Anna Holtzman is a chronic pain recovery therapist and coach based in New York City. She is a facilitator for Curable Groups pain recovery program and her writing can be found on the Curable blog and on Medium.
Q: HI Anna! Thanks for sitting down with us. I understand that you have your own chronic pain recovery story. Can you share a bit about that and how it impacts your work with pain management?
A: Hi, thank you for having me here. I’d be happy to share. I use my own chronic pain recovery story a lot in my work with therapy clients, because my recovery experience helps me understand what they’re going through and it helps them understand that their experience is totally normal - and that there is a way out. My story is that I had chronic migraines for over ten years. They started as a rare occurrence but became more frequent over the years, and eventually I was getting them one to three times per week, having to cancel work and social appointments and generally feeling fearful that I could get a migraine at any time. Although I’d been trying to address my migraines through psychotherapy for several years, I didn’t start to recover until I found the Curable app in 2018. That was the beginning of my recovery journey. I’d say that my recovery has had four phases. In the first phase, I learned that pain is a danger signal created in the brain when your nervous system feels unsafe; that the “danger” can either be physical (like a broken arm) or emotional (like an unhealthy relationship or repressed emotions from stress and trauma); and that in order to turn off the pain signal, you need to help your nervous system feel safe again. In the second phase, I learned how to release emotional stress from my body through daily expressive writing, which I learned from therapist and chronic pain expert Nicole Sachs’s work. In the third phase, I learned that my habit of negative self-talk was stressing out my nervous system, so I began to retrain my brain into loving self-talk, using a technique called “mirror work” that I learned from Louise Hay’s books. And the fourth phase, which is ongoing, is about letting go of my perfectionism about healing: Recognizing that healing doesn’t have to be perfect and that I don’t have to be perfect in order to get back into the activities that I enjoy and care about in life. I don’t get full-blown migraines anymore, but I still get head tension on a fairly regular basis - and I think it’s important to be honest with my clients about this. I want to instill hope that recovery is possible, without perpetuating perfectionism in recovery - which can actually stress out the nervous system and get in the way of recovery!
Q: Thanks for being so open with your story. It sounds like you’ve had fairly extensive experience in the pain management space. As you have spent more time in the field, are there any challenges to helping people in pain that stand out to you? And why are you optimistic about conquering those challenges?
A: I have to say that, in my experience, the biggest challenge is clients’ attachment to negative self-talk as a survival tool and their resistance to self-compassion. Most of us are taught self criticism from an early age - it’s a cultural norm in societies where children are taught to blindly obey authority (i.e. most societies) and it becomes a survival tool: We criticize and judge ourselves in order to try to avoid criticism and judgement from authority figures. We think that if we become our own worst critic, we’ll somehow manage to avoid the “failures” that will get us into trouble with authority. But unfortunately, habitual self-criticism guarantees that our nervous system will feel under threat at all times, and that can set off the “danger” signal of pain. When a client is strongly attached to their self-criticism habit, perhaps because it’s helped them achieve success in other areas of their life, it can be very hard to get their buy-in to self-compassion, and self-compassion is a key component of chronic pain recovery. However, I am hopeful! Because I’ve seen clients make that turnaround over and over again. It takes longer for some than for others, and that’s okay. We all come to things at our own pace, and as a practitioner it’s important for me to be patient and have faith in a client’s process.
Q: You also do some work with Nonviolent Communication. Can you explain what this is and how it can benefit people in pain?
A: Yes, this is one of my favorite tools to use in working with chronic pain. Nonviolent Communication was created as a conflict resolution method, but I use it to help clients resolve internal conflicts between different parts of themselves. Addressing emotional stress is an important factor in recovery from chronic pain, and often, emotional stress is a result of conflicting emotions that are battling each other inside of us. Here’s a common example: One part of you feels angry at a loved one, while another part of you feels guilty about the anger. So anger and guilt are battling inside of you, creating a great deal of tension and stress in your nervous system. Nonviolent communication provides tools that help you to sit down and chat with each of your parts individually, get clear on what they are feeling, what they’re concerned about and what they need in order to feel heard and validated, so that they no longer need to be in conflict with each other. It’s basically like “couples therapy” for the conflicting parts inside of you.
Q: When you are not working on helping people tone down their pain, what do you do for fun?
A: My favorite thing is hanging out with my partner and our three orange cats. We love to laze around and “do nothing” together. But I also love spending time by the ocean and going to museums. And I enjoy taking long walks by myself, which I do nearly every day.
Q: Where can people find more about your work?
A: People can find me on Instagram @anna_holtzman where I post daily tips, inspiration and support for chronic pain recovery. And my website is http://www.annaholtzman.com.