronic pain just is, as most. No-one will ever be pain free. But to keep something illegal that could save lives, I will never understand.

  5. carol at 5:27 pm

    I have been especially concerned with some of the recommendations that opioids be given for no more than 3 to 4 days, implying that pain over 4 days is chronic and not painful. Having been in need of high doses of Norco for weeks following several joint replacement surgeries, I have experienced first hand how important it is to have adequate medication for adequate pain relief. I have felt like a drug seeker when given enough meds for only one week and having to mail order meds for more than one refill. That just doesn’t work, esp when no refills are given. I know what it is to have to call the physical medicine doctor who prescribed meds at discharge, my ortho who gave one Rx and tole me to see my PCP for further meds and have my PCP give an RX for only one week. I wasn’t trying to become addicted, I was trying to function in the real world while recovering from joint replacement surgeries [5 in less than four years]. My concern now is for others that will be in similar situations and will have an even harder time to get the pain management that they need. Some meds work and some don’t. Sometimes opioids are needed. i have much empathy for those who are miserable and have no options for relief. I am concerned that there will be more suicides and more disabilities with patients unable to work. I do have on good thing to report. I recently had a bad fall onto my back. when I went to ortho urgent care, I was told to continue on the NSAID I take routinely for chronic pain and given an RX fir a muscle relaxant, PTL I had some antique Norco and took enough to take the edge off of the severe back pain. When I saw the orthopedic specialist the next week, he asked how much Norco I had left and then gave me a prescription for ninety tablets. A doctor who cares! A doctor who isn’t afraid to give Opioids for more then four days! A doctor who takes recovery seriously. I keep wondering what I can do to raise awareness for those who need to be treated for chronic pain and who are not addicted and who are not drug seeking. The ones who are focused on quality of life despite the pain.

  6. Christine jacoby at 3:07 pm

    There simply is no way to express the cruel, de humanizing effects of true chronic pain. Physically agonizing however then emotionally devastating for our brain to adjust to enduring this constantly with no control over getting away from it.
    It devastates our psyche, the brain attempts to adjust to save us incompatible agony, this eventually alters òur entire system leaving us in a state of snowballing destruction. Simple but inaccessible blocking of pain could normalize our bodies again allowing us life without bodily destruction. Yet òur greedy, self serving, cruel, sadistic gov has initiated their campaign against life saving medications for those of us who are dying a slow agonizing death. At first there was reasoning for abuse, however the campaign has ballooned into a mega payday for those who purport medication as evil, thus the campaign is now out of control full of propaganda, enacting regulations which have no medical merit, only the furthering of wrong doing of innocent medical professionals, suffering of patients , taking us back to midevil barbaric times.
    Genocide for us weakened by disease, illness, and pain.

  7. Therese at 1:56 pm

    Beautifully written, HJ – I too felt validated by this. Among the many gems is the delicate balance you describe between how once we continue to fall without a safety net, some emerge upright and some don’t. Which is why I can also relate to both Donna’s response (I have been there, although I believe Dr. Slater “gets it” a bit more than a certain PhD who has contributed to this site but I can’t seem to find right now. I have experienced just about every reaction/effect this one lists) and Kathy’s concern about anxiety – mine is often through the roof. Mark Ibsen MD, I found what you wrote very meaningful as well. Transformation is imperative, but a painful process in itself.

    And darn y’all for continually compelling me to respond when I feel much safer here all alone in my shell, LOL. I so admire the self-assuredness with which you are able to put your thoughts and stories here.

  8. GL at 11:12 am

    Donna Hill, I hope you are out of that dark place, and feeling somewhat better. I’ve felt that way many times over the past 3.5 years, due to chronic, severe, debilitating pain from SIJ Disorder. Thankfully it passes, and I hope it has, or will, for you. Please don’t give up. Can you have some real hope that there WILL be some alternative that will help us? That’s what keeps me going.
    And HJ, I agree that corporate healthcare and BigPharma do not care one iota. I believe some psychologists and doctors come from a place of good intentions, but unless they’ve experienced the decimation of their life, and suffer daily with the physical and emotional pain (it’s a double whammy….the pain meds only relieve about 50% of the pain, so it’s not easy-peasy, as some say), they can’t know. Keeping healing alternatives like MMJ and Kratom illegal is not helpful. The National Pain Institutes should join forces and get us REAL help. It’s very difficult to focus when you have severe pain, to do the distracting practice.

  9. cindy deim at 11:11 am

    I would like someone to address what the chronic pain community is going threw with the CDC guidelines. Many of us have lost our pain medication. Why does she not talk about the adverse effects of having had some quality of life just to be taken away?

  10. Donna Rubinetti at 11:04 am

    I read these comments with a heavy heart and am right there beside them. The depression, anxiety, fear, isolation and the stigma! I often feel like a failure because so many of these wonderfull suggestions, i.e. distraction, mindfulness, don’t work for me. Living with chronic pain is hell as you all know. We need more voices to advocate for us.

  11. Kathy C at 9:39 am

    Jeesh!
    Pain Psychologist sounds like a reasonable profession, someone we can seek out for “Expert” guidance. They are unfortunately few and far between. Most of us do not have access to any kind of “Pain Psychologists” due to Insurance restrictions, and the lack of these kinds of specialties in many locations. Unfortunately many Psychologists are unaware of Dr Slater’s recommendations or the things she discussed. Many of us have already been through these types of Therapies.
    Dr. Slater is not really indicative of what many of us have experienced. Her discussion of Chronic Pain here is in conflict with the DSMV, In fact seeking a Psychologist to deal with Chronic Pain can be damaging, since many of them are conflicted. They are likely to stigmatize the person with chronic Pain even further.
    Dr. Slater is in no way indicative of the types of Pain Psychologists many of us might have access too. The few of us who can even access a Pain clinic are unlikely to find anyone with this kind of mindset. Depending on the treatment we have available, the lack of any real “Guidelines” in Psychology, We are more likely to run into “Pain Psychologists” who have another Agenda, denying care, while turning to a contorted reason for Chronic Pain as outlines in the latest DSMV.
    Psychology is not really a Science, it is too loosley a reflection of personal Bias, Corporate Culture, or flavor of the week nonsense. Dr. Slater sounds really on top of this issue, and is in no way indicative of what many of us have experienced. People need to be very careful, since there are a lot of Quacks and Charlatans out there. In a lot of cases they only exist to deny care for people with Chronic Pain or injuries that lead to Chronic Pain. The DSMV explains it all for them, and should really be troubling. The DSMV has been rewritten in a way to help Insurers, Physicians, and Providers question the existence of Chronic pain and stigmatize the Patient, in an effort to increase Corporate Profits.
    Seeking Psychological “help’ when dealing with Pain Issues, can actually postpone diagnosis, and lead to more confusion and self doubt for people already struggling with the issues the come with Chronic Pain. The obfuscation of basic pain symptoms with Psychobabble, which many Psychologists believe is an alternative can be very damaging to the Psyche.
    There are Psychologists that believe irrationally that people can be talked out of Chronic Pain, that somehow it is just a manifestation of some character flaw, childhood trauma or repressed sexual desire. They wholeheartedly believe this. There are also the “Faith Based” Therapists, who actually believe it is a matter of prayer. Since there are no Standards, oversight or Regulations, this is a common practice.
    Often seeing a Psychologist can actually make the Symptoms worse, because talking about them is re traumatizing, a concept which many Psychologists are either aware of and do it deliberately or they just don’t understand it. This re traumatization, is very damaging and in it’s own way should be considered a form of torture. This kind of thing should be recognized by Psychologists, but it is part of their trade, making the “Client” more miserable, and dependent will keep them coming back.

    There is no way for any of these professions to improve, apply evidence based foundations to their treatments, or any real Standards. Psychology is one more example of a Corporate destruction of Science. With enough funding, any entity can find a Psychologist to endorse anything profitable or immoral. The of Psychiatrists and Psychologists for torture Programs should have be concerning. The changes to the DSMV also should have been a problem, yet they were not. The Industries that profit form this vagueness, and obfuscation, are the only concern here.
    There have been Zero real “Breakthroughs” in the last two or three Decades. Psychology is featured prominently in Popular Media, with silly meaningless “Studies” about Diets or Dating. they have become Infotainment, where they are used to sell products. Have we heard any criticism from the Psychological Community about anything? There used to be criticism and dissent in the 1970’s, not anymore. They don’t censure any of their fellow practitioners. Any assumption that they have an Ethical Code, or commitment to improvement to “Progress” is just a well crafted marketing idea.

  12. HJ at 7:57 am

    I saved this article in Evernote. Tellingly, among the tags I used were: grief, coping and VALIDATION

    Thank you so much. We need more articles like this and more support.

    There are a few illnesses where you fall into a support network when you get a diagnosis – like diabetes or cancer. Chronic pain is life-changing, and instead of falling into a safety-net of medical and social support networks, we just keep falling. Some of us land on our feet after stumbling. Some of us eventually… fall into depression and even suicide.

    People with diabetes and cancer are validated. They get treatments, support groups, a “cloud” of specialists and resources. People with cancer may be buoyed by support from family and friends.

    People with chronic pain quickly learn that it’s often best not to talk about their pain.

    … and then researchers say, “Oh, people with chronic pain also have emotional and mental health issues.” (well, gee… without support… well… yeah!)

    What is it about cancer that people inherently understand that they do not understand about chronic pain? Is it the mortality factor? Chronic pain doesn’t “kill” us out-right but our lives as we know it are often decimated.

    Lately, it seems that the medical community lacks compassion. Personally, I’ve looked for resources related to grieving and health. Even more generally, for “health psychology” resources. It’s a void — a black hole.

    Actually, what I find on chronic pain is often stigmatizing. While it’s mentioned in passing that there’s a stigma, it’s really not talked about much. If you’re a patient, there’s a silent recognition, but the health care industry…

    … the health care industry…

    … doesn’t give a damn about us.

  13. Mark Ibsen MD at 6:55 am

    Thank you Dr Slater.
    I believe that “it all begins in language ”
    Your contribution is valuable.
    The linguistics of pain management are critical, as you say.
    I have found that the most successful pain patients actually transform their relationship to pain.
    The calls for folks to be more present: i.e. If pain distracts, then distraction from the pain allows one to be present.

    Being present allies for creativity to return,
    Compassion to manifest,
    And
    Love to grow, rather than shrivel as it does when we are distracted.

    Ultimately, this is a spiritual transformation that Pain is demanding of us.
    Thank you for presenting this.
    Btw:
    I also am finding that pain calls for transformation in all of us.

  14. Donna Hill at 4:25 am

    By all means, get up, get dressed, go out while every movement, muscle, never ending, everything that touches your skin hurts. Just another person who had never experienced real chronic pain. Smart lady? Very. But she doesn’t “get it”.

    Sure there are times we must force ourselves out, excruciatingly. But do it on a regular basis? This is where you lose people.

    Oh. But you have to exercise to keep your muscles alive. Yes. We do. And can. AND I HAVE. When I’m on a regular schedule of heavy narcotics. Well. Guess what? Getting the narcotics you need to control your pain is like putting out wildfires with a watergun. Good luck!

    As of right now, I’m not on that. Barely anything for that matter and I’m suicidal.

  15. Kathy at 3:08 am

    I would like some one to address the anxiety that can accompany chronic pain. It has become as dibilitating as the pain for me.