A 45-year-old male presented for pain psychology evaluation with overlay of longstanding depression, anxiety, complex trauma, and autistic spectrum disorder (ASD) impeding recovery. He had been suffering with persistent pain involving pelvis, groin, hip, back, neck, jaw, lower extremities for several years.
Medical and pain management included pharmacological, procedural interventions, physical therapy, and a multitude of complementary modalities. Traditional talk therapy helped him to process much of his trauma, however, physical/somatic remnants of fear persisted compounded by years of bodily pain and suffering. We discussed the mind body connection and the role of the central nervous system in pain processing, shaping pain experience and amplitude. The multitude of factors, including ASD, kept him detached from his body and inconsistently able to detect internal signals and states. Compromised interoception made it difficult to attend to mental, emotional, physical needs and even left him injury prone.
Our work had to be adapted all along the way to ensure absorption and integration given ASD, as well as helping him to gently touch into body in non-traumatic safe ways. We aimed to reconnect mind-body, restructure & reframe anxiety-ridden cognitive schemas, build interoceptive awareness and unwind habituated fear patterns. We incorporated biofeedback which provided real time mirroring of nervous system activity such as heart rate, muscle tension, respiration allowing him to identify and regulate internal states via breathing practices, muscle relaxation, visualization. The computerized feedback helped build confidence in knowing his body and trusting the efficacy of acquired skills. We additionally utilized Safe & Sound protocol, somatic tracking, and pain reprocessing.
Pain psychology interventions successfully worked synergistically with the deeper work he had done and continued to do with his therapist to get him past the wall he had hit in his treatment. He is on a better trajectory with significantly less pain and greater functionality, a stronger sense of self & identity, and is actively cultivating a life worth living.