Before you fill this out, know this: I’m not trying to convince you to work with me. This helps you figure out if this is right for you, or if your time and money would be better spent elsewhere. Most people who fill this out aren’t a good fit. And that’s okay. It’s better to be honest now than waste your hope and time later.
This assessment takes 5-7 minutes. And there are no “right” answers, just real ones and fake ones. For the record, be real, not fake. Fake makes things harder for everyone.
The referral requirement is firm. Every client who works with me for pain management needs a written referral (which I provide) filled out and signed by their physician or pain specialist. That document includes your diagnosis, current medications, and your doctor’s acknowledgment that you’re pursuing this work. This isn’t just a formality. It’s how collaborative care works in a responsible manner. I’m not your doctor and have no intention of functioning like one. Your physician stays informed and involved. That’s the arrangement, and it’s not flexible.
Chronic pain that has outlasted conventional treatment almost always has two dimensions medicine doesn’t address. The first is the source — whatever initiated the pain signal in the first place, which may still be active and feeding it. The second is the signal itself — the nervous system’s learned pattern of broadcasting pain, which keeps running even when the original cause is gone or resolved.
I work on both. Sessions run from 90 minutes to 3 hours, and I approach every session as a complete intervention. As a 2021 meta-analysis in the International Journal of Clinical and Experimental Hypnosis found, the average person receiving hypnosis reduced pain more than 73% of control participants. That’s more than just a placebo effect. That’s a measurable outcome from a specific kind of work on a specific kind of problem.
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