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Episode 45 | Managing Chronic Pain with Sheena Rydings

Ep 45 - Managing Chronic Pain with Sheena Rydings

Episode 45 of Ask the Therapist

In this episode, Sarah talks to Sheena Rydings, Cognitive Behavioural Therapist and founder of Sheena Rydings Psychological Therapy.

Together they explore the role psychological therapy plays in the management of pain, along with explaining the Pain Gate Theory, the mind-body connection and how cognitive behavioural therapy can help with chronic pain conditions. Practical advice, tips and resources are shared throughout the episode.

Hear how the brain is key to experiencing pain at around 11 minutes, what psychological treatments are recommended for pain at 20:53, and what you can expect if you come to a CBT therapist for pain treatment at 23 minutes.

Find out more about Sheena at www.sheenarydingstherapy.co.uk

Find a BABCP accredited therapist here www.babcp.com

Spoon Theory – www.butyoudontlooksick.com 

Books mentioned –
Overcoming Chronic Pain: A Books on Prescription Title, by Frances Cole
Outsmart Your Pain: Mindfulness and Self-Compassion to Help You Leave Chronic Pain Behind, by Christiane Wolf
The Happiness Trap: Stop Struggling, Start Living, by Russ Harris
Mindfulness: A Practical Guide to Finding Peace in a Frantic World by Mark Williams and Danny Penman
Mindfulness for Health (Enhanced Edition): A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing by Danny Penman and Vidyamala Burch

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Episode Transcript – automated

SUMMARY KEYWORDS

pain, people, chronic pain, cbt, helpful, therapy, mindfulness, specialism, physio, relaxation, training, therapist, lots, working, absolutely, activity, programme, book, life, journey

SPEAKERS

Sheena Rydings, Sarah Rees

Sarah Rees  00:09

Welcome to Ask the Therapist, a monthly podcast for everyone who’s interested in how our minds work building resilience through journaling, and all things therapy. I’m your host, Sarah Rees, a mental health nurse and CBT therapist with over 20 years of experience in the field of mental health.

 

Sarah Rees  00:25

Hello, and welcome to episode 45 of Ask the Therapist Today I’m talking with CBT therapist Sheena Rydings. Sheena has a special interest in working with pain. She works part-time in a specialist NHS pain clinic. And also in private practice. Actually, she’s just joined me over in Wilmslow Therapy in my rooms there. So it’s been lovely getting to know her and to be working with her. And today she’s sharing her insights in how CBT is helpful for pain management, about psychological therapy and pain, and how it works. She’s going to be sharing some really helpful resources and tips. So this is a great episode if you’re struggling with pain, if you’ve been thinking about having psychological treatment for pain, or if you’re a therapist wanting to get some insights from a pain specialist, and to get an awareness of what the resources are some good books and shares, lots of tips as well. So do enjoy the episode.

 

Sarah Rees  01:27

Thank you so much for saying yes to coming on the podcast. It’s lovely to have you here. 

 

Sheena Rydings  01:32

No, thank you for asking me. So it’s an honour. 

 

Sarah Rees  01:35

Pleasure, pleasure. So I’m always curious about why therapists become therapists quite strange job to do, isn’t it? It’s quite unusual. Can you say a little bit about how you arrived at being a CBT therapist what your journey into it was? 

 

Sheena Rydings  01:51

Yeah, so my journey probably started when I did my psychology A level. And so I’ve had such an interest in psychology from that young age. I did my psychology level, then I did my degree. And I did my degree in psychology and crime studies at the time, which was really interesting. And then sort of after my degree, I went travelling for a year having a nice year out. But I think looking back, I’ve always been quite an inquisitive person, quite a nosy person quite, quite curious about how people tick and know why people do what they do and things like that. So I think I’ve always had that in my nature.

 

Sarah Rees  02:35

That’s a good quality for a therapist is yes, finding people fascinating. 

 

Sheena Rydings  02:41

Yeah, definitely. And then when I came back from travelling, I knew I wanted to get into sort of the world of mental health. So I then got a job at a local hospital on the mental health ward. And I was, it was an OT TI, which is an occupational therapy, technical infrastructure, which is quite a mouthful of a title. It’s basically like an OT assistant on the inpatient mental health Ward, which I absolutely loved at that job. I worked on the older person’s Ward, and I absolutely loved it. I think I’ve got so much time for like the older generation. And then alongside that, I did a HDA sort of bank role. And I worked on like the forensic ward ward, the adult and the older person. So it’s got quite a bit of mental health experience 

 

Sarah Rees  03:32

So as a healthcare assistant?

 

Sheena Rydings  03:33

Health care assistant, HCA, which is kind of like what used to be the nurse and auxiliaries. Yeah, now, HCA is I think that’s what they kind of rebranded them as, and then that’s when IAPT kicked off around that time then started and that’s when I saw the PW P training. So the psychological wellbeing training, I think then it was called Low-Intensity Therapists, they kind of reap retitled them. So I went to do my PWP training in an IAPT service. And then after a couple of years, I knew that you know, working alongside CBT therapists and being supervised and that was definitely the way I wanted to go and again doing IAPT, the IAPT high-intensity training came up and I apply for that and got that. So I qualified in 2013. 

 

Sarah Rees  04:23

And was it the most intense course that you’ve ever done? 

 

Sheena Rydings  04:27

It was the most intense stressful course I’ve ever done.  Obviously totally worth it in the end and you can see why

 

Sarah Rees  04:38

you learn so much – the biggest learning curve I’ve never learned so much so quickly. a massive learning curve lots of video role play

 

Sheena Rydings  04:49

 yeah, after a while you just get used to the camera been in the room don’t you, just videoing everything and yeah, it was really intense. Yeah, make sure my hair’s dawn when I get Yeah, the videos. Yes. And then I was in IAPT for 10 years I did my stint in IAPT

 

Sarah Rees  05:11

And now you specialise in pain. And that’s I don’t know if many people know that there’s CBT cognitive behavioural therapy for pain. And I have worked with it in private practice, but it’s a specialism all on its own really, isn’t it? How did you get into pain as

 

Sheena Rydings  05:33

so long term conditions and pain is becoming more and more over the last few years. And when I, as soon as I qualified, my lecturer said, at the time, you know, get some years experience and then look for a specialism. And it always stuck in my head that thinking what would what would I be interested in and I’ve always had an interest in mental health, obviously, but I’ve also had the real interest in how physical health and mental health are connected. Even when I worked on the ward, I could see how there was a connection there. And then when I qualified, there was an opportunity that came up in the IAPT service I was working for, to develop a pain pathway. And of course, I jumped at that opportunity. And that involves meeting with sort of physic chronic pain, physios and sort of developing a specific pathway for pain. And around the same time, a family member of mine who has chronic pain was going through a pain service, and seeing a psychologist at the pain service. And I find it really interesting how the biggest shift and movement in her ability to learn to live with pain and how she managed pain was actually probably through the psychologist. Now, don’t get me wrong, the physio and the consultant were absolutely fantastic. But the biggest shift in her mentally and her well being was seeing the psychologist and I thought that was fascinating to see how pain and physical bodies can be so impacted by us psychologically. And that alongside just that natural interest in that area and wanting to become, I wanted to become an advocate really for people with pain. And I saw the help that she got. And I thought I want to help people in that same way. And that kind of really led to that kind of reading a lot more about it, you know, really wanting to get more involved in in understanding pain and long term health conditions. 

 

Sarah Rees  07:35

What kinds of presentations do you see in your clinic? 

 

Sheena Rydings  07:38

So I do part private practice, which I’ve done since 2014. But I left I IAPT in 2020. And I got a job in a pain service and a chronic pain service, an East Cheshire one, so obviously, it’s brilliant. It’s like my specialism there. And I see people privately with with pain and health conditions. The presentations, you get very, it’s really quite an emotional thing to live with pain. People can get quite depressed and quiet down, their lives become smaller and smaller. You know, the lives can become all about the pain about appointments and things like that. People can get very down exhausted, understandably. 

 

Sarah Rees  08:25

And I know I have a lot of kind of negative beliefs about pain, like I, touchwood I’ve never had any kind of pain, I have such a wet line, no pain tolerance, no idea or no pain tolerance, never employed it, you know, but even beliefs and thoughts you have about yourself and pain are very entrenched, aren’t they? You know, 

 

Sheena Rydings  08:48

Absolutely the pain beliefs is a really important part of kind of what I would deal with what I would explore with somebody in a therapy session. People can become really anxious about pain, like you said about that pain tolerance. People worry about how their pain is going to advance. And they get very afraid of the pain. Understandably, it’s not something that we want to have, or we like having. And so people can very, very anxious about it and very avoidant of activities that might potentially increase their pain activities that might expose them to that, the pain, and avoidant of life, overall get consumed by the frustration of living with it.

 

Sarah Rees  09:35

Kind of full focus. 

 

Sheena Rydings  09:37

I also see a lot of people with, with a sense of loss, almost like going through the grieving process and it’s not a bereavement as such, but it’s definitely a loss, it can be a loss of their life, their their physical body, a loss of activities and hobbies, and a loss of kind of what they envisage for their life. So I work with a lot of people with that huge sense of loss and struggling to accept that this is their life now that that pain is part of their life,

 

Sarah Rees  10:06

And does that impact their sense of identity as well, who they think they are? 

 

Sarah Rees  10:10

I imagine I’d get very angry as well, because pain was not in my future.

 

Sheena Rydings  10:10

Absolutely, yeah, absolutely. Because people have this vision, we have a vision of what our life is going to look like and what our life might be like and what we want to do in the future. And that can hugely change when we have a diagnosis of chronic pain. Because we feel that life has been taken away from us or that it isn’t what I was expecting out of life. 

 

Sheena Rydings  10:12

Absolutely. 

 

Sarah Rees  10:12

Yeah. Yeah. So there’s quite a wide range of people. And, you know, one of the things, having psychological therapy for pain, I wondered if it might mean for people that you kind of send it’s all in your mind. And that there might be negative that, you know, like, people might feel like they’re being not heard, or it’s not being validated. Go and see a psychologist. 

 

Sheena Rydings  11:02

Yeah, you’re absolutely right. And I so many people that I see, say to me, it’s not all in my head, you know? And, no, it’s not, it’s not all in your head. It’s a difficult one, because actually, pain comes from the brain. So pain actually does come from the mind. But, and it’s a very big, but it doesn’t mean that it’s all in your head. And it doesn’t mean that it’s made up. And people get very frustrated. And quite often people have passed from pillar to post and medical appointments, trying to find out if there’s a cure for their pain or a fix of the problem, a solution and there isn’t. So by the time people come to me, they’re a bit like, Why am I coming to see, you know, a psychotherapists of pains in my body? Are you saying it’s all in my head? And people often get these mixed messages? That’s the reason they’re coming to me. 

 

Sarah Rees  11:59

They’d be on a lot of pain medication, or does, you know?

 

Sheena Rydings  12:03

It varies? I think it depends on how long the person’s had chronic pain as well, because recent guidance, like the nice guidance now is saying that medication is not that appropriate for chronic pain, depending on the type of pain it is. 

 

Sarah Rees  12:19

That it’s okay, short term acute pay, but not long term. 

 

Sheena Rydings  12:24

Yeah, so people often prescribed things like opioids, and the short term they are can be helpful, long term people, the research has shown now that there’s a tolerance that people build up to pain medication. So there’s a lot of people who’ve been on this medication for 10-15 years. And now new research is coming out saying actually, you know, it’s not helpful. And for some conditions, for example, fibromyalgia, which has fatigue and pain, the suggestion is no medication for that is actually helpful. And of course, trying to tell someone who is in pain every day, that medication isn’t gonna help.

 

Sarah Rees  13:02

There’s not no tablet for it. 

 

Sheena Rydings  13:05

No, it’s hard. 

 

Sarah Rees  13:06

Yeah. Yeah. 

 

Sheena Rydings  13:08

And like you said about feeling validated. That’s really difficult. People feel, don’t feel validated when they’re sent to see someone, a therapist. I often get, what can you do for me my pains in my back? Or, you know, wherever it might be? 

 

Sarah Rees  13:24

Yeah, 

 

Sheena Rydings  13:24

it’s, the first thing I often do is try to explain that mind and pain link. About actually how our mental health impacts our pain. Have you heard of the pain gate theory? 

 

Sarah Rees  13:39

No, I haven’t. No. 

 

Sheena Rydings  13:40

So a kind of simplistic version of it will be that when we feel pain, messages get sent to our sort of spinal cord, and that gets all the way up to our brain. And our brain then decides how much pain we’re going to experience whether that’s a little, a lot or not at all. The brain is actually vital in terms of our pain experience, and it goes off lots of different things like our environment, our set, we’re obviously we’re sensory beings as humans, aren’t we so our senses, memories, all sorts of things, and then it decides what pain experience we will,we will have. And there’s lots of different pain stories which are absolutely fascinating. So, for example, there was a man in China who was walking down the street, he felt a bit of rubble hit his head, carried on walking, went into a shop. Everybody started screaming and pointing out his head. He looked in the reflection and saw a knife sticking out of his head.

 

Sheena Rydings  14:41

And he hadn’t know he hadn’t felt it, so he suddenly hadn’t realised he only said he felt the pain when he saw the knife sticking out of his head. 

 

Sarah Rees  14:51

So what’s going on there?

 

Sheena Rydings  14:52

So it just shows that he wasn’t expecting it. He was just walking down the street minding his own business now, the knife actually on X rays just went through his skin it didn’t go through his skull would have heard though, but he just wasn’t expecting it. His brain obviously thought walking down the street. I’ve done this before. You know, it was just a bit of rubble and kind of got on with his day. 

 

Sheena Rydings  15:13

As you’re saying that stories come into my head about this guy. And this would be me, a guy that stood on a nail and went straight through the shoe, he was screaming his head off, which would totally be me. They took it took him to a knee, took his boot off, it come between his toes.

 

Sheena Rydings  15:31

And that was the other pain story that I would use. It’s kind of like the complete opposite, isn’t it? But he looked down assumed it went through his foot and was screaming agony in pain. Yeah, so it’s amazing the brain is I mean, they’re acute sort of injuries or not an injury. But the brain is responsible.

 

Sarah Rees  15:48

Yeah, a while ago, I had an operation. It was only like a really minor operation. I was so scared of being in any pain, I managed to convince the doctor to give me some kind of opioid. And because I wasn’t actually in any pain, but I thought I’ll have some at night. So I get a good night’s sleep. Yeah, it made me really vomit. I was really sad. It was because I’d almost too much medication for like no experience. Yeah. Anticipation. So I mean, that’s like, just don’t do that. 

 

Sheena Rydings  16:19

Yeah, but it shows how strong the medication is and also the anticipation of pain, that come out with it. Can we not cope with it? Will it be unbearable? 

 

Sarah Rees  16:29

Yeah, I’ve got no evidence to support any of my beliefs at all. 

 

Sheena Rydings  16:34

And thats it, a lot of people don’t. And also I would often say to people, you know, you’re stronger than you think. We think we’re not gonna be able to cope with it, but what we can and that that pain gate theory shows that when all these messages come to our brain, essentially with chronic pain, the messages have been sent too many times. So if imagine you ring a doorbell. You ring it once it goes ding dong. Yeah. When you’ve got chronic pain, you ring it once like the whole street, doorbells go off, the toilets going, the washing machines on, it’s really oversensitive to the pain signals.

 

Sarah Rees  17:10

So there’s not much pain, but the responses is huge. 

 

Sheena Rydings  17:15

Yeah, the response is bigger than what the pain is. Yeah, sometimes not all the time. It really is individual. That’s generally what chronic pain is, it means that there’s no actual hurt, like an injury, an acute injury. But we’re still feeling all this pain. 

 

Sarah Rees  17:34

And just people understanding that, does that kind of soften it for them? Framing how you think about it? 

 

Sheena Rydings  17:43

I think when people understand that, they can understand what’s going on in their own body. And it kind of makes sense as to why they’re feeling all this pain, even though all these X rays say you shouldn’t be feeling it, it kind of starts to make a bit of sense to them. And the theory that I work with is that imagine you’ve got like a little gate on those your spinal cord. Yeah, and when we feel sort of depressed or anxious or stressed, that gate is open so all those messages are going up to the brain. Yeah, if we help people with their depression, or their anxiety or their stress, we can kind of close the gate. So you the pain messages don’t get through as much. So you don’t experience as much pain. So that’s why we could we work with it in a psychological way. Because it kind of shows that it helps reduce our pain experience, the pain might well be there, but we don’t experience it as much. 

 

Sarah Rees  18:40

How many people get better and shift, like if 100 people can see you with quite chronic pain, how many would kind of rate their pain as lower after CBT that those statistics out there? 

 

Sheena Rydings  18:52

It’s really difficult to measure that. I don’t know if people necessarily would rate their pain is lower, but it’s more their quality of life, and how much they are living, you know, well, and living in line with their values and enjoying life.

 

Sarah Rees  19:10

So their quality of life really? 

 

Sheena Rydings  19:11

Yeah, yeah. Because the I guess the goal of CBT for pain wouldn’t be to get rid of your pain, because that’s not something we can do. It would be a happy benefit, when you are feel better, that you you experience less pain 

 

Sarah Rees  19:29

because your relationship with that pain is different, isn’t it? 

 

Sheena Rydings  19:32

Yeah, absolutely. Yeah. So I don’t know about kind of how the numbers some people say that their pain might be the same but they’re doing more things are enjoying more. So they don’t focus on the pain as much that relationship with the pain isn’t as you know negative. So therefore, it is rated differently. So when I was if I was doing rating before and after therapy or a pain programme I would always look at, what’s your quality of life like now? Yeah. Because that’s what’s important, isn’t it? Are we having a better quality of life? Are we enjoying life? Are we doing things that are meaningful to us? And people who are ready to make changes, and are ready to take on board these different things do really really well with with therapy. 

 

Sarah Rees  20:25

Do they? Because imagine you’re enjoying life, you’re happier, your body’s more relaxed, isn’t it? So the way it holds pain is different. 

 

Sheena Rydings  20:34

Yeah, definitely, if you’re stressed, you’re more tense your shoulders are up, you’re holding your body more tense is, you know, that’s why sort of mindfulness, recent relaxation is really helpful for you know, stimulating that rest and digest part of the nervous system rather than that fight or flight, which is often activated. 

 

Sheena Rydings  20:53

Yeah, because of pain. And that’s why I was gonna go on to ask is, is, is CBT, like the only psychological treatment for pain or there are other things that are beneficial? You mentioned mindfulness. Yeah, so NICE guidance for pain management, say CBT, and physio. So it’s a more of a holistic view. But psychological therapy it is CBT, which is the treatment of choice. And I do, I’ve done some training, and I do a lot of reading on Acceptance and Commitment Therapy, I think it really holds a really valued place for people with pain, especially the acceptance part of it, and also the values. I work a lot with people’s values. You mentioned earlier about identity, and losing that sense of identity. And I always like to help people realise that we haven’t lost that sense of identity. Because those core values that are important to us are still there, even though we’ve got pain, we just might have to live in line with that value in a slightly different way. So acceptance and commitment, therapy is really helpful, I think for for those with pain, and compassion focused therapy, something I’m also interested in, and I’m going on a training course in July. So I think although CBT is, you know, what is evidence based and proven to be the best form of treatment, I think having a different range of modalities to offer. 

 

Sarah Rees  22:22

Yeah, and psychology, the world of psychology is constantly evolving with the research. And it’s kind of we generally bolt on other things that are useful. 

 

Sheena Rydings  22:33

Yeah. So I’m looking forward to doing doing that. Because I think that would be really helpful to, you know, for some clients need different things, and that we don’t all fit into boxes, that sometimes 

 

Sarah Rees  22:44

I hear a lot of people that if they is struggling with pain and stuff, they will beat themselves up. Yeah. So working, compassion focused therapy is a lot about working with the critic and being kinder to ourselves, which sounds very straightforward, doesn’t it, but…

 

Sheena Rydings  23:01

Yeah, I think that people with pain are really self critical, especially if they’re not able to work anymore, or they can’t do the things that they used to be able to, and people can beat themselves up about it. And I think having that compassion and that dealing with that inner critic, would be really definitely helpful. So I think a range. Yeah, is always is helpful, depending on what the clients are presenting with really. 

 

Sarah Rees  23:26

Yeah. Could you give a bit of an overview of how you’d work with somebody with pain? And you know, so what they could expect if they came for treatment. 

 

Sheena Rydings  23:33

Yeah, so no, I do sort of got my NHS hat and my kind of private chat. In the NHS, you’ll probably find it’s more pain programmes. So a pain management programme, which like an eight-week course. And generally, they are, it is well I do, it’s the CBT and the physio based. So there is some physio and exercise elements to it. But a CBT base, but in terms of sort of individual therapy, I might work with people. So it’s just sort of adaptations to sort of usual CBT. And I think things like if someone’s very depressed, we might be looking at their activity levels to boost their mood, but I’ll be kind of interjecting pacing, in that. So pacing and activity management is one of the biggest tools you can have in your toolkit for pain. And if you can learn to manage your activity levels you will have pain will be on an even keel. It doesn’t mean it’s gone completely, but you’ve bet you’re in a better management of it. So something like improving your activity management, increasing your activity levels, in terms of what you value, what’s meaningful to you, what’s important to you. I’d also look at relaxation strategies, breathing strategies, and mindfulness. I’ve done some training on mindfulness and I think it’s really, really helpful for people with pain to be more present-focused, you know, and having no judgments, lots of different kind of things that are really good with mindfulness, and looking at people’s unhelpful thoughts, their pain beliefs. So whether it’s challenging thoughts isn’t always that appropriate with pain, someone has thought of I’ll be in pain forever. So it’s about responding differently to thoughts, trying to create distance to thoughts and not reduce the intensity of their thoughts. So there are a couple of things that I would be working with someone with pain. 

 

Sarah Rees  25:34

If somebody was at home now struggling with chronic pain, are there a few tips that they could try at home that you’d recommend? 

 

Sheena Rydings  25:42

So pacing, as I said, is very, important. There’s a theory called The Spoon Theory. Have you heard of The Spoon Theory? 

 

Sarah Rees  25:52

I have. but please go through it for us

 

Sheena Rydings  25:56

I think The Spoon Theory is a fantastic tool to think about. So on the website called, but you don’t look sick.com. So it’s a lady who’s got lupus from America who developed the Spoon theory. And essentially, it’s about measuring your activity levels in a sense of spoons. So you’ve only got, when you’ve got chronic pain, you’ve only got a set number of spoons per day. And each activity takes a number of our spoons. And if you can, that’s that planning in advance and think about what spoons take up what amounts of activity. So having a shower might be one spoon, and going for a walk might be three spoons. So you can really plan your activity out. And it might be that you get to the end of the day, and you’ve got a big pile of dishes that need doing or and that takes a spoon or you’ve got you want to do some relaxation or something more enjoyable. And you have to choose how to spend that spoon. And you can’t do both. Otherwise, you’ll be in a spoon deficit the next day. So it’s about utilising and getting the most out of your life. But using it

 

Sarah Rees  26:58

And that stops that boom and bust. People too much one day because they feel great. And the next day they can’t move Get out bad. Yeah, that’s a common pattern, isn’t it for people with chronic fatigue. 

 

Sheena Rydings  27:12

Yeah, so for chronic fatigue and pain, the boom and bust cycle is really common. So pacing and using that spoon of theory analogy will be really helpful with pacing. So that’s definitely my biggest top tip. Relaxation or meditation or mindfulness daily definitely helps. It helps us relax the body, it helps there are lots of different health benefits for general wellbeing anyway. 

 

Sarah Rees  27:38

I bet that’s really hard to get started with when you’re in pain. You just want to focus on it, to say go and relax. I’d really resist  that if I didn’t know the science behind it? But 

 

Sheena Rydings  27:51

yeah, I think just start small and give it a go because like headspace or the calm app, they have lots of different things on YouTube, you can just type in three minutes of breathing space and just have a practice and try different relaxation strategies and see what works for you. But I definitely think the pacing and the relaxation, are the things that I definitely would advise someone to have a look at. 

 

Sarah Rees  28:17

Yeah, and if and a lots of people be listening to that live in lots of different places. But in the UK, if somebody wanted a referral to a pain clinic, how would they do that? Because at the moment in the UK, it’s difficult to even see a GP isn’t it?

 

Sheena Rydings  28:34

Where I am, in Cheshire East there is GP referral only to the pain clinic. So if you wanted to go to a pain service, I would imagine it’s probably going GP referral only just because they are like the hub of all the medical appointments. And they have all your medical history, so they tend to be GP referral only or if you’re seeing a physio like in an outpatient, they can often refer in and so for the likes of the NHS and for sort of pain management services, it’s through your GP. But for the one I’m in there isn’t like huge, long waiting lists to be seen initially. And for pain programmes, there is a bit of a wait at the moment because of the pandemic. We haven’t been able to run them face to face so there’s a bit of a backlog. But like initial appointments and stuff, you should be seen, you know, relatively quickly. In terms of privately, if you wanted to see a CBT therapist, I would definitely recommend a BABCP accredited CBT therapist. And, you know, we all probably know a bit about paying but I think unless you’ve done different training or yours you specialism they’re probably the better people to go for because they have a bit more of an understanding about pain. 

 

Sarah Rees  29:52

The ability for online like you do it face to face and online so you can be anywhere in the country can’t you or in Europe?

 

Sheena Rydings  30:00

Absolutely, I think you don’t have to find someone local, you can find somebody because a lot, we’ve all been working remote, haven’t we over the pandemic? If you can find someone who’s done additional training in pain or long term conditions, I did a 10 week training programme through Manchester University and Greater Manchester Mental Health Trust on long term health conditions, and that included chronic pain. So that adds additional training. 

 

Sarah Rees  30:25

So there’s lots of CBT therapists that listen to this as well. So can you speak a bit about this course, what did you think of it? 

 

Sheena Rydings  30:32

I loved it, I thought it was really, really good. I mean, I was working on the long term health condition pathway in IAPTS. Anyway, so I’ve been on a few sort of CPD things from my supervisor who’s a kind of long term health condition specialist. But I found the training really, really good. It was really insightful. It taught me lots of different ways to adapt what I already know, and adapt it to different presentations and different health conditions. But yeah, if you’re going to I definitely, probably look for someone who’s had experience or interest or additional training in that. 

 

Sarah Rees  31:06

Yeah, so you can drop therapists to the inquiry, but for CBT, it’s in the UK, it’s BABCP accredited, I’ll put a link to the BABCP and your website as well. Are there any good books and resources that you recommend to clients? 

 

Sheena Rydings  31:23

Yeah, so there is understanding chronic pain. Oh, sorry, Overcoming Chronic Pain. And that’s by Francis Cole. So it’s quite a lengthy read. But it’s a really good book. And that is about mainly CBT strategies. There is another book that I really like called Outsmart your Pain, Christiane Wolf, and that’s compassion focused. So that’s a really, really, really good book. It’s more of a self help type book, so and so is the Overcoming Chronic Pain. And the last one I really like and book is The Happiness Trap. Now this isn’t, have you seen it by Russ Harris? 

 

Sarah Rees  32:02

Yes, I’ve got it behind me somewhere. 

 

Sheena Rydings  32:05

Yeah, I got it behind me as well on my pile of books. It’s obviously not just for chronic pain. But I think it’s a fantastic book, at getting you to think about things in a different way. And 

 

Sarah Rees  32:18

it’s based on that acceptance commitment therapy, isn’t it? 

 

Sheena Rydings  32:21

Yeah. So that’s really good. I think in terms of resources, The Spoon Theory on the www.butyoudontlooksick.com website is really helpful. And the pain toolkit. So if you Google the pain toolkit, there’s lots of different resources. On Twitter. Yes, yeah, that’s a really good point to look at to understand and look at different strategies of pain management. 

 

Sarah Rees  32:46

Yeah. And I know that there’s Mark Williams, who developed mindfulness, and he’s written the book, Mindfulness in the Frantic World, and there’s Mindfulness for Health, and I can never pronounce the name, but that is by written by people who have experienced long term. Okay. Yeah. That’s, that’s the focus of that is yeah, that’s my I’d be really good. Yeah. So that’s fantastic loads of resources for people to check out if you like a good book as I do. So my final question that I ask all my guests is, what would you say to your 15-year-old self? 

 

Sheena Rydings  33:27

And I’ve seen you’ve asked a few people, these on your podcasts. It’s hard, isn’t it looking back at that age?

 

Sheena Rydings  33:34

It’s such a tricky age, isn’t it?

 

Sheena Rydings  33:38

And, you know,, my parents divorced when I was 15 It was a really tricky age. But I think looking back now, what I’d say to myself is, I’d say I tell myself that I will be stronger than they are stronger than you think. I would probably say trust your instincts. I think you get driven along, you know, in a way that you follow the crowds and follow what’s expected of you, but I think if you follow your own instincts, and follow your path, you can’t please everybody. Yeah, that’s something that I wish I knew back then. Yeah. But yeah, it’s hard looking back, isn’t it? But yeah, definitely.

 

Sarah Rees  34:16

I like that, and earlier in the podcast, you said that you can just tell people that you’re stronger than you think we’re stronger as human beings and you said it in a very reassuring knowing way which makes me big I know you’ve done this a lot you worked with a lot of pain you know, you have absolute conviction that even made me think oh, I could tolerate a little bit of pain.

 

Sheena Rydings  34:39

You probably can yeah.

 

Sarah Rees  34:42

I won’t be trying it out. But it’s very reassuring that isn’t it? it’s very kind of gives us a sense of courage and 

 

Sheena Rydings  34:51

Oh, well that’s kind of hopefully what Yeah, as well and, and courage and hope and. There is on my on my website. I’ve written a blog, but I’ll say I’ve written I take the credit for somebody else who sort of written it. It’s called the pain journey, my story and I think the pain journey is exactly what it is when people come for therapy or pain clinics, it’s a journey. And you know, I’ve written it from a, from a client’s perspective, that they’ve written their journey and their from kind of beginning of being having chronic pain and that angry feeling, that loss feeling, the despair, going through all the way to learning and understanding and actually making changes and now living a really kind of happy life. 

 

Sarah Rees  35:36

And those journeys we’re supporting, that’s what we, you know, I’ve got a couple of chronic health conditions ago, thyroid problem and celiac and, and I think that is one thing that I really scrambled for is those, those journeys, that there’s so much negativity on, on the internet isn’t there and social media, there’s, you know, those lovely stories that take you on the journey, 

 

Sheena Rydings  35:59

We have a world of, you know, we’ve got to fight it, we’ve got to beat it, this is kind of the the messages were given quite long for people with long term conditions and chronic pain that’s not appropriate, to fight and to beat. We need to kind of, you know, go with it, and learn learn to live with it. And, and by that blog post that I did, I was what my hope is, is to give people that inspiration and that courage to see somebody who’s gone through a whole journey. And actually this could be you as well. And there’s no reason why you can’t come through that and out the other end of living well with pain. 

 

Sarah Rees  36:36

I’ll definitely share that I think that’d be a lovely thing for people to go in and therapists as well to, to go and have a look and share with our clients. 

 

Sheena Rydings  36:45

And to give therapists competence of working with people chronic pain, I found when I was in IAPTS people were always a bit weary of working with with pain and health conditions, because it was a bit you know, you have to just adapt to what we do and and to help people give them that, yes, chronic pain, we can’t get rid of it. But we can help people learn to live well with it. 

 

Sarah Rees  37:05

And I can see your enthusiasm and your like how much you love doing it, which is really rewarding. You know? So that’s where you’re here because yeah, yeah, 

 

Sheena Rydings  37:16

I do I really enjoy working with it. Because I can see, I can see potential, I can see the change in people, I find that really rewarding. And moving from IAPT where it was very busy, very generic. Going to like the specialist service and my private work getting more specialist in my private work has been more rewarding, being able to see kind of the area that I’m passionate about and work with that more. 

 

Sarah Rees  37:41

Fantastic. And if somebody wanted to follow you or get in touch, where’s the best place to find you? And what’s your website, I will link everything in the show notes. 

 

Sheena Rydings  37:49

So my website is www.sheenarydingstherapy.co.uk Instagram and Facebook, it’s @sheenarydings.therapy. there is my blog. I’ve only done that recently So I’m quite new to blogging,

 

Sarah Rees  38:10

Yeah, it’s good fun isn’t it getting that information out there. So I’ll link to all your social media and your website and, and let people know where you are, to get in touch. And thank you so much,  that’s been really, really valuable. Really helpful. 

Sheena Rydings  38:25

Thank you very much for asking me to come on.

Sarah Rees  38:31

Thank you for listening to Ask the Therapist. For more information about the CBT journal, visit my website at sarahdrees.co.uk. You can also sign up to download your free guide to building emotional resilience delivered straight to your inbox. You will then also receive regular newsletters where I share my blog posts, podcasts and tips and strategies for better mental health and psychological resilience. Don’t forget to review and subscribe to the podcast and you can also share episodes on social media using the #askthetherapist. This episode was written and presented by me Sarah Rees and edited by Big Tent Media and produced by Emily Crosby Media

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