Presenters
- David Clarke, MD, President, Psychophysiologic Disorders Association; Assistant Director, Center for Ethics. Oregon Health & Science University; Portland, OR
Summary
Recent controlled trials (see references) have documented relief of chronic pain (not merely improved coping) from two new forms of psychotherapy that focus on trauma, stressful personality traits, unrecognized negative emotions, psychosocial triggers and limitations in self-care skills. The techniques lend themselves to an integrated primary care environment as well as to patients with medically unexplained non-pain symptoms or chronic functional syndromes such as irritable bowel and fibromyalgia. The program will enable attendees to use these concepts in clinical practice and then further develop their expertise from interacting with future patients.
Chronic non-structural pain, medically unexplained symptoms and chronic functional syndromes are responsible for symptoms in 40% of primary care patients. Recent studies have revealed neuroanatomic changes in the brain in these patients and links to stress, trauma, and ACEs. New psychotherapeutic techniques have been developed to address these issues with the goal of symptom relief, not merely improved coping. Randomized controlled trials (see references) have documented the effectiveness of Pain Reprocessing Therapy and Emotional Awareness and Expression Therapy. They are significantly superior to various control treatments including CBT, MBSR and placebo injection. What is new about these therapies is their focus on patients’ trauma; stressful personality traits; unrecognized anger, fear, shame grief or guilt; psychosocial triggers and limitations in self-care skills. This is an advanced course, so it is recommended that attendees have attended prior CFHA sessions on Medically Unexplained Symptoms and/or read Reference #4 below and/or viewed videos on the PPD Association YouTube channel. The presenter has used these psychotherapeutic techniques for nearly 40 years on over 7000 patients.
Objectives
- Recognize which forms of pain/illness can respond to the new psychotherapies
- Be able to use the techniques of Pain Reprocessing Therapy for these patients
- Be able to use the techniques of Emotional Awareness and Expression Therapy for these patients