Chronic pain creates a chain reaction of complications, one of which may be addiction to pharmaceutical pain medication. In this interview, Stephen Grinstead, PhD, LMFT, ACRPS, CADC-II, whose Addiction-Free Pain Management® system teaches how to manage pain and medication, discusses his personal journey through and beyond the use of pharmaceuticals to treat pain.
Addiction to Pain Medicine
Loolwa Khazoom: How did you end up in chronic pain?
Stephen Grinstead: It started when I was 12 years old and got injured playing sand lot football. I got my lower back tweaked pretty good. I was rushed off to the hospital and put on Demerol , then sent home with Tylenol Codeine.
Like a lot of people, I had trouble with the medication, becase it not only helped the pain but also helped me cope in general. I was living in a very stressful household, with an alcoholic father.
LK: Please talk about your addiction to the meds.
SG: I convinced myself that I needed the medicine. Eventually it got to a point where I said, “OK, this is not working” and decided that I wanted to live life without pharmaceuticals.
I was fine at that point. I was into martial arts and training hard. But then I received the injury that really taught me some lessons. I was getting ready to move from doing construction work into opening my own dojo and teaching karate. On the day that was supposed to have been my last construction job, I got injured during work.
I went to a chiropractor and physical therapist, and everything got pretty well stabilized within six weeks. Then I made a silly decision: I took my second-degree black belt test, with a herniated disk in my back.
After that, I was totally out. I could not walk for a week or so, and I was on disability leave about two-and-a-half years. At that point, though, I didn’t want to use medications or have surgery. I wanted to find other ways to treat the pain.
Pushing Yourself Without Hurting Yourself
LK: I can relate to your story. I’ve had some experiences where I already had dealt with the debilitating effects of certain issues of chronic pain, and I felt that I just could not succumb to another setback. I felt that I needed to push through and not let the pain stop me.
My decision to push through always came from a place of positivity and strength – ie, that I would overcome the setback. In the end, however, pushing made things worse.
Some people can sit on the sidelines and judge, “Well you should not have taken the test with a herniated disk.” But I’m sure there was a reason you decided to push yourself and go through with it. Please talk about the mental process that led to your decision.
SG: I always have had this drive to excel, to be the best I can. In the marine corps, and later in martial arts, I learned that you just put your mind to something, and you can do it. I really wanted to compete. I really needed to have that level of expertise in my own dojo, and I was not going to let anything get in the way. I had this goal; I was fixated on it; and I made a bad decision.
A lot of people I work with do the same thing: They overdo it. Other people go to the other extreme, getting locked in and too afraid to do anything. Both extremes are dangerous for people with chronic pain.
LK: How does one find that elusive balance? How do I not let pain make me terrified of moving forward in the world and yet not go so far that I end up hurting myself even more?
SG: When I work with people, I suggest they get help finding balance. In my own life, I started working with a great physical therapist who helped me do activity pacing and find that balance. We need help from people who are understanding and compassionate with us and who can assist us in finding out what our healthy limits are.
Eventually we can exceed those limits, but at first we need to find out what they are. Finding balance is the most important thing. If you stay in either extreme, you’re not going to have a good quality of life.
Grieving a Loss and Finding Acceptance
LK: Please talk about how one injury can just totally turn your life upside down. What is the psychology of the accompanying frustration — of thinking, “I can’t believe that happened,” or “If only I had made this turn instead of that turn.”
SG: The psychology is similar to the grieving process when we experience the death of a loved one. The same stages of grief need to be resolved, before people can go on about their lives in a healthy way.
For me, it took over two years before I even could watch a karate tournament again. I was so depressed, feeling as if my life were over. Today, however, I can honestly say that the injury was the best thing that ever happened to me.
SG: If I had not been injured, I would not be doing what I am doing today. I would not have trained over 10,000 people in the last 12 years, teaching effective pain management. In the middle of this journey, however, I went through shock and denial: “This can’t be happening.”
Then there was the anger – that extreme anger. Then the bargaining: “If only I would have” and “I’ll do anything it takes.” Next was a deep depression, then finally, acceptance.
A lot people think that when you get into the acceptance stage, you’re done. But I don’t think that is true. When I work with people, I find that there needs to be one final step, called “reintegration.” That is the stage where the individual honestly can say and believe, “Today my life is better than it ever has been. It may be different, but it is better.”
LK: There are different camps of thought about the whole “why bad things happen to good people” phenomenon. Some people feel that everything happens for a reason. Others feel everything is the manifestation of random chaos in the universe. I myself straddle different camps of thought, having come to my own conclusions about my own life experiences.
Do you feel that there is some divine plan – that there is a particular reason your injury happened to you? Do you feel that your life was destined to go in this direction? Do you feel that everything is random? Or do you have some other belief system about what happened?
SG: I have a bias that pain management needs to include a spiritual component, and for me it’s not religion. It doesn’t have anything to do with religion, but it is spiritual. I do believe that my experience of pain offered the opportunity for me to face adversity and come out on the other side. It was my decision how to do that or whether I would at all.
I do think the journey through pain was a spiritual gift — part of my process, part of my path. Whether that’s right or wrong, true or false, I don’t know. But for me, that thinking helped me through.
I can remember my karate sensei always saying: “Whenever something happens, be grateful. Find something to be grateful for. If you break your foot, be grateful it wasn’t your leg. If you break your leg, be grateful it didn’t kill you.” And then he would laugh and say, “And if it does kill you, be grateful you don’t have to finish this class!”
Stephen P. Grinstead, PhD, LMFT, ACRPS, CADC-II, is the Senior Consultant and Trainer for the Gorski-CENAPS® Corporation. He is also an author and internationally recognized expert in preventing relapse related to chronic pain disorders, and he is the developer of the Addiction-Free Pain Management® (APM) System. He has lived — and thrived — with his own chronic pain condition for over 27 years and often has the opportunity to practice what he preaches.