Becoming Pain-Free: Dr. Garry Spink Of Spink Psychology On How to Alleviate Chronic Pain

An interview with Maria Angelova

If you have experienced prior trauma or abuse, consider if this plays a role in your pain and seek support to get it addressed if needed. Frequently, chronic pain can be related to prior trauma, and trauma is a risk factor for the development and perpetuation of pain.

So many people suffer from chronic pain. Often people believe that they have tried everything, and that there is no real hope for them to live pain-free. What are some things these individuals can do, to help reduce or even eliminate their pain? In this interview series, called “Becoming Pain-Free: How to Alleviate Chronic Pain” we are talking to medical professionals, pain management specialists and authors who can share their insights and strategies about how to alleviate chronic pain. As a part of this series we had the pleasure of interviewing Garry L. Spink Jr., PhD

Dr. Spink is a pain psychologist who helps people with chronic pain. As a pain psychologist, he focuses on the intersection of the mind-body, and how it plays a role in causing and perpetuating chronic pain. He is a member of many organizations including the International Association for the Study of Pain (IASP) and the American Psychological Association.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” better. Can you share your “backstory” with us?

I originally graduated with a bachelor’s in biotechnology, following which I worked in the pharmaceutical industry for six years. Over the course of six years, I learned that my personal values did not align with that industry, as well as found a passion for psychology and using research-based, non-medical treatments to help people who struggle with chronic illness. While still working in the industry, I began taking classes part-time while applying to graduate programs. After almost 2 years of trying to get into a graduate program, I was accepted to the Ph.D. program in Clinical Psychology at Syracuse University. There I focused on learning about the intersection of mind-body and psychological factors impacting health and well-being. I completed my internship and post-doctoral education At the Rochester Institute of Technology- Rochester Regional Health Consortium, where I had numerous opportunities to work with various medical specialties including cardiology, bariatrics, pain medicine, and neurology. Since that time, I have continued to expand my knowledge and collaborate with medical specialties, as well as provide training and advocate for person-centered care. In July 2022, I opened my private practice focused on helping people with chronic pain and chronic illnesses, which I hope to turn into a training program to provide more options for people as there is a dearth of trained mental health providers who can provide research-based treatment to people who struggle with chronic pain and illness (c.f., Darnall et. al, 2016).

Can you share the most interesting story that happened to you since you started your career? What were the main lessons or takeaways from that story?

The most interesting part of my journey has been the stark contrast I encounter with physicians in their approach to health care. A growing number of physicians are engaging in person-centered, biopsychosocial care hoping to support individuals with chronic illness in the best way possible for them. On the other side is a still, rather large contingent of physicians that continue to hold onto outdated and refuted dualistic perspectives (illness being either all psychological or all biological) which can leave patients feeling misunderstood and dismissed. There is a great opportunity for education and improvement as medicine shifts more toward person-centered, biopsychosocial models and treatment plans. The main takeaway I have that I share with my patients is that, if you do not feel understood by, dismissed, or unheard by your providers, you should either (1) speak up to that provider or (2) seek out a new provider. Insurance can be a barrier sometimes that patients face enacting this plan though, as a growing number of providers are moving away from being paneled with insurance companies from my experience. This leaves fewer options for patients who prefer to use their insurance as they may not be able to seek out a new provider.

It has been said that our mistakes can be our greatest teachers. Can you share a story about a mistake you made when you were first starting? Can you tell us what lesson you learned from that?

First and foremost, I believe this to be true. I am a big believer that our discomfort helps us grow and that we can learn from mistakes and discomfort. Too many times, discomfort, distress, and mistakes are pathologized, diagnosed, and treated unnecessarily when time and support from loved ones would be more effective than formal treatment.

I cannot think of any specific mistake I can discuss here. What I have learned is that time alone is insufficient to offer effective treatment and growth within psychology and mental health. The practice of psychology involves regular evaluation of your performance and growth (Goldberg at l., 2016). What I do is engage in regular retrospection and evaluation of my performance and actively plan my ongoing development and training to better serve my patients and supervisees.

When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?

By providing education to providers, patients, and health systems alongside treatment directly to patients, I am helping the medical system and people better understand psychological factors that impact their health, pain, and illness. This also helps people to better manage the emotional and psychological aspects of their health. I am also helping to advocate for person-centered, biopsychosocial care. In the real world, there is no physical and mental health, it is all just one overall health; the separation is one we make as a society. When people start to realize there is no difference, it opens new avenues for improvement and success.

Let’s jump to the main focus of this series. For the benefit of our readers, can you please tell us why you are an authority on the subject of chronic pain?

Per the definition of pain (revised by the IASP in 2020), pain is always a physical and emotional experience; however, most treatments only attempt to address the physical components. This is a concern as upwards of 75% of people with chronic pain have diagnosable emotional difficulties, and emotional difficulties have been found to reduce the effectiveness of medical treatments and perpetuate chronic pain. I have devoted my entire career to better understanding the research on the psychological and emotional components of pain, and how to help people to address these to better manage their pain and get their lives moving.

Can you please share with us a few of the most common causes of chronic pain?

From a psychological perspective, one of the best predictors of who will develop pain in one year is depression. Similarly, depression has been proposed as one of three indicators of the course of chronic pain (alongside widespread pain and length of time in pain; von Korff and Miglioretti 2006). The cause of pain is more than just physical, and that is because the same neural mechanisms are at work whether you are discussing physical or emotional pain (as I mentioned early, there is no difference biologically between physical and emotional). Other psychological risk factors are also important including (but not limited too) prior trauma/abuse, focusing/paying attention to your pain, anxiety, fear of movement (or causing future pain), pain catastrophizing (which essentially means seeing the worst-case scenarios), sleep difficulties, over- and under-activity, and certain types of relationships.

There are many different types of pain that people struggle with. Which specific form of pain would you like to focus on in this interview? Why that one?

The parts of pain I discuss and address affect pain regardless of the specific diagnosis, and in similar ways. The brain does not discriminate against the cause of pain, it just plays it role. I would just suggest discussing chronic pain in general and pain psychology.

Here is the main question of our interview. Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey toward becoming pain-free? Please give an example or story for each.

1 . Use effective stress management techniques. For many pain conditions, stress is one of the largest triggering factors (including migraines; cf van Casteren et all 2021). Effectively managing your stress helps prevent and manage pain. Techniques such as mindfulness, yoga, and breathing exercises are just some of the many strategies that can help.

2 . Find ways to improve your sleep. Sleep has been found to increase the intensity of painful stimuli, as well as increase the amount of information that is perceived as painful. It also affects your ability to cope with stress (#1 above). There are many ways to improve sleep quality including decreased lighting, engaging in a relaxing activity prior to bed, having a bedtime routine, and making your bedroom comfortable. In many instances, a good understanding of your sleep can find areas to improve (whether or not you are currently having chronic pain) that do not involve medication.

3 . Find ways to get active. When I say get active, it does not necessarily mean exercise. It can involve walking to the mailbox to get your mail, or doing a couple of dishes. Figure out where you are at, and start small. When you are active, try to pace appropriately. Research has shown that too little or too much activity can exacerbate pain and subsequent stress. Find your medium activity level and try to stay consistently around there.

4 . If you have experienced prior trauma or abuse, consider if this plays a role in your pain and seek support to get it addressed if needed. Frequently, chronic pain can be related to prior trauma, and trauma is a risk factor for the development and perpetuation of pain.

5 . Watch how you speak to yourself about your pain. Our thoughts and the words we say to ourselves really affect our experience of pain, it can amplify or dampen the experience. I am not advocating being overly positive as that is a different issue. However, people sometimes have mistaken beliefs (i.e., disc degeneration causing pain, c.f.., Brinkikji et al. 2015 showed many of the “abnormal” imaging findings occur naturally in people without pain in up to 97% of people). Additionally, having thoughts such as “this is never going to get better” can increase stress, depression, and anxiety, leading to worsened pain.

If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?

Viewing pain in its entirety versus just as a physical phenomenon. There is a lot of stigma around pain, from opiates, to people believing you are faking, and including it is all psychological. Seldom is it caused by one thing and people frequently have to address the many parts of it to gain some form of improvement.

What is the best way for our readers to further follow your work online?

I have Twitter, Facebook, and Instagram accounts. I also have a blog where I publish psychological relevant material on pain psychology. Links to all these can be found on my website www.spinkpsychology.com

Thank you for these really excellent insights, and we greatly appreciate the time you spent with this. We wish you continued success.

About The Interviewer: Maria Angelova, MBA is a disruptor, author, motivational speaker, body-mind expert, Pilates teacher and founder and CEO of Rebellious Intl. As a disruptor, Maria is on a mission to change the face of the wellness industry by shifting the self-care mindset for consumers and providers alike. As a mind-body coach, Maria’s superpower is alignment which helps clients create a strong body and a calm mind so they can live a life of freedom, happiness and fulfillment. Prior to founding Rebellious Intl, Maria was a Finance Director and a professional with 17+ years of progressive corporate experience in the Telecommunications, Finance, and Insurance industries. Born in Bulgaria, Maria moved to the United States in 1992. She graduated summa cum laude from both Georgia State University (MBA, Finance) and the University of Georgia (BBA, Finance). Maria’s favorite job is being a mom. Maria enjoys learning, coaching, creating authentic connections, working out, Latin dancing, traveling, and spending time with her tribe. To contact Maria, email her at angelova@rebellious-intl.com. To schedule a free consultation, click here.