Living With Pain!

An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates
Volume 11, Number 1

January begins the year anew with fresh hopes for the coming year. It is a very good time to set goals for each month and for the year ahead. Meeting those goals will allow you to grow and develop as a person as well as give you a sense of satisfaction. Hopefully by January of next year, you will be able to look back, see what you have achieved, and have a sense of satisfaction. Consider putting exercise and mindful meditation into your life as both will help you to reduce daily stress and cope with life’s challenges.

This month’s E-Letter focuses on Living with Pain. Our email of the month is about Ten Hardly Known Benefits of Yogurt, and our Ask the Doc question is about getting an adult child to move out. We hope you find the enclosed information helpful. We also thank you for reading our E-Letters and for the many comments we have received through our 10 years of E-Letters.

Practice News

Job Opening. We are currently looking for a licensed mental health professional with at least 2 years of experience to affiliate with our practice, part or full time. This is a terrific opportunity for an individual practitioner to join our well established practice and develop your own caseload. If you are interested, know of anyone who may be interested, or want more information, please email

Depression groups. Our ongoing weekly depression therapy groups meet regularly in our office. A men’s support group and a women’s support group are run by Dr. Jim Kaikobad and meets for one and one-half hours. The group is educational, supportive, and confidential and is limited to 8 people. A third and fourth group will be starting soon. If you are interested in attending, please contact Jillian at 954 755-2885.

Eating Disorders Support Group. We are developing a support group for women ages 18-30 who are in recovery from an eating disorder. This group will work in conjunction with the patient’s treatment team to strengthen their recovery. The group will be led by Dr. Terry Newell and if you are interested in participating, please call Jillian at 954 755-2885.

Afterschool Tutoring. We are pleased to announce that we will be offering tutoring for students in grades 1 through 8 after school in our offices. Jill Kimmel, an experienced educator, will be helping students to understand and learn their academic concepts as well as provide assistance in doing homework. To find out more about our tutoring services as well as to schedule an appointment, please contact Jillian at 954 755-2885.

Handouts from previous E-Letters can be found on our website, We invite you to read and download them if desired.


Our E-Letter this month focuses on the very difficult task of living with pain. Being in pain is the most common reason that people see a doctor. At least 100 million Americans adults suffer from chronic pain which constitutes huge financial costs in terms of productivity, disability claims, and medical visits. Pain is an indicator of some type of injury. Acute pain such as a burn or cut usually heals within a three month period. Chronic pain however is more complex and has emotional and psychological factors as well as biochemical factors. Living with chronic pain can cause hopelessness, depression, anger, anxiety, and frustration. Using certain psychological treatments to address the thoughts and emotions that accompany pain can actually reduce the intensity of pain.

A comprehensive pain management program will be multi-dimensional and include medications, psychotherapy, physical therapy, and behavior therapy. Research has shown these combined procedures to be quite effective in reducing reports of pain and improvement in mood, daily functioning, and return to work. Behavioral and psychological approaches to the treatment of pain focus on increased self-management, behavior change and cognitive change.

CBT or Cognitive Behavior Therapy focuses on changing attitudes and feelings about pain in order to increase coping skills and a sense of control over one’s life. It can help to decrease hopelessness and frustration as well as unrealistic expectations. CBT also includes the learning of relaxation techniques to decrease muscle tension and the overall level of arousal. ACT or acceptance and commitment therapy encourages people to accept pain in a non-judgmental manner rather try to control it. This is a holistic approach that increases psychological flexibility to decrease the experience of suffering. Other behavioral/psychological treatments include:

  • biofeedback is a technique through which patients learn to interpret physiological feedback to relax areas of muscle tension
  • relaxation training to reduce tension levels and increase control over pain
  • guided imagery where all of a person’s senses are used to imagine a safe and peaceful place to distract from the sensation of pain
  • hypnosis is a highly relaxed, trance-like state where a person is more open to pain reduction suggestions
  • acupuncture is thought to decrease pain by increasing the release of endorphins to block pain
  • meditation-mindfulness is the practice of focusing attention on experiencing the moment without judgment to feel calm and less aroused
  • Pain can be coped with by staying active and doing the activities you enjoy. Exercise but don’t overdo it and know what your limits are. Maintain friends and family for support and distraction from your pain. Continue to be hopeful and try to stay in control of your life. Distract yourself with other activities such as going to the movies, reading a book, or taking a walk. Take your medications as prescribed and be aware of abuse/addiction potential. Finally, consider seeing a psychologist to learn coping techniques, to reduce your stress, to increase your sense of control over your live, to increase optimism and to change your thinking to more be more realistic and accepting of your pain.

    We offer the following information on Living With Pain! (You can download this from our downloads page)


    Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken”.— C.S. Lewis


    • Pain has been defined by the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”
    • Pain is the most common reason for seeing a doctor as at least 100 million American adults suffer from chronic pain
    • Acute pain occurs suddenly and feels sharp such as broken bones, cuts, or burns and usually ends when the injury is healed
    • Chronic pain lasts longer than three months or continues after the injury is healed and causes muscle tension, lack of energy, depression, and low energy
    • Chronic pain affects more Americans that cancer, diabetes, and heart disease combined
    • The experience of pain includes biochemical as well as emotional factors and it can cause anger, withdrawal, hopelessness, anxiety, addiction, and financial problems
    • The costs, both direct and indirect, of pain have been estimated to be from $125 billion to $215 billion annually including treatments and disability claims
    • How we deal with pain is often psychologically affected by attention and mood: paying attention amplifies the sensation of pain and mood can affect people’s tolerance for pain
    • Living with chronic pain is quite stressful and stress in turn, can cause high blood pressure, heart disease, anxiety, depression, overeating, and muscle tension
    • Benefits of including psychotherapy in pain management include increased self-management of pain, improved coping resources, reduced disability, increasing realistic expectations, and reduced emotional distress
    • Cognitive Behavior Therapy (CBT) has been found to be effective in reducing pain as it deals with attitudes, feelings, coping skills, and feeling in control over one’s pain
    • CBT will change unrealistic beliefs and expectations and also includes learning relaxation exercises and teaching coping skills
    • ACT or acceptance and commitment therapy encourages people to accept pain in a non-judgmental manner rather try to control it; this holistic approach increases psychological flexibility to decrease suffering
    • Other treatments include biofeedback, hypnosis, acupuncture, meditation-mindfulness, progressive muscle relaxation, and guided imagery
    • Since pain is a mind-body issue, the most effective treatment is multi-modal which includes medications, physical therapy, behavior therapy, and psychotherapy

        • Stay active and do the activities you enjoy
        • Know when enough is enough and do not push yourself to do too much
        • Do not isolate yourself and see friends and family to increase your support
        • Find distractions such as walking or watching a movie to diminish your attention to pain
        • Take prescription medication only as prescribed by your doctor
        • Maintain hope and optimism that you can enjoy life despite your pain
        • Seek professional help to lessen unrealistic expectations, stress, depression, pessimism, and anxiety that accompany pain
        • WE CAN HELP!
          Call us at (954) 755-2885 or email us at

          Joel I. Kimmel, Ph.D., P.A. and Associates 5571 N. University Drive, Suite 101 Coral Springs, Florida 33067

          Copyright © 2016; by Joel I. Kimmel, Ph.D.

          As always, we would like to welcome new readers to our e-Letter. We hope that you find it informational and enjoyable. We invite you to share this e-Letter with others. If you have received this from a fellow reader, please send us your email address to include you on our list.

          Ask The Doc

          BG writes: I have a 42 year old son who still lives at home with my husband and I. He works from time to time but does not have a steady job. He has a girl friend that he sees every weekend but I don’t think it’s serious. He spends most of his time playing videogames and watching youtube. We have asked him to get a steady job so we can stop paying for him. He says he will but he never does. We feel sorry for him but we are out of ideas to get him to move out. What can we do?

          Dr. Joel Kimmel replies: It sounds like you have made it too comfortable for him to leave. In fact, why should he? He really doesn’t have to work as his needs are met at your home. By your caring for him, you have actually contributed to his not growing developmentally. By this age, which by the way is middle age, he should be independent and providing for himself. He is not a child but a man who is still living like a child.

          One of the tasks of being a parent is to teach children the necessary skills to be able to live on their own and raise their own family. For whatever reason, you have allowed him to become dependent. Your love for him and caring for him have actually done him a disservice as he has not developed into a responsible adult.

          Having said this, getting him to leave and take on adult responsibilities will be a difficult task for you. I suggest that you give him deadlines for completing certain tasks such as getting a full time job and finding his own place to live. For starters, you can charge him rent to live in your home and to use your car. You can require him to do his own laundry and prepare his own meals.

          This may be tough for you but you will be doing the correct thing as a parent. Be prepared for his resisting your requests or complying with them for only a short time. Remember you will be shaking his comfort zone yet it needs to be shaken for him to become a responsible and independent adult. Stay strong and believe that you are doing the correct thing for him.

          Email of the Month

          We thank Robert C. for the following email:

          10 Hardly Known Benefits Of Yogurt

          Yogurt is a great food for us as it helps with digestion, gives us a good energetic feeling and tastes wonderful. But not many people know that it has many other benefits you may not know quite yet. After reading all of this I’m sure you’ll start acting like me, and do your best to eat one cup of yogurt every day or two.

          Helps You Lose Weight:
          Yogurt helps build muscle and this means that it helps burn fat. The high amounts of protein will also help you stay fuller for longer periods of time while reducing your need for snacks and unhealthy foods.

          Protects your teeth:
          The lactic acid in yogurt has a positive and protecting effect on your gums and teeth. It can help keep your teeth healthy and pretty and overcome the damages done by other foods and drinks, most commonly – coffee. It’s important to note that although containing sugar, yogurt has no harmful effect on the enamel of your teeth.

          Reduces Allergy Symptoms:
          Those of us with seasonal allergies know how hard it can be to do anything when the symptoms start to appear, but a cup of yogurt might be an easy fix to this problem. The probiotics found in yogurt may decrease your body’s reaction to pollen and other allergens, minimizing your allergic reaction.

          A Great Source Of Energy:
          Aside from the energy provided by the carbohydrates in yogurt, it also contains B vitamins which are just what your body needs when you feel like you could use a little pick-me-up.

          Fights The Common Cold:
          The common cold will always be there, not much you can do about it. But there’s still hope preventing it in time. Research proved that yogurt can strengthen your immune system, making your T-cells stronger and more active. They are more prone to beat the sickness out of you before it drags on too long.

          Prevents Yeast Infections:
          If you are given a prescription for antibiotics, you might want to consider yogurt to protect yourself. Using antibiotics usually raises the chances of yeast infections and the yogurt’s active cultures can help balance pH levels and prevent this uncomfortable problem.

          Reduces The Risk Of High Blood Pressure:
          A recent study, conducted over the course of 15 years, revealed that 30% of volunteers that took at least 2% of their daily calorie intake from yogurt, were less likely to develop high blood pressure. That’s only from 2%.

          Helps Prevent Osteoporosis:
          All milk and dairy products are in general a great source of calcium, and help build healthy bones. Look for yogurts with added vitamin D for a greater help in keeping your bones strong and healthy.

          Great Pre Or Post Workout Snack:
          Yogurt is rich on carbohydrates that can either help re-fuel you throughout your workout, or replace the energy lost after you are done. The potassium and sodium found in it can also help replace those electrolytes you sweat out and keep you feeling fresh even after a hard workout.

          Builds Muscle:
          Yogurt contains all of the essential amino acids necessary to build muscle and other tissues in the body. It is a complete protein, which means it is also a welcome addition to our diet as they support all the necessary biological functions of the human body.

          Keep an eye open on the sugar content in your yogurt. Many kinds of yogurt contain added sugars and artificial sweeteners you do not want. Stick between 12-18 grams of natural sugar per serving and you’re free to sit back and peacefully enjoy a cup of the good stuff!

          Till February…

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          If you find this information interesting or helpful, please forward this E-Letter to your contacts and friends. Copyright © 2016 by Joel I. Kimmel, Ph.D. P.A. and Associates.