Psychotherapy/Conversion Disorder related to Migraines

Hello,

My wife of seven years has daily migraines ranging from 6 to 10 on the pain scale. When it gets to 8-9 we make a trip to the ER which usually happens every 2 months. Like many posters she has literally tried every medication known to mankind. She has had CAT scans, MRIs, blood work etc etc etc. Last year she had neck and back surgery for degenerative issues. It was hoped this might help with migraines as well, but it may have actually made it worse or possibly caused her to focus even more on the migraine pain. She was the victim of sexual abuse as a child. I read something recently that indicated victims of abuse have a significantly higher rate of migraines.

My question is: has anyone successfully engaged in psychotherapy with the result being a reduction or elimination of migraines?

I have not, as of yet, but I will be beginning psychotherapy in the next few weeks. I have my first meeting with the psychiatrist tomorrow. I have heard of trauma adding to or even causing migraines, however, I don't believe that being in therapy will eradicate the migraine. But, it might help.... Good luck to you and your wife.

Michelle

Not sure if it might hit the spot for some. There is a book by an English lady called Olivia Roberts.
She suffered from migraines herself, she has an interesting back story.
She has found a way which might loosely be termed psychology, but its hard to put a name to it.
She is helping a lot of people, and the nice thing is, using the book, everyone works at their own pace and if it doesnt work, you lost a few dollars/pounds.

I know she has helped people with many pain conditions, fibro and IBS too.
Some of my group are using the book, but it only just came out, so too soon to tell.

I did check her out thoroughly though.
She is kosher, there are no hidden charges, and nothing more to buy.

Perhaps if anyone wants to explore this avenue, and BTW she does not suggest we dont have a neurological problem at all, then why not give it a try.
Not a lot to loose....

Being that migraines are neurological in nature, you can't eliminate them completely. If they do go away, it's on there own. Tramatic stress/abuse can certainly be a trigger but I don't believe that tramatic stress "causeses" them.

"causes"

Hi All,

First of all, I know that there is a theory in psychology that connects migraine or other diseases with some sort of childhood trauma. However, for the larger patient population, especially for those who suffer chronic migraine, I do not think that the disease is caused by any sort of childhood "trauma." I certainly do not buy the conversion disorder theory. Any good psychologist or psychiatrist should be able to tell if this is a converion disorder or not.

Pen, if the book is helping you or others and isn't doing you any harm, then continue.

I have seen a psychologist for several years- mainly just to talk about the headaches and life so that my friends and family do not have to hear it all the time.

There are a thousand things that can contribute to migraine. When did your wife have the neck surgery? It is one of the worst feeling in the world when something that is supposed to stop the migraines doesn't. It sounds like you are really worried about your wife and looking for anything that will help. Is there a headache specialist or a good neurologist in your area? That is where I would start. And hey, seeing a psychologist may help you both deal with the stress of all of this.

I hope this helps.

Pain free days,
sailingm

She had back and neck surgery in 2011. The physician cautioned against too much hope regarding improvement in the migraines and he was correct. She has seen neurologists, pain management specialists, chiropractors, etc etc. They have done everything but botox, which the ins denied, but based on what I have seen on this forum it was a long shot anyway. She has co-occurring depression which I'm sure play off of each other, but are probably independent diagnoses. She is currently taking Kadian which was recommended over hydrocodone. She sees a therapist weekly to address a bonanza of issues. When it comes to chronic pain issues everyone is in a losing position. The medical community is always on the look out for drug seekers so everyone seeking pain relief is a potential recipient of that label. Since physicians can't run tests to confirm pain they have to make subjective assessments based on patient reporting and their own biases and interpretation of information. They have to decide if they are dealing with a drug seeker, part-time drug seeker or under managed patient. Meanwhile the patient, already miserable, has to fight through everything from insinuations to irritation to accusations simply to get temporary relief for a condition which will return.

In my original post I asked about secondary gains and I received the responses I expected which is fine. Sometimes I feel like the embodiment of both the patient desperate to get relief and the medical community wondering if they are getting played. That may sound harsh to the sufferer, but to the people living in that world, it becomes demoralizing as well. As the spouse, I end up doing 80-90% of the house work while working full-time and parenting three children (not hers). She works part-time in a very flexible situation after being fired from three other jobs for various reasons. She spends most of her time alternating between the bedroom and the couch, watching television, sleeping or on her Kindle. Even when she appears to be doing reasonably well she does not increase the amount that she helps, which does not create much good will. Since we have been married (almost eight years) we have spent thousands upon thousands of dollars in deductibles and co-pays for every test, treatment and medication known to man. I struggle to remain sympathetic and I have felt resentful for quite sometime that she doesn't step up when it appears she is able to do so. Oddly, besides eating and watching television the only other activity she is consistently interested in is sex. Besides the obvious reasons, she says it is because it makes her feel better if only temporarily. I would think the activity would aggravate the pain, but she says it doesn't. So she is all for engaging in that activity, but will walk by a basket of laundry that needs to be folded or a sink of dirty dishes without a problem. She has two cats and guess who cleans the litter boxes 90% of the time? This all seems very inconsistent and self-serving to me and that is why I asked the question about secondary gain.

I came here looking for treatment options or just about any kind of information that might be new or even a twist on something already known. I am also trying to figure out what is "normal" for chronic sufferers regarding daily activities. I know everyone is different, but your feed back is appreciated.

no one can make a judgment regarding your wife, but from what you are describing, it seems that she is certainly majorly depressed, and you are already addressing that with the counseling she gets.

not being built that way (i.e.: to ignore household tasks that need doing) because i am ADHD at age 72, i can't really speak to that behavior. when i am in #8 or #9 pain, there is no way i could ever watch tv or do anything else but lie in bed and suffer, praying for sleep.

my chronic daily migraines are less severe, so usually i can get lots of tasks accomplished. i live alone, so if they're going to get done, guess who gets to do them? i have learned how to not think about the pain by being super-active when possible. as i tell people when they say "you have a lot of energy", i answer "it's all fake". really, it is. i also have fibromyalgia, and everything i have, hurts, all the time....it's just a matter of how much.

the only wisdom i can share is that you two NEED to talk about these issues. not that you haven't already, of course. can you just chat about the fact in a friendly/non-threatening manner, that you are doing everything and she is contributing very little to the relationship? i hate to think of migraine sufferers being more maligned than they are, but there are probably cases where the migraineur does get some secondary gain. personally, i have always just bristled when doctors or others have even dared to suggest that.

everyone's different in their emotional needs. i hope you and your wife are able to come to some agreements soon. like her, i have been through every expensive test, treatment and surgery known to man and woman, and i get absolutely NO secondary gain. in fact, i never mention my migraines unless it's a particularly bad day and i need to explain my clumsiness or other failing. best wishes to you, dianne

I'm so sorry to read about what you family is going through. I think its great your wife is starting therapy. If it isn't mentioned, I definitely recommend going in for some couples/family sessions too, as you write about some issues such as the pain vs. chores which could benefit from some mediation. I think its likely a combination of issues are going on. Of course with pain someone often doesn't feel up to doing their daily activities. Sometimes someone can be in great pain without any outward signs, but typically when it gets into that 8-10 range you will see some.

I could see that even if she was having a good day she would rather savor it than do chores, or she is in a depression and just doesn't feel like she can handle doing anything. Its really hard to know what is going on until you get down to the root of it. I can however say I look a lot better than I feel. I just won't let myself stop work or stop keeping up the house. Some folks are however that bad...they are bed bound, or can only do a very limited amount of activities. It is however really tough to know what someone can handle from looking at them. If they are crying out in pain its obvious they can't do anything. If they are up running around doing fun stuff, its obvious they can handle some chores. In between is a mystery. I hope some of this is a motivation problem, depression, etc.

Its good she is able to hold down part time work. I agree that communication between you two is very important. Not in the nagging or even asking her to do more, but starting that line of communication to understand why she does what she does. How much does she say the pain meds help? Kadian is a form of long acting morphine. For some, this can be a life changer. I am also on narcotics. Tolerance is a huge issue, but at one time I got 50% relief with them (currently probably 30%). 50% is a good goal for that type of treatment. If the pain meds aren't make a sufficient dent in the pain, it may be time to try a new type or a dose increase.

I think for a small percent of folks headaches and migraines may be exacerbated by psych issues such as a conversion disorder. I do think its overstated. Too many doctors push their patients off on a psychologist when they fail a few treatments, saying they can't help them as its all in their head. I have already had one doctor do this to me (say they wouldn't see me any more until I saw a therapist). The pain specialist I see now also insisted I get a psych assessment, and kinda suggested that I needed to follow any recommendations for therapy to continue to be treated by him. I do agree one could be helpful for me, but I'm doing it on my own terms. Just having someone to talk to about how the chronic pain affects your life can be good for any patient. I also suffer from some anxiety and of course, frustration.

I know how difficult it must be for a spouse to stay sympathetic. I really hope she benefits from the therapy because I think there may be some underlying issue there. Its just my opinion, but if you are up for sex, you can probably manage doing some dishes! Hang in there. This is a good step. You may even benefit from seeing a therapist on your own to get some tips on how to best talk to your wife about these sensitive issues. Best wishes.

When I was on a bad (pain level 8-10)cycle of non-stop migraines for months, I still had to function.But really I wasn't functioning but faking it. It was the only thing that kept me sane dealing with constant pain at that level. Plus, having to take care of the kids.

It sounds like there is a lot more that is going on with your wife than just migraines. I would have to know more about your situation to even try and guess what could be going on with your wife.

Thanks Sailing M. I make no promo, nor promises, I merely wanted to put it out there.
As no one truly knows what truly causes migraine, then we should be open, but not gullible.
There is no magic, but if even one person finds some relief then I feel it is worth a mention.

I am finding it helpful with my fibro so far.

P

In what way is this book helping with your fibro???

Im not sure Gail. As with others it seems following the book and its ideas just seem to ease the pain and it is making me feel I am a bit more in control rather than the pain. Long way to go, and time will tell, but so far, less meds and sleeping a bit better. Will get back to you if you want me to in time.
Nice to hear from you Gail.

P

I picked up this book at a book shop that may help coping with chronic illnesses:

http://www.amazon.com/How-Sick-Buddhist-Inspired-Chronically-Caregivers/dp/0861716264/ref=sr_1_1?ie=UTF8&qid=1334444744&sr=8-1

It is not a relgious book, just buddhist inspired coping skills. I think the same ideas are found in Christianity. Read the the reviews, it may give you an idea as to what the book is all about. From what I read in this forum and my own experiences, with chronic headaches, the author (who has a severe chronic illness) is right on.

Martin

P.S. After owning a kindle for several years, I feel the need to hold a book in my hand.

Thanks for this Martin. This is also a FB group and lot of interesting ideas on there.
Sounds interesting.

Pen

thanks for posting this book martin. I ordered it yesterday. (amazon.ca) I already have an interest in Buddhism. Also, I checked what the author had to say on her Website. I related completely. (I have pain 24/7.) So, thanks again.

What impressed me about the book, when I was browsing in the book store, is where the author wrote: The very things that you used to enjoy, are the things that make your condition worse (using my own words). With me it is photography, I would spend hours scanning B&W film and working on it on my computer. No more of that.

I've also have had an interest in Buddhism for quite a few years.

Hopefully, the book will help us cope.

Martin

My two main enjoyments in life were (note the past tense) listening to music and reading. I can no longer enjoy music. The majority of the time now I cannot read. Yes, I have noticed how this circumstance has taken away the two things I enjoyed. I wonder what this means? When I read, by the author, that she wrote this book lying in bed with her laptop on her stomach, I knew I wanted to purchase this book. I have been known to lie down with my laptop by my side typing with one finger. I guess I'm not alone. Do you have the book in your possession now? (I thought you did) Gail Very sorry about your photography. I remember being very impressed with your previous photo. The one taken in profile.

Yes, I have the book. I read it in about two to three days. I am lucky that reading, for the most part, is something I am able to do. Again, my 24/7 headache pain level is now low level, with occasional flare ups to moderate levels.

Martin

Gail, I also miss reading and music so much.

The main things in my life taken from me (other than humans of course