Psychiatrist - Medication - Psychologist - Distraction = Pain Management

From: Helen Dynda (
Sun Feb 6 14:18:49 2000

I am not pain-free; but my chronic pain is considerably reduced as a result of professional help and what I am doing to help myself.

I have been seeing a psychiatrist, who specializes in pain management. She has prescribed medications specifically for me and has adjusted my medications, as needed, since January 1997.

Currently I am taking 200mgs of Carbemazepine (generic of Tegretol) in the morning and 400mgs of Carbemazepine before bedtime.

She has also prescribed Amitriptyline (generic of Elavil) for me. I am currently taking 100mgs of Amitriptyline. I have actually been taking Amitriptyline ever since 1975. I have written about my first experience with Amitriptyline on the Adhesions Quilt (at the top of this webpage).

At my very first appointment with her, she wrote a prescription for me to have blood drawn so that she would know what my blood level of Amitriptyline was. This vial of blood was then sent away to be evaluated. When the results of my blood level came back, my blood level was at a toxic level!! It was 525mgs!! It should have been between 100-150mgs. Then my psychiatrist had to slowly wean me off of that extremely high level until my blood level was brought down to 100mgs.

My psychiatrist periodically has my blood levels of Carbemazepine and Amitriptyline checked; because both of these medications are considered to be "high risk medications". Why are they considered to be "high risk medications"? Too much of either or both medications could be toxic to and cause harm to my liver.

What has made it even more difficult to live with chronic unrelenting pain is my discovery in 1984 that my entire life had been affected as a result of the alcoholism of my father. I discovered that I am an Adult Child of the Alcoholic (ACOA)!! From a very early age I had learned unhelpful ways in which to cope in an alcoholic home - "don't talk, don't trust, don't feel".

I have also been seeing a psychologist for talk therapy since January 1997. I am given the chance to talk about how chronic pain has and is affecting my life. She has helped me to develop a trusting relationship with her so that I feel comfortable as I tell her about how both alcoholism and chronic pain have affected and are affecting my life. She guides me, as needed, so that I am able to share my feelings with her; which, in turn, helps me to be able to share my feelings away from the therapeutic setting.

I have felt especially blessed by these two therapists, who are both women. Both my psychiatist and psychologist are located within the same facility; so they are easily able to communicate with each other about my situation. These two professionals, working together, is similar to multidisciplinary pain management. I don't think that I would be able to share so openly - if either or both therapists were male.

My very first appointment with my psychiatrist was for 1 hour. Gradually these appointments have been cut back so that currently my appointments with her are only for 15 minutes; and currently my appointments are spaced 4 months apart. As long as I am doing okay with the medication I am taking - and as long as there are no traumatic events in my life which could affect my pain level - I am doing okay for now. I am not pain-free; but I can function pretty well with the medications I am now taking.

I have mentioned this previously - and I will mention it again. I know that I am benefiting pain-wise by the use of "distraction". What is distraction? Distraction is a psychological technique in which a person keeps their mind so busy that pain messages are blocked from reaching the brain. I have already mentioned on this forum that I am a firm believer in the *mind-body connection*. Distraction is an example of the *mind-body connection* at work.

How do I use the technique of distraction in my daily life? The best example, which I can give, is that I do whatever is necessary to draw attention away from myself. My involvement with the International Adhesions Society is perhaps the best example of how I use distraction. In response to having seen my story [which I originally posted at] entered on the various search engines of the Internet, I made a decision to share my research with anyone and everyone who wrote to me for this information. This has really kept me busy! This has taken the focus off from myself and also takes the focus off from the pain I live with daily.

I have truly been blessed in that I have heard from people from all over the world. I have learned so much from this experience!! By involving myself in the lives of other people in a helpful way - this helps to block pain messages from reaching my brain. This distraction is not a conscious effort on my part - it happens automatically! This is an example distraction at work - a psychological technique which I have used perhaps all of my life - but I did not know that there was a name for it. DISTRACTION does work!!

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