Treat Your Own Chronic Pain: The Chronic Pain Bible for Doctors, Psychologists, and Clients

By Christine Sutherland

The overwhelming majority of chronic pain, some 94%, is non-malignant pain which is "out of kilter" with any pathology. This includes most back pain, post-surgical or post-injury pain, phantom pain, fibromyalgia, rheumatoid arthritis not in an inflammatory phase, and "mystery" pain.

Despite the evidence that no current treatment, being pharmaceutical, physiotherapy, or psychological, significantly relieves pain for the majority of the 1.5 billion sufferers worldwide, disappointingly, almost all current treatments and textbooks recommend strategies that we already know do not work very well, if at all. This includes the unfortunate recommendation of CBT and/or mindfulness which are known to have little or no effect on clients' pain levels. Likewise specific exercise programs are not superior to enjoying an active hobby.

This important book aggregates the most recent research into this type of chronic pain, comprehensively explaining a very new but robustly-validated theory of chronic pain, including an explanation of exactly why existing treatments fail so spectacularly for most people.

Finally you'll learn a completely new treatment approach, SDR Therapy, which accurately and precisely addresses the true nature of chronic pain, being conditioned pain signalling, finally giving hope for significant resolution of this awful disorder. This is a book which has the potential to finally bring psychology into the science arena and thus change the face of mental healthcare world wide.

Readers are offered free access to supporting training and therapists are invited to upload their demonstration videos for debrief and discussion in order to help skilful implementation into their practices. Being told how to treat pain and being helped to treat pain are two very different things.

• Language: English
• Publisher: Christine Sutherland
• Release date: Dec 6, 2021
• ISBN: 9780645353907

Christine Sutherland

Christine Sutherland is a licensed massage therapist and massage instructor. She is the co-founder of the Sutherland-Chan School & Teaching Clinic in Toronto and the Director of the Canadian Institute of Palliative Massage. She makes Fort St. John, British Columbia, her home base as she travels the world spreading her message of hands-on healing.

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Treat Your Own Chronic Pain

The Chronic Pain Bible for Doctors, Psychologists, and Clients

By CHRISTINE SUTHERLAND

Yes, you can switch the damn pain off!

Copyright © 2020 by Christine Sutherland

All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations in a book review.

Printed in the United States of America

First Printing, 2021

ISBN: 978-0-6453539-0-7

www.SDRTherapy.org

Cover and typesetting by Awadhesh Yadav.

Disclaimer

This book details the author’s professional experiences with and opinions about chronic pain and mental health issues generally. The author is a clinical researcher and behavioural therapist, not your healthcare provider.

The author and publisher are providing this book and its contents on an as is basis and make no

representations or warranties of any kind with respect to this book or its contents. The author and publisher disclaim all such representations and warranties, including for example warranties of merchantability and healthcare for a particular purpose. In addition, the author and publisher do not represent or warrant that the information accessible via this book is accurate, complete or current, merely that the author has done her utmost to provide information that aspires to those high standards.

The statements made about products and services have not been evaluated by the U.S. Food and Drug Administration. While the claims made in this book have been comprehensively researched and are founded on studies, meta-reviews and meta-analyses by other researchers, they cannot be in any way warranted to diagnose, treat, cure, or prevent any condition or disease for any specific individual. Please consult with your own physician or healthcare specialist regarding the suggestions and recommendations made in this book. Correct diagnosis is the foundation of any treatment, and your licensed medical practitioner or specialist is the best person to advise you.

Except as specifically stated in this book, neither the author or publisher, nor any authors, contributors, or other representatives will be liable for damages arising out of or in connection with the use of this book.

This is a comprehensive limitation of liability that applies to all damages of any kind, including (without limitation) compensatory; direct, indirect or consequential damages; loss of data, income or profit; loss of or damage to property and claims of third parties.

You understand that this book is not intended as a substitute for consultation with a licensed medical practitioner. Before you begin any healthcare program, or change your lifestyle in any way, you will consult your physician or another or other appropriate licensed healthcare practitioner to ensure that you are in good health and that the examples contained in this book will not harm you.

This book provides content related to physical and/or mental health issues. As such, use of this book

implies your acceptance of this disclaimer.

Christine Sutherland

Dedication

I dedicate this book to you, my valued reader, because together we have an incredibly important job to do. That job is the elimination of chronic pain for the great majority of people.

At this very moment over 1.5 billion people on this planet suffer from chronic pain on a daily basis, and yet there is not a treatment or combination of treatments that even comes close to relieving that pain for the majority of those people. Medications of all kinds, physical therapy, and psychological techniques have failed and continue to fail to this day. You’ll see the incontrovertible evidence for that laid out in detail in this book.

I believe, based on clinical experience and on the results of my own and very many other researchers’ independent studies, that SDR Therapy is the gold key to eliminating or greatly reducing chronic pain for the overwhelming majority of sufferers.

There is a desperate need to get this information to patients, and to those dedicated health professionals who are best placed to finally provide effective treatment that eliminates or greatly reduces pain for more people.

This book is my sincere effort to get this information out there, and is dedicated to all who suffer, all who love them, and all who care for them, because we now have the answers for some 94% of these chronic pain patients¹.

Contents

Disclaimer

Dedication

Acknowledgments

Foreword

Chapter 1: About This Book

Chapter 2: Things That Don’t Work, And Why Trusting Your Own Judgement Can Be Your Biggest Mistake

Chapter 3: Things that do HELP, at least to some extent, and which you can actually control

Chapter 4: What Chronic Pain Actually Is

Chapter 5: Implications Of Using SDR Therapy Instead Of Current Treatment As Usual

Chapter 6: SDR Therapy And Sdr Techniques

Chapter 7: What Else Can Sdr Therapy Be Used For

Chapter 8: Comprehensive Training For Psychologists And Other Health Professionals

Chapter 9: Common Questions About Recovering From Chronic Pain

About The Author

Research References

Important Warning

SDR Therapy is a rapid and effective way to reduce or eliminate non-malignant chronic pain which is out of kilter with any pathology. However SDR Therapy should not be used to treat others unless you are a qualified psychologist, psychiatrist, or counsellor so that you can provide a safe and appropriate therapeutic environment in which SDR Therapy may be an important and reliable strategy.

In addition, SDR Therapy is not appropriate for everyone. SDR Therapy has important contra-indications which should not be ignored. It is unsuitable for use while people are in the midst of experiencing dissociative disorders, psychosis, sociopathy or psychopathy, severe personality disorders, or severe unipolar depression, because of the risk of abreaction.

These particular issues are best addressed via medication and/or supportive psychotherapy rather than the application of techniques whose action is primarily on conditioned neurological processes.

However following resolution/control of symptoms of those specific disorders, SDR Therapy may be used under supervision to address the trauma of having been unwell, along with other issues such as depression, anxiety, addiction, and maladaptive thoughts, feelings, and behaviours generally.

Acknowledgments

The amount of health misinformation, health fraud, and plain health delusion in the media is both shocking and overwhelming. Even the health and wellness section of our local newspaper is crammed with this junk. Even licensed health professionals are spreading the most awful outright lies about vaccination right in the middle of a global health crisis. Some have even fraudulently provided medical exemptions.

How do we work out what’s true and useful vs what’s false and dangerous? There’s only one way, and it’s not anecdotes or testimonials. It’s not what some quack or celebrity touts on Facebook or YouTube. The one and only way is through robust, quality research.

Without robust, quality research there can be no progress, only blind dabbling, misinformation and misleading anecdotes and even fraudulent advertisements on every media you can possibly think of, with nothing to counter that virtual tsunami of poor and even deeply flawed research that unfortunately gets published in even the most prestigious scientific and medical journals.

Without so much recent, excellent, deeply credible research, my message would just be a lone voice in the wind, as it has been for over 20 years, instead of finally constituting an appropriate and urgent call to recognise and appreciate a new and far more useful theory of chronic pain which includes an effective new treatment strategy suitable for most people.

So I gratefully acknowledge the work of clinical researchers and also the various science writers who have brought that work into the public domain. Credit where credit is due, you’ll find citations to this important work throughout this book, making it not at all a book of ideas but a book founded as soundly as possible on a true and quite massive evidence basis.

Foreword

While this book includes detailed methods of self-treatment aimed at eliminating chronic pain signals in the majority of chronic pain cases, it cannot possibly address every strategy for every person in every circumstance. The type of chronic pain this book is about is not only the most common, but is also unique for each individual, for reasons you’ll shortly appreciate. So as well as giving people actual techniques to eliminate or reduce chronic pain, and as well as providing free videos and a support group to help people apply SDR Therapy as usefully as possible, there is another main purpose behind this book, aimed at getting this work where it is most needed.

That additional main purpose is to provide the strongest possible evidence for the claims made in relation to chronic pain and the SDR Chronic Pain Program because even now with such a mass of evidence already available in the scientific literature, there is still a critical need for that evidence to be aggregated and comprehensively set out in the public domain rather than just via disparate research papers that the general public can’t easily access and can’t easily interpret, so that it reaches the people who need it most, being both patients and the health professionals who serve them. I hope this book will fulfil that need.

So I’ve got to tell you right now that there’s a lot of science and a lot of discussion of research in this book and I know that can be pretty dry for a lot of people, especially if life is already a struggle because of pain. So I’ve tried to put shortcuts and interesting sidebars and callouts to make it a good read rather than a tedious one. Excuse my cartoons here and there. They’re pretty dreadful but I like them …

And look, honestly, if all you do is go to the back of the book and read and try the SDR strategies then that’s a win. It might be that all you do with all that science is show it to your health professional and that’s OK as well.

***

Now first let’s face something you probably already know full well but which for a lot of health professionals (certainly not all) is an unpalatable truth. And that’s the fact that most chronic pain programs carefully avoid saying that they will reduce or eliminate your chronic pain. A lot of them say outright that they’re not even going to try because that’s not what their program is about.

There’s a very good reason why the great majority of chronic pain programs do not declare an intention to reduce or eliminate your pain, and instead talk to you about improving your quality of life despite the pain, or managing your pain, or even learning to live with your pain. It’s because they don’t have treatments that actually work to eliminate or reduce your pain, and they know it. And those who do claim to reduce your chronic pain, usually have no real evidence that they actually do (apart from very short-term effects which we know fade fast), and use strategies which have been demonstrated not to significantly reduce pain for the great majority of people (for example CBT and mindfulness, and also pain education). A popular chronic pain app claims that it’s backed by research, but the studies listed don’t demonstrate significant decreases in pain, and the therapy strategies they use have been demonstrated to not only fail to reduce pain, but to not significantly assist with quality of life either. Despite the glowing testimonials. (Yuck, I’m going to prove beyond question that testimonials are worthless later in this book).

The best these programs seem able to do is to significantly increase your pain self-efficiency. Sounds good, doesn’t it? But no, it actually means that you no longer complain so much, or seek help so much, probably because they’ve used CBT (cognitive behaviour therapy) on you to manipulate your behaviour and get you to stop complaining, not to actually reduce your pain. So increasing your pain self-efficiency might make you look better from the outside, but it doesn’t get rid of your pain. I think of pain self-efficiency as a particularly nasty con job.

The strategies that I share with you in this book have been available since the late 1990’s but despite being supported by robust scientific evidence have mostly been rejected by allied health practitioners who have been convinced that they are already using the best evidence based strategies, even though so many studies show that those strategies actually don’t have much clinically significant evidence at all. I’m sorry to be so critical but by this stage I’m fed up, and I apologise in advance for some of the language and shade I’ll be throwing at current practices that are most commonly used in chronic pain treatment today. And please realise that I’m not just mouthing off – I’ll be providing iron-clad, robust empirical evidence for every claim.

I sincerely hope this book gets those same health professionals very excited at the prospect of being able to help clients far more effectively than ever before. And perhaps some of them, who already realise that some of what they’ve been taught is bunk, will even be relieved that something far, far better, and truly evidence based, is now available.

In this book I prove beyond doubt that this type of pain is usually created by your brain. But please never think that I’m trying to say it’s in your head because it clearly is real pain, exactly as real as the pain of a bad cut or burn, or a broken bone, or other real pain. Pain is pain and you’re not in any way, shape or form imagining it. But the thing about pain that has become chronic is that it doesn’t have the same cause as a burn or a break, and it doesn’t even use the same nerve paths or involve the same brain activity, as we can see when we investigate this brain activity via fMRI (functional Magnetic Resonance Imaging). Chronic pain uses unique brain activity and unique nerve paths, but it hurts every bit as much as acute pain, which of course you already know very well. It is still pain.

Some health professionals assume that because it’s so clear that a psychological component is involved in experiencing chronic pain that this refers only to thinking and emotion, but this falls very short of the truth. If you are a sufferer of a certain type of chronic pain (which happens to be the majority of chronic pain presentations) then your brain has learned, using quite well-known and well-understood neurological processes, to produce real, actual pain signals. This is why no drug, no physio, no device, and no CBT or DBT or mindfulness or anything else that has been thrown at sufferers has yet eliminated or even significantly decreased chronic pain for the majority of people. Study after study shows that NONE of these perform significantly better than placebo, which is to say they don’t significantly perform AT ALL. (I am very far from alone in making this claim, and the scientific commentary and citations throughout this book demonstrate and validate this claim comprehensively.)

This is why it’s absolutely not your fault if you still have pain, and it’s not the fault of your thinking or your attitude. It’s cruel and nonsensical to claim such a thing and yet this blame (spoken or implied) forms the basis of many chronic pain programs even now when we all should know better because the cold, hard evidence shows again and again that these programs simply fail to reduce pain for the overwhelming majority of chronic pain patients. Reducing so-called catastrophic thinking, or improving your attitude does not reduce pain.

So well-meaning therapists are quite wrong when they tell you it is some flaw in your thinking or your attitude that is to blame for your suffering. That stuff comes from Buddhism, not science, but unfortunately has permeated the entire field of psychology, which is supposed to be a science that delivers treatments based on actual evidence of effectiveness, not on unproven or disproven philosophical concepts, or unverified theoretical frameworks.

Another wild claim is that your suffering is because you don’t understand your chronic pain, and that if you only understand that chronic pain doesn’t mean there is physical damage, and if you only stop carrying on about it (catastrophising), you will suffer less. This claim is also deeply wrong and the available research (which you’ll read about shortly in detail) clearly demonstrates the uselessness of pain education for chronic pain sufferers in terms of actually doing anything significant about the pain.

Of course you deserve to know the truth about the nature of your pain that is so out of kilter with any existing pathology (that it’s not actually due to physical damage), but knowing this truth does not equal pain relief. Pain education is a humane thing to do so you’re fully informed and you know what’s going on, but it is not in any way treatment or a cure.

If we can only leave all that nonsense behind, and apply proven strategies such as SDR Therapy to treat chronic pain, we will switch off the pain, and the suffering along with it.

I hope you’ll read this book with patience, and lean heavily on the support videos, the webinars, and the community group where I’ll do my best to answer questions and provide whatever help I can. These are all free so please make full use of them. Take a look at

www.facebook.com/groups/treatyourownpain.

The problem of chronic pain

It’s absolutely blooming massive …

There isn’t currently a precise analysis of the entire global economic burden of chronic pain, but this burden is likely to be well be over a trillion dollars annually, with the USA alone accounting for up to $635 billion². Prevalence and costs are increasing and the World Health Organization predicts that by 2030 chronic pain will be a significant co-morbidity in the four biggest disease burdens globally³.

That’s a lot of suffering right now, and if we stay on this track it’s likely to get even worse. That’s not even factoring in long COVID, which is frequently accompanied by chronic pain.

According to Safe Work Australia, in the workers compensation space the cost of chronic pain has more than doubled in the last 15 years⁴. That’s despite the actual number of claims decreasing! Fewer cases, but costing a lot more.

In Pain Australia’s 2018-19 Pre-Budget Submission⁵ a claim is made that the failure to relieve chronic pain is due to the fragmentation of chronic pain services, followed by a recommendation of increased access to allied health services and greater communication between service providers⁶ as a comprehensive, multi-disciplinary approach to chronic pain. We’re seeing a big push toward expanding these types of programs and care throughout Australia right now.

Sounds great, doesn’t it? However all this is likely to do is waste yet more bucket loads of money as well as people’s time and energy, because to date we don’t actually have robust evidence for significant effectiveness of ANY current treatment for chronic pain, including these newer multi-disciplinary programs, and medical practitioners in NSW have even been advised to inform their patients that there is not yet a cure and that complete relief is rare, but that management of the pain is the goal of treatment, such that quality of life is maximised despite the pain (www.health.nsw.gov.au/pharmaceutical/doctors/Pages/chronic-pain-medical-practitioners.aspx).

So going down the path of multi-disciplinary or comprehensive chronic pain programs by increasing people’s access to current services, and having service providers share client information more comprehensively, is nowhere near enough, and is likely to be just a recipe for disaster, dramatically increasing expenses without delivering significant benefit, despite claims to the contrary. After all, you don’t get improvement by combining a whole bunch of stuff that we already know doesn’t work. That’s the definition of insanity, isn’t it? If something isn’t working, do more of it?

While there have been claims of effectiveness for pharmacological interventions, physical therapies, cognitive behaviour therapy (CBT, DBT, etc), EMDR and mindfulness in the treatment or management of chronic pain, it is widely recognised that both effect sizes and efficacy rates are low (or even no different to placebo or even worse than placebo), and despite small improvement to quality of life scores sometimes being reported, there is little or no change in pain scores. This is frequently the same for TENS and even for surgical intervention, as you’ll see shortly.

Current research relating to chronic pain has mostly been restricted to the above treatments and has demonstrated that those treatments simply don’t have significant clinical effectiveness. These are variants of cognitive behaviour therapy, physical therapy, pharmacological strategies, and even acupuncture (though it is widely recognised and will be clearly demonstrated in this book that acupuncture is a joke, being merely expensive and relatively risky theatre with effects no different to placebo). Many studies show that surgical intervention for chronic pain produces results no better than sham surgery, and that the TENS machine is also problematic, with one meta-analysis reporting that 15 out of 17 trials showed it to be no better than placebo⁷.

Lee et al⁸ puts the current lack of effective treatments down to poor understanding of causal factors (that have) stifled the development of effective treatments, while others claim to have identified causal mechanisms, such as Fordham et al⁹, proposing mechanisms that are not mechanisms at all but are correlational issues, the treatment of which does not significantly help the pain at all.

I propose that the reason that true causal mechanisms are not widely understood is that many researchers keep looking at the same correlational factors that Fordham and others have been so interested in and thinking that these are actually causal mechanisms, while others keep looking at the dorsal root ganglion, or genetic factors, and again finding correlation but not causes, which have obviously not led to treatments which achieve any sort of significant efficacy. If removing or modifying the suspected causal mechanism doesn’t result in significant change then we have to accept that the mechanism is probably not causal at all.

The development of a truly effective treatment for non-malignant chronic pain without sufficient explanatory pathology would not only bring relief to over a billion sufferers, but would relieve a burden of cost that is currently endangering our health system and harming sufferers and