Whole Health for Veterans with Chronic Pain Veterans Health Administration

Dr. Michael Hollifield and Dr. Ben Kligler discuss how to put all of this information together into a pain management approach that improves health and well-being. This includes topics such as how to talk with your provider, combining clinical care with acupuncture, chiropractic care, physical therapy, medications, and other approaches with self- care, having a team, developing a plan for flare-ups, and resilience and self -efficacy. We also consider how our community and society impacts Whole Health and chronic pain as well as the future of Whole Health and pain care in the VA. Social and Structural Determinants of Health are discussed as important underlying factors that contribute to health.

In this episode, Dr. Katherine Bailey and Dr. Kaye Morgan explore the role of thought processes in pain management. People with chronic pain can have their thoughts hijacked by pain, and once pain takes your focus it is hard to think about anything other than the pain. We discuss how thoughts create emotions and physical sensations in the body, including how our fear of or anticipation of pain increases pain in the body. The good news is that if we can worry ourselves sick, we can imagine ourselves well. Cognitive Behavioral Therapy and other mind-body approaches are explored as solid evidence-based tools for chronic pain and suffering.

Growing and Connecting- Dr. Brown Johnson and Chaplain Cleaver join us in the podcast to discuss how spirit and soul can be an important part of healing from chronic pain. We discuss how this can be part of the clinical visit or even support providers in their work. We discuss how moral injury can be a factor in chronic pain and suffering and how this can be addressed and discussed. Often injuries in war are associated with seeing and doing things that go against our beliefs or moral code. It can be hard to release the pain without addressing shame and guilt and forgiveness. These are practices that can be cultivated and worked on with mental health providers, chaplains, and other spiritual advisors.

Dr. Aaron Martin discusses the connection between sleep and pain and how they influence each other: people with chronic pain have poor sleep due to pain, while poor sleep leads to chronic pain. Chronic pain is due to an overactive nervous system while sleep requires the nervous system to be in a relaxed state. There are many ways to approach sleep and rest besides taking medications and, in fact, many sleep medications do not provide good quality deep sleep. Instead, we can re-train the body and brain to relax and allow rest and sleep thus improving pain and suffering.

Dr. Nancy Cotter joins the podcast to demonstrate how what you eat and drink impacts the amount of pain you experience. During this episode we learn that food is information for your cells, and anything we consume that is not a healthy whole food is treated as a toxin. Healthy foods are broken down into nutrients the body can use for fuel and cell repair, while unhealthy foods activate the body’s emergency response system and produce biochemical reactions designed to destroy the invader that you ingested. This process damages tissue and creates an overload of inflammatory chemicals that increase pain. Dr. Cotter explains the importance of eating the rainbow, eating mindfully and moderately, and considering food an act of self- love and nourishment. While some people have limited access to fresh healthy foods or fresh water, what really matters when making food choices is doing the best you can. It starts with one small change. Each of us can examine our diet and what is possible for us.

Dr. Dave Kopacz discusses chronic pain as a call to growth and change, a physical, emotional, mental, and spiritual journey to become someone new. He explores re-engaging in meaningful activities, focusing on what you can do, and allowing grief over loss of previous activities. Because chronic pain is processed through the brain, developing new interests, hobbies, taking classes, or any focus on developing oneself further creates new brain pathways that decrease focus on pain and shift focus to new possibilities, passion, and hope. Chronic pain itself can be a call to focus on our personal development, and we explore the concept of pain as a hero’s journey.