A Novel Proposal for Treating Chronic Pain.

The Nature of The Problem.

Chronic Pain, Trauma, and Addiction are interrelated.
A change in one invariably causes a change in the other when it comes to these patients.
Chronic Pain is influenced by Biology, Psychology, Sociology, and Spirituality.
Trauma involving any of the above departments will likely increase Pain.
An increase in Pain, without appropriate coping or treatment mechanisms, may lead to Addiction in one form or another.
Addiction, to substance, activity, or anything for that matter; may lead to desperate measures to continue to Reward oneself.
These desperate measures often lead to Pain (Emotionally, Physically, Spiritually, Socially).
And Thus, the cycle continues.

Adverse Childhood Experiences. ACEs.

The Nature of The Problem and further be understood by Adverse Childhood Experiences.
There are a multitude of subtypes of ACEs.
Injury, Mental Health, Maternal Health, Infectious Disease, Chronic Disease, Risky Behaviors, Lack of Opportunities.
Being the Victim of, or even Exposed to the above will increase the ACEs of the individual.
The CDC and Nadine-Burke Harris has shown an increase in ACEs leads to a multitude of Adverse Outcomes: Poor Health, Addiction, Early Death.
ACEs can originate from Abuse: Physical, Emotional, Sexual.
ACEs can originate from Neglect: Physical, Emotional.
ACEs can originate from Household Dysfunction: Mental Illness, Mother Threatened Violently, Incarcerated Relative, Substance Abuse, Divorce.

The Relation.

ACEs lead to Trauma.
ACEs lead to Pain.
ACEs lead to Addiction.
And all of the above have the potential to lead to another.

Social Determinants of Health. SDOH.

The Sociology component of Pain must consider what is known as the Social Determinants of Health.
Health is not a matter of Genetics alone.
SDOH emphasizes the importance of Economic Stability, Education, Social and Community Context, Neighborhood and Environment, and Health Care.
ACEs noted how many have a Lack of Opportunities.
To struggle with any of the above SDOH due to Lack of Opportunities highlight perhaps the most important indicator of Health.
Without Health, Chronic Pain, Trauma, and Addiction set in.
Now it is no wonder Socioeconomic Status, Race, Religion, Gender/Sex/Orientation, Generational Wealth, and Environment have a role to play.
To ignore these is to ignore Trauma.
To ignore Trauma is to ignore The Soul.

Trauma.

A moment on Trauma.
The Mental Traumas: Psychiatric Disease, Traumatic Brain Injuries, and so forth.
The Physical Traumas: Injuries, Abuse, Motor Vehicle Accidents, Genetics, and the like.
The Social Traumas: SDOH, SDOH, SDOH.
The Spiritual Traumas: Betrayal, Lies, Guilt, Loss, Death, and so on.
Traumas are The Root.
The Root of Pain. The Root of Addiction.
To ignore Trauma is to ignore The Soul.
This is the basis for our Treatment Plan.

The Treatment Plan.

For Pain we have Body Work, Exercise, Physical Therapy, Nutrition, Supplements, Surgery, Injections, Medications.
For Addiction we have Medication Assisted Treatment.
Think Suboxone, Methadone, Nicotine Patches, and the like.
Harm Reduction is the name of the game.
For Addiction we also have to get at The Trauma: Group Therapy, Psychotherapy, Mindfulness Meditation, Community, Healthy Coping, Prayer.
So The Pain-Trauma-Addiction complex has options.
And the role of Psychedelic Assisted Therapy opens up.
And Osteopathic Manipulative Therapy has a role to play to.

Psychedelic Assisted Therapy.

The Ayahuasca Retreats, The Ibogaine Centers, The Ketamine Clinics.
The Rites of Passage, The Initiations, The Ecstatic Illuminations.
Lysergic Acid, Dimethyltryptamine, Psilocybin.
Rick Strassman and his Spirit Molecule.
Perhaps the likes of the Harvard Psychedelic Club would be keen on the re-emergence of the American Psychedelic Fetish.
Timothy Leary and Richard Alpert, From Aldous Huxley’s Mescaline.
Andrew Weil and The Natural Mind. Mark Plotkin and The Shaman’s Apprentice.
Now the Multidisciplinary Association for Psychedelic Studies and Rick Doblin.
Open The Eselalen Institute and The Institute of Noetic Sciences.
Stan Grof and the Holotropic Breath. The McKenna Brothers and their Magic Mushrooms.
Alexander Shulgin, The Shaman of Chemists.
A Zendo Project for The Burning Man Escapists.
Paying Homage to the above: but is there promise this time around?
In the age of Michael Pollan’s objective take: are we ready?
The focus now is on the Set and Setting.
On the shattering of the Default Mode Network of the Mind, The Autopilot.
And importantly on the Therapeutic Integration of the Ego-Shattering Experiences.
When it comes time for The Trauma to be released, explored, and examined: Consider The Power.
But remember, Harm Reduction is the name of the game.

Osteopathic Manipulative Therapy.

Let us explore the five models, or are there six?
Biomechanical: the posture of the body.
Behavioral: the mind, the biopsychosocial.
Respiratory-Circulatory: what is a body but gas and fluid?
Metabolic-Nutritional: food is key.
Neurological: The Autonomic System (Sympathetic – fight/flight/freeze, Parasympathetic – rest/digest), Central System, and Peripheral System
And Jan Hendryx proposes a Bioenergetic Model for the Abstract Minded.
The Osteopathic Physician and Her Hands may address the above.
To find the Pain-Trauma-Addiction at the Source.
And allow the body to heal itself.

Fascia.

The Connective Tissue in the Liminal Space.
The Web of Tissue that hold all the pieces of your body together.
Trauma is held here.
This tissue moves with Tensegrity, A Network of Tension.
And an electric charge that may store The Trauma in the Body: Piezoelectricity.
To have this tissue palpated by an Osteopathic Physician to allow a release.
A Myofascial Release. A Fascial Unwinding.
One may notice the Emotional Traumas release too.
A Somato-Emotional Release.
For when the body is allowed to relax, and an Energy Cyst is released, an involuntary “letting-go” just might happen.
Do not panic. This is a healing reaction.
In this event, we hold space in The Stillness.
We acknowledge the power of Set and Setting as the psychonauts do.
We breathe in tandem, the provider and patient inhale and exhale together.
And the healing begins.

Integration.

The integration of Psychedelic Medicine and Osteopathic Medicine has potential.
As the integration of Mind-Body Medicine.
The Pain-Trauma-Addiction complex requires novel approaches.
And approaches that get to the root cause need to be prioritized.
If done responsibly, a Spiritual Healing is possible.
Body Work.
Mind Work.
Spirit Work.
The Stillness in The Tide.
And the healing begins.