When you suffer, you have the same set of thoughts over and over, a process that clearly reinforces a given neurological circuit. Suffering takes many forms. Ways it is manifested include complaining, arguing, manipulation, gossiping, etc. There are often strong repetitive thoughts regarding the mess that your life has become.  The resulting anger is the jet fuel that gets these circuits really spinning. It is almost impossible to “let it go,” because the anger feels so justified. The situation is miserable before we consider the unrelenting pain.

I recently had a patient who was convinced that somehow the orthopedic surgeon had done a poor job on his rotator cuff surgery five years earlier.  Although he was in my office to look at his neck, he continued to rant about how he had been irreversibly damaged by this surgeon. I don’t know how well the surgery went compared to how well he had done his rehab after the shoulder surgery.  He was so focused on the story and the sensations around his shoulder that I could not even touch his skin around the shoulder girdle. Regardless of the reason for his condition, his daily quality of life was additionally compromised by these repetitive, ruminating thoughts.

Often patients with chronic pain see a psychologist for help in dealing with negative thoughts/suffering. This is a generally a good idea — I am a strong proponent of psychological support for almost any situation.  However, it must be used in the correct context.  In my experience, if your sessions are used only to talk about your problems, you are merely firing up negative neurological circuits and making them more complex.  It can be a form of “sophisticated suffering.”  For psychological interventions to work, you also need a “reprogramming” component, which I will discuss at length. Not sharing your pain