Overcoming Resistance And Denial For Effective Chronic Pain Management
What Is The Inner Saboteur Developed & Presented By Dr. Stephen F. Grinstead Based In Part On The Gorski-CENAPS® Model
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The Monkey Mind
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
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Overcoming Resistance And Denial For Effective Chronic Pain Management
The Committee
Set Of Mistaken Thoughts, Beliefs, Opinions & Conclusions
The Inner Saboteur Evil Wolf
Monkey Mind
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When we have exciting dreams and goals anything seems possible. Sometimes we sabotage ourselves and talk ourselves out of exciting possibilities. What are some ways that you got in your own way and stopped a dream from coming true? What did you say or do that stopped you?
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
We develop problematic perceptions and beliefs We seek support to shore them up and develop self-talk the reinforces them We engage in activities that support our beliefs We surround ourselves with others who will also help us support our perceptions and beliefs Even though we experience negative consequences we will not let go of our beliefs
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Thoughts
Feelings
Urges
Actions
Pause and notice the urge without doing anything about it—Put yourself in Time Out! Relax by taking a deep breath, slowly exhaling, and consciously imagining the stress draining from your body; Reflect upon what you are experiencing by asking yourself: “What do I have an urge to do? What has happened when I have done similar things in the past? What is likely to happen if I do that now?”; and thenC
Decision Point © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Health Decide what you are going to do about the urge. Make a conscious choice instead of acting out in an automatic an unconscious way. Do it when you make the choice about what you are going to do, but remind yourself that you will be responsible for both the action and its consequences—Easy does it; but DO IT!
Work
Painful Reality Money Relationship Minimization
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Automatic and unconscious reactions that defends us against the pain of recognizing serious problems
It’s a Normal Part of the Human Condition © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
1. We Are Truth Seeking Animals A. Who Am I? (Identity) B. Why Am I Here? (Purpose) C. Where Do I Fit In (Belonging) D. What Is Wrong With Me? (Diagnosis) E. How Can I Get Well? (Recovery) 2. We Are Fallible Human Beings A. The Truth Is Hard To Find B. We Have A Tendency To Make Mistakes © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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3. We Have A Tendency To Lie To Ourselves We Tend To See Things In A Way That C Causes The Least Pain Gives Us The Easiest Solution Or Way Out 4. We Have A Tendency To Lie To Others We Tend To Lie When C We Are Threatened Or We Believe It Is In Our Best Interest 5. We Can Become Sincerely Deluded By Believing That Our Lies Are True © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
6. We Need Truth-Seeking Systems To Protect Us From C
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
1. Denial Is Turned On By C Thinking Or Talking About Painful Problems 2. Denial Is Turned Off By C A. Thinking And Talking About Other Things Taking The Focus Off Of The Problem B. Managing The Pain Caused By Focusing On The Problem C. Solving The Problem That Causes Pain
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
1. Benefits 0f Denial ... Denial Is A Blessing That... Helps People Deal With Unbearable Pain And Overwhelming Problems 2. Disadvantages 0f Denial ... Denial Is A Curse That Prevents People From Seeing What Is Wrong And Taking Appropriate Action
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Anger - The problem is disrupting my life + Fear - It’s getting worse & I can’t solve it + Guilt - I’ve done something wrong + Shame - I’m defective as a person = Pain - Thinking & talking about the problem just hurts too much
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
Lack Of Information Wrong information about the problem or solution Conscious Defensiveness The person knows something is wrong but doesn’t want to face the pain of knowing
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Denial Automatic & unconscious defense mechanism that guards against pain & helplessness Delusion Deeply entrenched mistaken belief held in spite of overwhelming evidence to the contrary
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
A Clinical Procedure For Managing Denial In The Treatment Of ... 1. Substance Use Disorders 2. Mental Disorders 3. Personality Disorders 4. Lifestyle Problems 5. Chronic Pain © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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To Teach People How To Think And Talk About Serious Problems C 1. While Staying Centered 2. Without Activating C The Denial Defense Mechanism Treatment Resistance
Formula For Success
The Referral
Your Tool Box
Addiction Symptom Review Life & Addiction History Presenting Problem Analysis Denial Pattern Management Denial Pattern Identification
Denial Triggers, Pros/Cons, And Antidote For Denial Denial As A Normal Part Of The Human Condition © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Avoiding
Thinking or Talking About Painful Reality
Reality
Manipulating
Trigger
Primary irrational thoughts that C Deny seriousness of problems Protect from the pain of facing problems Lead to worsening of problems
There Are Twelve Common Denial Patterns Complying © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Definition Refusing to think about, talk about, or do anything that will focus on my problems Mistaken Belief If I refuse to think or talk about my problems, they will magically go away!
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
Saying Nothing It will go away if I don’t talk about it! Distraction It will go away if I focus on other things! Uproar It will go away if I create a crisis! Playing Dumb It will go away if I pretend not to know about it!
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Definition Refusing to admit that a problem exists in spite of convincing evidence that it does Mistaken Belief If I can convince myself and others that I don't have a problem—then problem solved!
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Definition Seeing problem as less serious than it really is Mistaken Belief If I can convince myself and others that the problem it isn’t really that bad, it will go away
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
How Bad Does It Have To Get Before You Stop It?
1
10 Pounds 5
100 Pounds
10
1000 + Pounds
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Definition Justifying your problem behavior by creating good reasons for having it Mistaken Belief Having a good enough reason for the problem will solve it and save me from negative consequences
You Can’t Think Your Way Out Of A Problem That You Behaved Your Way Into Dr. Stephen Covey
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Definition Refusing to accept responsibility for solving the problem by believing that it is someone else’s fault Mistaken Belief If someone else is responsible for the problem, I don't have to deal with it Have you blamed others to avoid taking action to help yourself? © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Blaming Puts & Keeps You In The Victim Role
Avoidance Total Denial Minimizing Rationalizing Blaming
1-2-3-4-5-6-7-8-9-10 1-2-3-4-5-6-7-8-9-10 1-2-3-4-5-6-7-8-9-10 1-2-3-4-5-6-7-8-9-10 1-2-3-4-5-6-7-8-9-10
My Choice is: __________________________ © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Definition Believing that it’s not a problem because other people have more severe problems Mistaken Belief If someone else is worse off than I am, that proves that I don't have a problem
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Definition Forcing others to act as a rescuer by refusing to solve my own problems Mistaken Belief If I can get someone else to fix my problem, then I don’t have to do anything to solve it for myself
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Definition Using fear to avoid making changes I won’t have any more problems if I just get scared enough Mistaken Belief Without _________ my life is over Fear alone will prevent me from future trouble
F.E.A.R.
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Definition Pretending to solve the problem so I can be left alone. Mistaken Belief If I can get people to leave me alone by going through the motions, the problem will go away.
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Definition Believing that I’m all better now and can stop doing what helped me in the first place. I convince myself I don’t have to do anything else—I don’t have to change/grow. Mistaken Belief Feeling better means I’m cured.
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Definition Acting hopeless or being hopeless in order to convince people to stop trying to help me Mistaken Belief It’s hopeless so I convince myself and others not to try I pretend to be hopeless so others will leave me alone © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Definition Believing I have the right to live my life the way I want despite my problems Mistaken Belief Because I have the right to destroy myself even if I hurt others, I should be left alone
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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Comparing 1-2-3-4-5-6-7-8-9-10 Manipulation 1-2-3-4-5-6-7-8-9-10 Recovery By Fear 1-2-3-4-5-6-7-8-9-10 Compliance 1-2-3-4-5-6-7-8-9-10 Flight Into Health 1-2-3-4-5-6-7-8-9-10 Hopelessness 1-2-3-4-5-6-7-8-9-10 Right To Be This Way 1-2-3-4-5-6-7-8-9-10 My Choice is: __________________________ © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Review Your Scores For The Big Five And The Small Seven Denial Patterns Pick The Pattern That Troubles You Most Write Down That Pattern Now Share With A Partner Why You Picked It Share What This Pattern Means To You
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
Personalizing Your Most Important Pattern Create Short Personal Title: Come up with a word or short phrase that has emotional meaning to you Create Short Personal Description: Start this description with the words I know I’m using this denial pattern when I (do something) and start using (describe how the pattern works) and it causes (describe the pain & problems) © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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My Pattern Is: _________________________ Why I Picked It Is: _____________________________________ ___________________________________ My Personal Title Is: ___________________________ My Personal Description is: _____________________________________ ___________________________________ © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
Bio
Spiritual Psycho
Social
© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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Overcoming Resistance And Denial For Effective Chronic Pain Management
Pain Management Recovery Goals
Biological
Psychological 25
Social
25
Spiritual 25
Reduction or elimination of resistance and denial Decreased perception of pain & freedom from suffering Increased levels of functioning & quality of life Develop effective non-pharmacological proactive pain management skills Resolve co-occurring psychological disorders Reintegrate with family, community and work Proactive relapse prevention plan Therapeutic continuing care & transition plans Shift from victimized to empowered
25 © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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www.FreedomFromSufferingNow.com www.youtube.com/drstevegrinstead www.chronicpainanonymous.com www.terrygorski.com www.cenaps.com www.relapse.org Dr. Grinstead’s Contact Information Email:
[email protected] Phone: (916) 575-9961 CENAPS Phone: (352) 596-8000 © Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982
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© Terence T. Gorski and Dr. Stephen F. Grinstead, 2014, 1982: Based on Dr. Grinstead’s Workbook DMC for Effective Pain Management. Grinstead Treatment & Training (916) 575-9961 or
[email protected]
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