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Veterans Chronic Pain Group and Treatments That Work at the Brand New Rocky Mountain Regional VA Medical Center

john d. otis treatments that work managing chronic pain a cognitive-behavioral therapy approach

I attended my 10th Chronic Pain Group with the VA this week and was delighted to be one of the first Veterans to visit the new $1.8 billion VA Hospital in Aurora, Colorado.

First of all, the new Rocky Mountain Regional VA Medical Center is fantastic! The whole series of buildings are connected via a majestic, continuously-curving central concourse with a 5-story atrium running the entire half-mile length. This grand hallway accounts for a significant portion of the interior space. When I was there, it was the first week of opening and still mostly empty.

The Rocky Mountain Regional VA Medical Center Aurora Colorado

The Rocky Mountain Regional VA Medical Center Aurora Colorado – Concourse between building 2 and 3.

The old VA hospital in Denver was built in 1952 and is still functional, but it’s a design feels like a traditional hospital with hallways which are barely wide enough for two people to pass. By contrast, the new hospital feels spacious and open, at least until you get into an interior room without any windows.

Giant Robot Art at the VA Rocky Mountain Regional Medical Center in Colorado - PTSD - Outside Looking In by Rod Ford

This giant robot art “PTSD – Outside Looking In,” standing about 10 feet tall, is on Exhibit at the new Rocky Mountain Regional Medical Center in Aurora, Colorado (a Veterans Administration building)

While new facility has fewer hospital beds than the old hospital, it offers much larger rooms for individuals plus space for their families to spend the night, even a private bathroom… amenities which weren’t available in the old hospital. The new center’s spinal clinic, which won’t open until 2019, will offer inpatient beds, a rehabilitation gym, a hydrotherapy pool, and an outdoor courtyard with therapeutic elements such as stairs and varied surfaces on which to practice maneuvering a wheelchair.

Treatments That Work

Overall, my commitment to 10 therapy sessions has been well worth my time. I received many intangible benefits, including a new perspective on my pain which affords me more control over my reactions, emotions, and prevention of pain flare-ups.

Each session of the Veterans chronic pain group is masterfully guided by a nationally renowned pain expert, a Ph.D. who has been working with the Denver VA since 1993. He heads up the Health Psychology group and is the Director of Pain Psychology and the Chronic Pain Care Clinic, and he hosts five different chronic pain groups each week. It was an honor, a privilege, and a healing experience to be in this doctor’s intelligent and compassionate care.

His team was one of the first to move over into the much anticipated VA facility located in Aurora, Colorado, which just opened on July 21, 2018.

Managing Chronic Pain by John D. Otis workbook cover

The VA’s program for the chronic pain group follows the guidelines from the book “Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach” by Dr. John D. Otis. The workbook is priced online well over $20, but they are given free of charge to the Veterans who attend this group therapy. I think the Therapist’s Guide to the program looks interesting enough to grab a copy for myself. Gleaning every insight into the perspectives involved with therapy helps me have a better understanding of treatment.

Each session of the program teaches a new skill you can use to help manage chronic pain that will complement your medical treatment. With practice, these techniques can help reduce your pain and increase your ability to cope. This program enables you to take control of your pain, which can improve the quality of your life as well as decrease your reliance upon medical interventions [including drugs].” From David H. Barlow, Editor in Chief of TreatmentsThatWork

The workbook is broken down into 12 chapters which cover the following topics:

  • Education on Chronic Pain
  • Theories of Pain and Diaphragmatic Breathing
  • Progressive Muscle Relaxation and Visual Imagery
  • Automatic Thoughts and Pain
  • Cognitive Restructuring (to practice changing negative thoughts into positive coping thoughts)
  • Stress Management
  • Time-Based Pacing
  • Pleasant Activity Scheduling
  • Anger Management
  • Sleep Hygiene
  • and Relapse Prevention and Flare-Up Planning

One chapter is used as the basis for each session.

Improvement Tracking

Every session usually starts out by having Veterans in attendance fill out a simple 3-step PEG scale to measure our perceived level of pain for the past week. On a 0-30 scale, we’re essentially arbitrarily grading how much attention pain has stolen from our lives.  I started off with a score of 15 and ended after my ten visits with a score of 5, which is a significant reduction. Many Veterans who shared the room with me were scoring higher than 24 – which is more intense than I have probably ever experienced.

The difference group therapy provided to me was the #2 question on the PEG scale: “What number best describes how, during the past week, pain has interfered with your enjoyment of life?” The highest number I filled in was a 6, and the lowest was a 1. Of course, this scale is arbitrary and is really just a measure between self-awareness and the perception of pain so that we can track how it changes over time.

To recap, I began my therapy by claiming that chronic pain had stolen 50% of my waking life, and only 16% of my waking life by the time I had attended 10 pain group therapy sessions. I consider this to be a 34% change in my perception of suffering from pain. But to be honest, I was combining a whole bunch of therapies during this time. Thus, my change in PEG journals is not a measure of how much group therapy changed me as much as the general improvement or change I experienced in between the time of my first and tenth sessions – which was just about 6 months for those who wonder.

The Development of a New Perspective

While my chronic pain is blamed by me on a shoulder injury, which I sustained while in service, it was not a combat accident. During chronic pain group at the old VA hospital, I encountered Vietnam-era soldiers who had been literally blown up by explosions or had witness their comrades being blown up and still have nightmares today.

By listening to these men, the degree of my personal trauma and perceived suffering was cast into a stark perspective. I realized that in my life, while everything is relative to each person’s unique circumstances, I had very little to complain about.

The degree to which we are haunted by our traumas and experience suffering has a significant portion of its origins in the way we’re thinking about things, the way we’re looking at the past more specifically, and the way we’re holding onto it.

Turns out, holding onto past trauma is something the body was designed to do automatically. Meanwhile, letting go of trauma requires the development of our self-awareness muscle memory (the frontal lobes of the brain) through awareness training. This may include any number of things, such as meditation, brainwave entrainment, floatation therapy, or clinical Acceptance and Commitment Therapy (ACT).

Therefore, it’s not necessarily even our conscious choice when we “hold onto things,” and we are unable to simply “let go of things” because we haven’t yet developed that skill.

The Wonderful Depth of Empathy and a Connection to Others

Unfortunately, one of the members of the chronic pain group was lost during my span of time with the group. Learning of his death was shocking but not surprising. He had a lot of problems and was rapidly collapsing inwards upon himself under the gravity of pain so great that it was unbelievable to me this man could ever find the motivation to make it out of his house and to the group.

After getting home and cracking open a beer to sob over, I sat down and cried for this man. It’s the first time I’ve ever cried for someone I barely knew. It’s the first time I experienced love for somebody else for being part of the human race. He was someone we could all relate to in his struggles with life. I cried, and it felt good to have empathy for another.

And then I became overjoyed to experience this feeling for the first time in my life. It was the first time I felt love for a near stranger, whom I had only known for a few hours between maybe three or four sessions before he was gone. I’ve never felt this depth of empathy for anyone so easily, so casually. Usually, feeling an emotion this deep only happens when I’m feeling self-pity. The nature of the empathy emotion, and the energy it carried, felt quite a bit different in my body.

Conclusion: Major Healing Progress, Still Plenty of Room for Improvement

That was a turning point in my life, because, through group therapy, I have finally come to know love for others (other than family). New territory!

It is this perspective, I believe, one must have in order to experience true compassion for self and others. Group Therapy with the VA has been a healing experience.

I wish the same for all my fellow Veterans but know it won’t be possible for everyone to recover from war.

We can certainly try though. And there’s no doubt, a whole lot more can still be done to help our Veterans. That’s why I founded the U.S. Veterans Treatment Discount Program, starting with Colorado. Expansion plans for a 50-100% discount program for Veterans include Washington, Texas, Virginia, and Florida.

As a result of the remarkable improvement from a self-directed healing path, I’m ready to help others achieve the same. I hope some of you will help too!

Thanks to the VA program for developing the Veterans Chronic Pain Group Therapy (CBT-based group therapy), and enormous gratitude to the man who helped me change my perspective and gives so much of his time helping others to find a way out of misery.