by Gordon Nary
Gordon: When did you join Holy Name Cathedral Parish and how has the parish contributed to your spirituality?
Dr. Cosio: I began attending mass at Holy Name about four years ago. I had been raised in the Catholic Church and had even served as an altar boy in my youth. After I moved to Chicago ten years ago, I struggled to find a parish which I could call home. After a break-up in a serious relationship, I sought to find true connections and meaning, which led me to Holy Name. I have been coming here ever since then.
Gordon: Where did you receive your Ph.D. and what was your most challenging course and why?
Dr. Cosio: I obtained my Ph.D. in Clinical Psychology from Ohio University in Athens, Ohio. I also received a specialization in health psychology and became certified in gerontology at that time. My most challenging courses were in statistical analyses. However, I learned a lot and have been able to conduct research studies competently due to those courses.
Gordon: What initially interested you in pain management and where did you continue your studies in this specialty?
Dr. Cosio: I had my first patient who suffered from chronic pain when I worked in college counseling in 2006. I then received training in biofeedback and hypnosis at the University of Massachusetts-Amherst during my internship. It was during my post-doctoral training at Edward Hines VA Hospital that I began treating more patients with chronic pain and was identified as an expert in the field.
Gordon: Where are you currently on staff and what are your primary responsibilities?
Dr. Cosio: I am the psychologist in the multidisciplinary outpatient Pain Clinic and the psychologist in the 12-week CARF-accredited interdisciplinary program at Jesse Brown VA Medical Center. I also serve as faculty at the University of Illinois at Chicago College of Medicine in the Pain Medicine fellowship program and at Northwestern Feinberg School of Medicine in the Psychiatry and Behavioral Sciences department.
Gordon: According to the American Pain Society (APS), pain is the leading public health problem in this country and the most common reason people seek medical care. What are the primary challenges to physicians in treating pain and what are the primary challenges to the patient?
Dr. Cosio: Most people who suffer from chronic pain seek their treatment from primary care providers. Primary care providers may not have the resources necessary to address the needs of complicated pain cases. In fact, the average time spent with a patient in primary care is about 7 minutes. In order to adequately address chronic pain, a thorough assessment is required to develop a comprehensive pain management plan. Often times what challenges these cases in the lack of communication between the patient and the provider.
Gordon: Please comment on the CDC Guideline for Prescribing Opioids for Chronic Pain.
Dr. Cosio: The CDC recognized the US opioid crisis as a “public health epidemic” in 2016 and released guidelines for the initiation, selection, and assessment of opioid therapy risk in March 2016. At the same time, several studies were conducted which concluded that there was limited evidence supporting the benefits of long-term opioid use. The purpose of these guidelines was to keep the patients and community at-large safe but have instead been used to create regulations at the state and federal level.
Gordon: Please provide an overview of some of the most effective alternates to pain management drugs.
Dr. Cosio: There are over 20 different types of treatments for chronic pain to choose from. There are four general classifications to these treatments. These range from traditional options, such as medications, interventions, physical medicine & rehab, to other things patients may not have even considered. There are psychological interventions, such as hypnosis, biofeedback, cognitive-behavioral therapy, and Acceptance & Commitment Therapy. These treatments may play a role because the same part of the brain that is responsible for pain is also responsible for our emotions. There are also benefits we can glean from complementary and integrative health modalities, such as acupuncture, relaxation, mindfulness, spinal manipulation, and massage therapy. There are also lifestyle imbalances which may have a negative effect on the person’s life, such as diet, sleep hygiene, physical activity, and their spiritual needs.
Gordon: In your opinion, what are some of the most effective methods to alert physicians to these alternatives?
Dr. Cosio: I have focused most of my career on empowering both patients and providers through education. Education is the best analgesic! I believe that when people know what their available options are for treatment, they make the safe choice. There are a lot of barriers to care, but we must start by improving the communication between patients and providers. Beyond that, there need to be changed in our health care coverage to ensure these other options are affordable to patients.
Gordon: Congratulations on the publication of your recent book Pain Relief: Managing Chronic Pain Through Traditional, Holistic, and Eastern Practices What are some of the primary recommendations in your book?
Dr. Cosio: Over the past 10 years, I have been teaching about pain management to veterans in the Pain Education School program at the Jesse Brown VA Medical Center. I have also been teaching providers in the private sector throughout the country. What I have learned over time is that both patients and providers have unmet educational needs when it comes to chronic pain. I wrote this book because I felt that the information I teach in the Pain Education School program is something everyone can benefit from learning. The book is laid out in three general sections: pain education, assessment, and treatment. The objective is to put pain management into the patient’s hands.
Gordon: Thank you for the interview which will be of help to many people.