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EMDR for Chronic Pain

EMDR for Chronic Pain

Introduction to EMDR and Chronic Pain at Flourish Psychology

The relationship between physical health and mental well-being is complex and multi-faceted. While advancements in medical technology have made diagnosing and treating various physical ailments more straightforward, the connection between psychological factors and chronic physical pain is something we are still in the process of discovering.

We know now that chronic pain – while it might be physical in nature – both affects and is affected by mental health. That’s why many people see therapists for chronic pain, as a way to get treatment for this potentially difficult mental health condition.

One treatment that therapists might choose to consider is Eye Movement Desensitization and Reprocessing (EMDR), a psychotherapeutic technique primarily associated with treating post-traumatic stress disorder (PTSD). EMDR has emerged as a promising avenue for addressing chronic pain.

The Relationship Between Chronic Pain and Mental Health

Chronic pain is typically defined as pain that persists for more than 12 weeks, despite medication or treatment. It’s a condition that affects millions of people worldwide and can have a debilitating effect on daily activities, work, and overall quality of life. But beyond the physical aspect, chronic pain often has a significant impact on mental health.

Some of the psychological damage of chronic pain can include:

  • Emotional Toll – Chronic pain is not just a physical condition; it’s a full-body experience that influences emotional well-being. The constant pain can result in emotional stress, leading to conditions such as anxiety and depression.
  • Cognitive Impact – Over time, chronic pain can affect cognitive functions such as memory and concentration. This can stem from both the distraction of dealing with the pain and the emotional toll it takes.
  • Social Ramifications – Chronic pain can lead to social withdrawal and isolation, affecting interpersonal relationships. The cycle of pain and isolation can create a feedback loop that exacerbates both physical and emotional suffering.

The link between mental health and chronic pain can be bidirectional. Not only does chronic pain contribute to mental health disorders, but pre-existing mental health conditions can also exacerbate the pain. Stress, anxiety, and depression can heighten the perception of pain and make pain management more difficult. This complicated interplay between mind and body creates a need for an integrated approach to treatment, which considers both physical and psychological components.

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a form of psychotherapy developed by Francine Shapiro in the late 1980s. Initially created to treat individuals with PTSD, EMDR has since been applied to various other conditions, including anxiety disorders, depression, and most recently, chronic pain. Some of the core principles of EMDR include:

  • Bilateral Stimulation – The most distinguishing feature of EMDR is the use of bilateral stimulation, often in the form of guided eye movements. This stimulation is thought to activate both hemispheres of the brain, facilitating the reprocessing of traumatic or troubling memories.
  • Desensitization and Reprocessing – EMDR works by helping individuals desensitize their emotional responses to painful memories or experiences. The bilateral stimulation aids in reprocessing these memories, allowing individuals to integrate them more adaptively.
  • Phases of Treatment – EMDR is structured around eight phases, beginning with history-taking, progressing through the preparation, assessment, desensitization, installation, body scan, closure, and finally, reevaluation. Each phase has its purpose and helps the individual move toward psychological healing.

While EMDR was not initially designed for chronic pain management, its mechanisms offer an intriguing possibility for treating both the psychological and physical components of chronic pain. The process of desensitization and reprocessing can help break the cycle of pain and emotional suffering, providing relief on multiple fronts.

How EMDR Can Treat Chronic Pain

Eye Movement Desensitization and Reprocessing (EMDR) is steadily gaining recognition as a viable treatment for chronic pain, albeit one that operates differently from conventional medical interventions. It’s crucial to understand that while EMDR may not “cure” the physical causes of chronic pain, its psychological approach can often make the pain more manageable and less debilitating.

With EMDR for chronic pain, we take an approach that includes:

  • Identifying Triggers – Often, chronic pain is associated with specific triggers that can be either physical or psychological. EMDR begins by identifying these triggers as the “target” memories or experiences.
  • Desensitization – The core of the EMDR process is desensitization, where patients are encouraged to confront these memories or experiences in a controlled environment. The use of bilateral stimulation helps in restructuring the emotional response associated with these memories.
  • Reprocessing – Post-desensitization, the reprocessing phase encourages the individual to integrate the now-neutral memories, altering their response to pain triggers in the future.

The mind-body connection is essential in understanding how EMDR provides relief from chronic pain. By reducing psychological stress and emotional distress related to pain, individuals often report a correlating decrease in physical symptoms.

Limitations and Considerations

While EMDR has shown promise, it is essential to note that it’s not a standalone treatment for all kinds of chronic pain. It’s most effective when used as part of a multi-disciplinary approach that may include medication, physical therapy, and other forms of psychotherapy when warranted. Working with your therapist, we’ll look at what makes the most sense for your wellness and recovery.

Psychotherapy Alternatives to EDMR for Chronic Pain

EMDR is just one of the various psychotherapeutic interventions available for treating chronic pain. Other alternatives include:

  • Cognitive Behavioral Therapy (CBT) – This is one of the most widely used psychotherapy methods for pain management. CBT focuses on changing negative thought patterns and behaviors that contribute to chronic pain.
  • Mindfulness-Based Stress Reduction (MBSR) – This approach combines mindfulness meditation and yoga to help people become more aware of their thoughts and feelings and make it easier to manage their pain.
  • Acceptance and Commitment Therapy (ACT) – ACT helps individuals accept their pain and commit to actions that improve their quality of life despite the pain.

Each of these therapies has its merits, and sometimes, a combination approach yields the best results. Consult your healthcare provider to assess which treatment options are most suitable for your specific condition.

Chronic Pain Treatment with EDMR at Flourish Psychology

Chronic pain is a complex condition that calls for an equally multifaceted treatment approach. While medications and physical interventions remain essential, the potential for psychotherapeutic treatments like EMDR cannot be overlooked. EMDR offers a unique way to manage the psychological aspects of chronic pain, thereby reducing the physical symptoms.

Although EMDR is still a growing field in the context of chronic pain, early evidence suggests it can provide meaningful relief to those grappling with the debilitating effects of chronic conditions. As our understanding of the mind-body connection continues to evolve, treatments like EMDR stand to become increasingly integral to comprehensive chronic pain management strategies.

Given the complexity of chronic pain and the limitations of any single treatment approach, EMDR is most effective when used in conjunction with other therapies. If you’re experiencing chronic pain, contact Flourish Psychology in NYC to create a balanced, tailored treatment regimen that addresses both the physical and psychological aspects of your condition.

We are also licensed in more than 30 states. Please review our locations page if you’re outside of the Brooklyn and New York City area.

Our Fears and Our Successes

Our Fears and Our Successes

Most of us – not only those that struggle with anxiety, but most of us that are out there in the world trying to achieve our goals – struggle with fears that hold us back. We have negative self talk, or we worry about issues that may come up and get in our way.

Sometimes, those fears and worries hold us back and prevent us from achieving these goals and dreams. Other times, we are able to overcome them. We push ourselves through the worries and concerns and we are able to succeed at the goals we set out for ourselves.

What Success Means About Your Fears

While we are often told to look at failures as learning opportunities, successes are often learning opportunities too. Successes serve as reminders that our fears are not something that needs to hold us back. They’re an opportunity to remember that the worries you had and the fears that you felt along the way ended up not coming to reality.

Let’s look at this in a different context:

There’s a treatment for phobias called exposure therapy, where a person that has a fear – for example, a fear of spiders – is placed into situations where they are forced to confront these fears. They may have to think about spiders, or look at photos of spiders, or even be in the room with a spider.

During this time, this person has fear. But, over time, when nothing happens to them, the person starts to experience less fear. The therapist then explains to the person that all those fears ended up not coming true, and shows them that fear (in this case, of spiders) shouldn’t be something that holds them back.

Success can be seen the same way. When we succeed, it shows us that the fears we had along the journey were “for nothing.” We were able to overcome them, and still able to successfully achieve our goals. By reflecting on this after successes, we can not only bathe in the feeling of success for longer, but also hopefully have less anxiety and fewer fears the next time we try to achieve goals.

Therapy for Business, Financial, and Personal Success

Though we typically see therapy as something used to treat mental health disorders like anxiety and depression, the principles of therapy are such that they can bring out the best in you in all aspects of your life. Learn more about therapy and how it can help you achieve your goals by contacting Flourish Psychology, today.

Chronic Pain, Sleep, and Mental Health

Chronic Pain, Sleep, and Mental Health

Chronic pain is not merely a physical sensation. It is an issue that permeates various aspects of one’s life, affecting emotional well-being, daily functioning, and even the quality of sleep.

A key area often overlooked in the discussion about chronic pain is the effects of its relationship to disruptive sleep patterns. While we often recognize that pain can interfere with sleep and sleep quality, we often forget about the role that sleep plays in mental health. Identifying the effects of this relationship is an important part of managing a person’s mental health and wellness when they live with chronic pain.  

It’s important to delve into this complex relationship to offer a more comprehensive approach to managing chronic pain and its ripple effects on mental well-being.

The Interplay Between Chronic Pain and Sleep

Chronic pain and sleep have a bidirectional relationship. Poor sleep can exacerbate the perception of pain, and chronic pain can make it difficult to attain restful sleep. It’s a cycle that, once initiated, can be challenging to break. Understanding this relationship is crucial, especially given that inadequate sleep has its own set of repercussions:

  • Increased Sensitivity to Pain – Lack of sleep can heighten the body’s sensitivity to pain, making chronic conditions even more unbearable.
  • Reduced Healing – Sleep is the body’s natural way to restore and heal. Without it, the body may not effectively manage pain, hindering recovery.
  • Impact on Daily Functioning – Poor sleep can lead to difficulties in concentration, decreased productivity, and impaired motor skills, further complicating daily life for someone already coping with chronic pain.

So we already know how important sleep is for you to manage both your chronic pain and your life. But we also know that poor sleep can lead to even further challenges.

Mental Health Implications of Poor Sleep

Poor sleep doesn’t just impact pain and daily functioning. It has a direct effect on mental health. Some of the mental health challenges aggravated by poor sleep include:

  • Depression and Anxiety – Both can be outcomes and contributing factors to sleep deprivation. The relationship between emotional disorders and sleep is complex and often cyclical, much like that between pain and sleep.
  • Stress and Irritability – Lack of restful sleep can elevate stress hormones and reduce one’s threshold for irritants, leading to heightened stress and emotional volatility.
  • Cognitive Impairments – Reduced cognitive functions, such as attention and memory, are associated with poor sleep, potentially impacting decision-making and emotional regulation.

These can impact a person’s quality of life as much as the pain itself, and – since mental health also affects pain sensitivity – can further increase the feelings of chronic pain.

Breaking the Cycle: Steps Toward Better Sleep and Mental Health

Addressing this intricate relationship requires a multifaceted approach. You and your physician will work towards reducing or eliminating the causes of chronic pain. But it’s also important to work on strategies to improve sleep and mental health. In therapy, we do this through approaches that include:

  • Cognitive Behavioral Therapy (CBT) – CBT is often effective for treating insomnia and has been found useful in addressing the mental health implications of chronic pain.
  • Mindfulness and Relaxation Techniques – Methods like Mindfulness-Based Stress Reduction can teach you how to become aware of thoughts and behaviors that can worsen pain and poor sleep.
  • Activity Regulation – Maintain a consistent sleep schedule and engage in regular physical activity as advised by your healthcare provider. Exercise can improve both sleep quality and mood.

We’ll also talk about the changes you can make in your routine or environment to help you prioritize sleep and fall asleep faster. A comfortable mattress, blackout curtains, and noise-reducing strategies can make a significant difference. Once you start addressing your sleep quality, your mental health and your chronic pain may improve as well.

Additional Support for Comprehensive Care

Chronic pain, sleep, and mental health are interlinked, requiring an integrated treatment approach. Collaborative care involving medical practitioners, psychologists, and sleep specialists can offer the most comprehensive and effective treatment plan. If you’re grappling with these interconnected issues, consider reaching out for specialized support tailored to your unique needs.

Do The Genetic Roots Of Mental Health Disorders Affect Treatment?

Do The Genetic Roots Of Mental Health Disorders Affect Treatment?

Mental health is an intricate tapestry of genetic, environmental, and situational factors. Just as our physical characteristics can be attributed to our genetic makeup, research is increasingly finding that the roots of many mental health disorders can also be traced back to our genes.

However, this genetic root can lead to many questions. If these conditions have genetic origins:

  • Does this mean that they are inevitable?
  • Does this mean that they cannot be treated?
  • Does this impact the success of treatment?

Sometimes, our own mental health issues can make us believe that developing mental health challenges is and was inevitable. But while many can have a biological component, mental health is not that simple, and the good news is that most common mental health conditions can be treated.

The Genetic Underpinning Of Mental Health Disorders

Several studies have identified genes associated with an increased risk of mental health conditions. For example, there are genes that are known to play a role in conditions such as:

  1. Eating Disorders – Research has indicated that specific genes can make individuals more susceptible to eating disorders. These genes are believed to affect behaviors linked to conditions like anorexia nervosa.
  2. Anxiety and Depression – Twin studies have been particularly illuminating, suggesting that if one twin develops a condition like major depression, the other twin has a significantly higher chance of experiencing the same condition, indicating a genetic component.
  3. Schizophrenia and Bipolar Disorder – These are among the most hereditary mental health conditions. Numerous genes have been identified which increase susceptibility, yet none guarantee the condition’s onset.

It’s crucial to note that genes alone don’t dictate the emergence of these disorders. Environmental triggers, trauma, and life circumstances play a substantial role, often activating the genetic predispositions.

Psychotherapy And Genetic Roots – Do They Coexist?

So, if these disorders have a genetic foundation, can psychotherapy still be effective?

The resounding answer is yes. Even when your mental health has a genetic component, it can be addressed effectively with treatment such as therapy. This is because of other scientific findings that include:

  1. Gene-Environment Interaction – Genes often provide a predisposition, not a destiny. The expression of genes can be influenced by the environment. Psychotherapy can serve as a positive environmental factor, potentially mitigating the adverse effects of certain genetic predispositions.
  2. Neuroplasticity – Our brain is adaptable. It possesses an incredible ability, known as neuroplasticity, to reorganize and form new neural connections throughout life. Therapies, especially cognitive-behavioral therapy, can promote positive changes in brain patterns and pathways.
  3. Coping Mechanisms – Regardless of genetic predispositions, therapy equips individuals with coping strategies, tools, and skills to handle stressors, manage symptoms, and navigate challenges more effectively.
  4. Holistic Healing – Treatment is not just about addressing genetic factors or the brain’s chemistry. It’s about healing the individual holistically, encompassing emotional, cognitive, and behavioral aspects. Psychotherapy offers a space for introspection, growth, and healing that can benefit everyone, irrespective of their genetic makeup.

Our brains are constantly developing. When we’re young, we do not know how to do basic math, and then we learn, and then we know math. We never stop knowing math, even though we were born without the ability to do math. Our mental health works in a similar way. We may have a predisposition because of our genes, but through learning, coping strategies, building connections in our mind, and more, we can address these same mental health struggles.

The Path Forward

Understanding the genetic roots of mental health disorders can be empowering, offering clarity and insight into one’s experiences. However, these genetic revelations should not be seen as a treatment barrier. On the contrary, they can help tailor and optimize therapeutic approaches for individuals.

In the realm of mental health, the coexistence of genetics and therapy is not only possible but also promising. It’s a testament to the resilience of the human spirit and the potential for change, growth, and healing.

If you or someone you know is navigating the complexities of mental health and seeks guidance, reach out to Flourish Psychology. Together, we can chart a path to well-being, understanding, and hope.

Pronoun Use and Gender Identity

Pronoun Use and Gender Identity

Accurately acknowledging the pronouns of the people you meet has become a professional and scholastic standard over the past several years. Besides fostering a greater state of mental health, correct pronoun use can also create a more confident sense of gender identity in ourselves and those around us.

Our choice to recognize and acknowledge the pronouns of others is not only for accuracy and respect. It is also, according to evidence, a way to prevent our own role in fostering severe depression symptoms – potentially even a decreasing suicidal thoughts and tendencies.

But the widespread use of pronouns in society is, in many ways, new – at least for many of us. While the effort required to recognize every person’s chosen pronouns can seem daunting at first, a little can go a long way in creating a more comfortable work or school environment

Understanding Pronouns and Pronoun Preferences

None of the information here is meant to pertain to anyone’s personal gender, or even their acceptance of exploring self-identity. This guide is meant to only assist in treating others with the respect and decency we should expect within a professional environment. It is not intended for either self-expression or correction, but simply for educational reference and understanding. 

We are also not going to go over every pronoun someone may claim as their own, as that simply cannot be done here. Activists and educators are, even as we speak, working with language to try to find scientific and acceptable ways to help people better communicate who they are and what they need.

What we can do however, is provide a basic overview of what one can expect terminology to infer, and therefore how we can respond with recognition, if not support.

  • He/Him: By identifying with He/Him pronouns, a person is telling those around them to view them as a man. This does not necessarily mean they associate themselves with what we view as “masculine”, but it does imply that this individual views himself as a male. Therefore in a professional setting he should expect us to follow best practices and refer to him as such, as that decision is a part of his life that we are not involved in.
  • She/Her: In utilizing She/Her pronouns, an individual is making it clear that they view themselves as a woman, and live a life associated with that. That can look differently to different women, and again has nothing to do with her relationship with femininity. The chosen pronoun simply reflects the gender identity she may feel represents her accurately.
  • They/Them: Referred to as “nonbinary” pronouns, there are several different meanings someone may be considering when going by They/Them. There could be a complete abandonment of the gender binary, meaning they don’t identify as male or female, or they may see parts of both genders reflected in who they are, and therefore have chosen a middle ground. 

There are other possible reasons for this pronoun choice as well, which does well to highlight that main fact: whatever their reasoning is, their pronoun choice simply asks that we refer to them as with They/Them rather than He/Him or She/Her.

  • He/They: Lastly, but by no means comprehensively, there are many who associate with two pronouns, and offer an option of use rather than a strict identity. Someone claiming He/They as their pronouns may view themselves as a man sometimes or partially, while also associating with a degree of nonbinary identity.

The same would be true for someone who’s pronouns are She/They, in that they identify both as a woman and as nonbinary in some form or fashion. Again, while these pronouns may seem harder to understand at first, it is only because they represent an identity that is personal to the person claiming them.

What somebody identifies as and how they wish to be referred to has nothing to do with who they were before we met them. It can be helpful to view someone’s pronouns in the same way as someone’s name. It represents them, and what they wish to be called is their choice. Some pronouns, like “they” may seem difficult at first. But remember that we already use “they” to refer to individuals whose gender we do not know.

For example, when we hear a name that is not typically associated with a single gender, like “Jordan,” we may already ask questions that use the term “they.” For example, we may say “what do they do?” or “who are they to you?” This type of plural usage is common in American English. Those that are choosing to go by “They” are essentially asking you to use the same.

More on Gender Identity

Gender identity and pronouns may be included in today’s political battles. But for most of us, all they are is a sign of respect, and a way to help make sure that those that identify as a specific pronoun and those that are struggling with or learning to acknowledge their own gender identity, are treated with respect – respect that also may support their mental health.

If you are someone that is struggling to feel affirmed with your own gender identity, or you find that others around you are not offering the support you need, please contact Flourish Psychology today to learn more about our LGBTQ affirming care services and other forms of therapy.

Therapy is Not Only For Disorders

Therapy is Not Only For Disorders

The Diagnostic and Statistical Manual, known as the DSM (in this case, the DSM-V), is a manual that psychologists and therapists are meant to use to guide patient care. It provides therapists and patients with a diagnosis – for example, “Generalized Anxiety Disorder,” that, once identified, helps guide treatment.

But there are issues with the idea of using diagnoses at all.

For one, every person is different. While many conditions present in very similar ways, there are situations where two people experience similar symptoms, but one qualifies for a diagnosis and the other does not, or may qualify for something else. Treatments are also very individual based, and may need to change based on how the person responds to questions.

There are also issues with patients that adopt their diagnosis as an identity. Some clients actually feel their symptoms get worse when someone tells them that they have a specific condition. There are many, many reasons that diagnoses can actually be problematic.

Today, we’re going to talk about another one.

Does a Diagnosis Even Matter?

Most people are familiar with depression. Depression is one of the most common and most challenging mental health conditions. Living with depression can be extremely difficult, and the sooner you seek treatment, the better the outcome will be. There are different forms of depression, such as chronic depression and major depressive disorder, and each one has its own diagnostic criteria.

But what many people do not know is that, to qualify for a diagnosis of chronic depression, a patient has to exhibit clinical symptoms for at least 2 years. This means that, if you’ve only experienced depression for 1.5 years – even if you have all the same symptoms – you do not qualify for a diagnosis.

There are many valid reasons for this, and maybe we can discuss them in a different article. But there are also drawbacks. If a client has all the symptoms of chronic depression, but hasn’t yet hit the criteria, a therapist may still determine that they would benefit from a treatment that targets chronic depression. The diagnosis may not matter.

Similarly, therapy and counseling are designed to make your life better and address areas of concern. They do not require a diagnosis to be helpful, nor are they only designed to treat the diagnostic conditions. Imagine if you have other issues:

  • Worried About the Future of Your Career in an AI Obsessed World?
  • Stressed About Parenting?
  • Feeling Sad About Losing a Pet?

If you are relying on a diagnosis, you may not qualify for a treatment, as these are not necessarily mental health disorders. But these are still issues that affect your quality of life, and therapy is also capable of addressing these very same issues. That is why many people see their therapists for years. It is not just about getting a diagnosis, but, rather, trying to make sure that your overall quality of life is better.

We see this with disordered eating as well. “Orthorexia” is a term that describes an obsession with healthy eating that can actually make a person unhealthy or preoccupied in a way that affects their quality of life. Most eating disorder therapists, including our team here at Flourish Psychology, recognize and understand that it is a very real condition. But it is not currently included in the DSM-V, and would thus not qualify as a condition that can be diagnosed according to that manual.

Treatment Regardless of a Diagnosis

One of the reasons that we’ve chosen to be a cash-only private practice is because we do not believe that diagnoses should be required to seek treatment. Insurance companies frequently require a diagnosis, and may refuse payment if no diagnosis is given or stop treatment if the psychologists believe the patient is no longer struggling. They also require that anything that is diagnosed be reported, and become a part of a person’s permanent medical record.

Diagnoses are extremely helpful. We study them extensively in graduate school, and we learn how to treat them. They are also limiting and cause problems for both patients and practitioners. If you feel like you might benefit from a therapist, it is always beneficial to seek help. Do not worry about if you have a diagnosis. Instead, embrace the idea that you can have someone on your team to help you improve your overall quality of life.

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