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About James Joseph Parker
Expertise
I can offer individuals who suffer from the effects of Post Traumatic Stress Disorder, or PTSD, the understanding that is often sorely lacking in this area of mental health, and I can answer many of the questions that are specific to this disease. In addition, I can address many of the questions that individuals who have lived, or who are now living in an alcoholic household need answered, to help them address the emotional, physical, and spiritual toll this illness exacts, not only on the alcoholic, but those who live with the alcoholic as well. I can not address questions concerning the prescription of medications or the diagnosis of disease.

Experience
I am a former Marine who served one tour of duty in Vietnam. I was diagnosed with PTSD in 1980, and have been in several in-patient programs, clinical veteran groups, and one-on-one counseling for approxmately twenty years. I was raised in an alcoholic household, and I have been a member of Adult Children of Alcoholics (ACOA) for sixteen years. Over the years, I have acquired a wealth of experience that I believe can be beneficial in helping others to examine their own issues. I am also a writer, and I have used writing as a means of examining my own life, and as a tool for working through personal issues.

Organizations
ALANON (ACOA) - A 12 Step Program (16 years). Disabled American Veterans (DAV) (20 years).

Publications
Buffalo Evening News

Education/Credentials
B.S. Computer Science - Buffalo State College 1988 Currently tutoring English students at Buffalo State College, and working on my undergrad degree in writing.

Awards and Honors
Decorated military veteran Exemplary Service award from English department of Buffalo State College.

You are here: Experts > Health/Fitness > Mental Health > Post-Traumatic Stress Syndrome > PTSD and Chronic Pain

Post-Traumatic Stress Syndrome - PTSD and Chronic Pain

Expert: James Joseph Parker - 10/28/2009

Question
I am currently undergoing treatment for chronic pain and have recently begun cognitive behavioral therapy (CBT) to learn better coping skills beyond trying to control the pain with painkillers and physical therapy. I am very guarded about a preliminary diagnosis of PTSD I received about 9 months prior to the beginnings my chronic pain from a different therapist. I don't like the thought of bringing up the PTSD in the chronic pain CBT sessions to the new therapist. I see it as a separate issue from my chronic pain, however the more I read about the two conditions the more I find that they are often comorbid.

The issues surrounding the trauma and subsequent PTSD are very much improved but I still have major trust issues discussing these topics. My question is how important is it to bring up the PTSD to my new therapist that I am seeing for chronic pain?

Answer
Paul,

    The simple answer to your question about discussing your PTSD with your chronic pain therapist is, "Why not?" If your research has shown that both conditions, chronic pain and PTSD, are "often comorbid," would it not make sense to make certain that your pain therapist be apprised of your PTSD, and your PTSD therapist be apprised of your chronic pain treatment? That said, the following are suggestions that I hope you will consider when making your decision about whether or not to inform your chronic pain therapist about your PTSD.
    If chronic pain and PTSD are frequently seen as operating simultaneously, there has to be a correlation between the two. Not a cause and effect correlation, but perhaps more an exacerbation of one by the other and vice versa. The PTSD amplifies chronic pain, and the chronic pain amplifies the PTSD. That's my theory. In my opinion, whether there's any truth to the aforesaid is of no consequence in your situation. I've always felt that laying my cards on the table has always been the best approach. Whenever I see my PTSD counselor, I always tell him everything. This has, for me, been my most successful tactic in dealing with the difficulties that PTSD often presents in my life. Conversely, when I go to my medical doctor, regardless of the reason, I invariably bring up my PTSD. Because my PTSD often distorts the way I perceive things, I make certain my doctor knows this in advance.
    Like you, I kept my PTSD pretty much to myself. I felt a very strong sense of shame and embarrassment, like PTSD was a character defect. It was only after I became comfortable with the disease of PTSD that it began to recede from my consciousness. It was as if, by acknowledging its presence, I gave myself permission to stop holding on to the illusion that nothing was wrong, and that in turn allowed me to release all the energy I was burning up denying my condition, a condition which often left me emotionally exhausted. Once I acknowledged how bad things really were, I could begin to make them better. In that respect, my PTSD is no more a shackle for me than having a bad arthritic right knee; it's a pain in the ass at times but, with few exceptions, it doesn't dictate what I will or will not do. I do not compartmentalize my PTSD. I suggest that you not do so either.
    If you are uncomfortable with your PTSD, at least in terms of telling people about it, then make a commitment to yourself to make a plan to begin getting comfortable with it. For the time being, try to share your feelings about your PTSD with a trusted friend, at least for a little while. Slowly you will get more comfortable with the fact that you have this disease and that it is now, to some extent, part of who you are. It sounds like you are trying to ration out your PTSD, as if it's OK to have it in some places, but not in others. PTSD is a disease of self fragmentation, where one part of the self is separated from another part of the self. The cure (if such a thing exists), is in bringing the divided selves back together. To that extent, I find it best to acknowledge all of my pain, both emotional and physical.
     I apologize in advance for the lengthy reply to your single question, but the question covers a good deal of ground. It’s easy to say “yes” or “no,” but the “why” is more important. Why should you tell your chronic pain therapist about your PTSD? Because the therapist may be able to tailor your treatment to both the physical and emotional components of your pain; in theory, your physical pain could be partially a manifestation of your PTSD, and your PTSD could be fed, to some extent, by your chronic physical pain.
    Finally, there’s the simple issue of fairness. How can your chronic pain therapist be reasonably expected to form a comprehensive treatment program without knowing your entire medical history? Having all of the facts allows the therapist to make informed decisions about how best to proceed in your situation.
    In the end of course, it’s up to you to decide what you will or will not tell your therapist about your PTSD. However, in my opinion, the sooner you are able to answer “yes” to the question, the sooner you can get on the road to managing not only your chronic pain, but your PTSD as well.
    I hope that the above helps you out in some small way. If I can be of any further assistance, please do not hesitate to contact me.

Take care, Paul.

Jim

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