by Gauri Savla, Ph.D.

Dear SDPA members and guest readers,

Welcome to the first issue of the 2017 San Diego Psychologist! We have a new President of
the SDPA, Annette Conway, Psy.D., and a new Board of Directors. I have thoroughly enjoyed working with Annette so far, and am looking forward to our continued collaboration. Before I introduce the current issue and people who contributed to it, I would like to thank Ellen Colangelo, Ph.D., the outgoing President for her grace, kindness, and wisdom. I am grateful to have had her guidance as I navigated my first year as the Editor of The San Diego Psychologist.

The theme of the Winter 2017 issue is Pain. When Annette and I discussed our plans for the Newsletter late last year, we mutually agreed that one of the topics of focus would be on the role of psychotherapy in treating patients with chronic pain. As psychotherapists, most of us have encountered patients with comorbid psychiatric disorders and chronic pain, with latter typically  preceding the former. As a geriatric psychologist in private practice, I find that 60% of my current patients suffer from chronic pain. Indeed, all four of the articles that make up this Pain issue mention that chronic pain affects more people in the United States than diabetes, heart disease, and cancer, combined. That is roughly about 100 million Americans and counting. Pain is all-consuming, intractable, and in most cases, invisible. It requires that the sufferer embrace a “new normal,” i.e., a life irrevocably changed by pain.

Self portrait by Frida Kahlo: “I am not sick. I am broken. But I am happy to be alive as long as I can paint.”

I was reading George Orwell’s “1984” recently and one quote from the book especially jumped out at me: “Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.” I found myself saying, “But there are heroes. I see some of them in my office every week.” (I also beg to disagree with Mr. Orwell about his statement on physical pain; we know the devastating effects of psychological pain well in our profession.) I doubt there is anyone who suffers from chronic pain who does not wish that their pain would be gone; however, there are people who live valued lives despite their pain. Even those who merely seek psychotherapy because they are tired of their narrow, pain-centered lives are heroes. It is our job, as psychotherapists, to help them separate the reality of their pain from suffering on account of it. As I write this, I am acutely aware of the recent influence of the Acceptance and Commitment Therapy (ACT) bootcamp I attended a couple of weeks ago. I have been looking for new tools to help my clients with chronic conditions, and was intrigued by the ACT processes and principles and the evidence-based research supporting them. (I want to acknowledge that my curiosity about ACT was piqued as I edited the last issue of The San Diego Psychologist that focused on Mindfulness and Resilience; I want to sincerely thank Shoshana Shea and Jill Stoddard who both wrote excellent articles on ACT for the issue.)

…there are people who live valued lives despite their pain. Even those who merely seek psychotherapy because they are tired of their narrow, pain-centered lives are heroes. It is our job, as psychotherapists, to help them separate the reality of their pain from suffering on account of it.

As common as chronic pain is, we expected to receive an overwhelming response to our call for articles for this current issue. Unfortunately, we only received a small handful or articles, of which we selected two of the best ones. We solicited several more from experts in the field, from which we chose to publish two more articles. We reached out to physicians specializing in pain for their perspective on chronic pain management, but did not receive any positive responses.

So, four wonderful articles from five mental health professionals in San Diego make up the content of this Winter 2017 issue. Dr. Harpin and Ms. Gammon have written an excellent article giving a broad overview of the role of psychotherapy in pain management. It draws on Dr. Harpin’s long career in pain research and practice, and we are fortunate to learn from his experience and knowledge. Dr. Tayer, who has now become a regular contributor to the Newsletter, has written a powerful article about her own experience with working with pain patients. As usual, it is evident that she pours her heart into her work. Similarly, Ms. Chester has written a thoughtful and personal article about her unique approach to treating chronic pain, as she draws parallels to grief therapy and Maslow’s theory of Need Hierarchy. Finally, we invited Dr. Kangas to write about the use of medical marijuana by chronic pain patients, given its increasing popularity over opioid use in this population. Her concise article is well written and is full of great information. The art accompanying the articles and this editorial is by famous and less famous people who lived with chronic pain.

The resources and recommended readings suggested by the authors have been separately compiled into the Resources page. Please check them out if you are interested.

Our Spring 2017 issue, which we are hoping to publish by the end of May, will focus on Couples/Family Therapy with Diverse Clients. We would be grateful if those of you who have experience working with LGBTQIA, ethnic minority, or refugee families would consider contributing to the next issue. Submission guidelines may be found here.

Please share your feedback in the comments below, or email me at TheSanDiegoPsychologist@gmail.com.

Thank you for reading.

–Gauri