Pain, Progress & Psychedelics: Dr. Wayne Kampers on Chronic Primary Pain, Psychedelics and Mental Health

In this episode, Dr. Wayne Kampers, a consultant psychiatrist with a deep interest in pain, shares his personal journey and professional insights into chronic primary pain. He discusses his journey from suffering debilitating back pain to finding relief and developing a comprehensive pain recovery program. Dr. Kampers highlights the role of the autonomic nervous system and the importance of addressing both physical and emotional aspects of pain. He also delves into the limitations of Western medicine, the potential of integrating Eastern philosophies, and the emerging role of psychedelics in psychiatry. The conversation also delves into the importance of self-care, curiosity in medical practice, and a holistic approach.

00:00 Introduction to Self Matters Podcast 
00:32 Dr. Kampers' Journey into Psychiatry 
01:02 The Struggle with Chronic Pain 
04:59 Discovering the Root Cause of Pain 
06:52 Understanding Pain and the Nervous System 
09:34 Charlie's Personal Pain Experience 
14:54 Approaching Pain in the Clinic 
19:51 The Future of Psychiatry: Psychedelics and New Therapies 
23:58 Dr. Kampers' Self-Care Routine 
25:15 Improving the Mental Healthcare System 
27:20 Closing Remarks and Farewell

Creators & Guests

Host

Charlie Wells

CEO & Founder of HelloSelf

Guest

Dr Wayne Kampers

Consultant Psychiatrist at 10 Harley Street

What is Self Matters?

The stories from the people shaping the future of mental healthcare.

Charlie: Hello, I'm Charlie Wells and welcome to Self Matters, the podcast where we interview the people shaping the future of mental health.

This week, I'm so excited to announce that I have Dr. Wayne Kampers joining me. Dr. Wayne Kampers is a Consultant Psychiatrist, with a specialist in pain, but also really interested in biopsychosocial models, ancient practices, psychedelics, all sorts of interesting things that we're going to cover today while looking at how can psychiatry really change the system for mental health sufferers. Very exciting.

Welcome to the podcast, Wayne.

Wayne: Thanks, Charlie.

Charlie: As you know we always like to start the podcast by really understanding who is Dr. Wayne Kampers and how did he become he so let's start right at the beginning. Why did Dr. Wayne Kampers become a psychiatrist and how did you get your specialist interest in pain?

Wayne: I didn't become a psychiatrist because I ever intended on specializing in psychiatry. It was my journey that took me on the route to become a psychiatrist and I think that context is really important. I think the best thing for me to do is to actually tell you my story and then it'll all become apparent. I want to take you back about 18 years to 2006. I was living in the UK prior to that I had qualified in medicine in South Africa in Cape Town and then I had been a GP in rural Canada for about five years where as a young doctor, I ran a rural practice of about 20, 000 people, 24 hours a day. I was the only doctor in town. All the responsibility was with me and obviously it was an incredibly phenomenal learning experience, a very steep learning curve, and the context of that is important. The reason why I wanted to tell my story about pain is because I've walked this walk and I've been down this journey and I understand this condition very well, and it is one of the most poorly understood conditions because, currently, there are probably about 1.5 billion people in the world that suffer with chronic primary pain, as it's now known or medically unexplained symptoms. Conditions like fibromyalgia, chronic fatigue syndrome, all of these conditions fit into this category. And historically Western medicine has not been good at dealing with these conditions. 18 years ago when I develop pain. I had a young child, my son was about 18 months at the time. I was fit and healthy. I had no problems at all. I mean, I was training six days a week. I had always been very healthy, had no problems and never had any injury and I went on a long haul plane trip to South Africa because my South African family hadn't seen my son.

I don't know if you know, you can't buy a plane seat for a child until their two. So when they're 18 months, they have to be on your lap and so we had this 18 hour flight to South Africa and very active 18 month old on our laps. And when I got to South Africa, I out of the blue developed this crippling back pain, pain like I've never experienced at all. I was in so much pain that I had to get myself upgraded to business class that I could lie flat for the whole flight.

My wife hasn't forgiven me for that, leaving her in business class with our son. When I got back to the UK I was completely paralyzed with the most severe back pain I have ever experienced. So I went and did what all people with pain do you go and see your doctor, they did an x ray on me and my back X-ray showed all of the sort of degenerative disc disease degree of spinal stenosis herniated disc, nerve impingement, root impingement, et cetera. I then went down the journey of trying to get this sorted out.

And I literally tried everything, absolutely everything. I changed my car, I had to stop exercising, I did things that I'd never done before. Acupuncture, Reiki, Mactimony chiropractics Pilates, you name it.

There was not a single thing I did not try in order to correct this. I had three spinal epidurals which didn't work. And so finally what the specialist said to me is I need to have major spinal surgery. I just could not accept that because I had no injury. At that stage my GP had gradually increased my doses of medication and I was probably taking 30, 40 different tablets a day. I knew the pharmacology inside. I targeted every single receptor and I was one short of going onto opioids. With all of that, I was only managing to get two hours sleep a night, still having to get up the next day and try and go to work and try to function. I just thought to myself I can't see a way out of this. My wife, Laura, in former life, she should have been a CSI detective she stumbled across a book in the library and she read this book and then said to me, I know what you're going to say but I think you should maybe read this book. I was like how's a reading a book gonna help anything, but I read the book. The book was by Dr. John Sano , a medical doctor, professor of rehabilitation medicine, and what he had seen was all of these people coming in with unexplained pain that didn't match or didn't get better. The premise of what he was saying was that the structural pain that I was experiencing was due to underlying repressed emotional causes.

And so that was the starting point of me then beginning my journey to recovery and that took a while, it took a while for me to slowly get back and I eventually, managed to wean myself off all of the medication, managed to start exercising, managing to get back to where I was.

That then led me on to, this is such a global problem that we are facing at the moment there's approximately 1. 5 billion people globally that suffer with pain, it's the single greatest cause of our opioid epidemic but the whole medical community really has not focused on this issue.

It wasn't until about a couple of years ago when finally the World Health Organization and the International Association of Pain identified and has now given in the ICD 11 a diagnosis of chronic primary pain.

​

Wayne: so the next reason to really address is, why do people actually develop this kind of pain? I think it's important to just outline a few real basic medical principles here. And that is the body is clever and everything in the body should be fully healed by three months. There are some spinal disc lesions that may take up to six months. The second really important point to make is our skin is our biggest organ system in the body. And most people don't realize that our body does not have pain receptors. What it does have are things called nociceptors and nociceptors literally means picking up danger, picking up change. Okay, so let's say for example, I'm in the kitchen, I'm making myself some dinner and I cut my finger with a knife. I look at my finger. It's bleeding but before that's even happened the nociceptors in my finger picked that up, sent a message straight up to the pain matrix area of my brain, which is a very complicated process, but that then it interprets all of that information that based on previous experience, what you understand about pain, what you've experienced before, and the brain makes a decision. Does it need to send a message back down to that injured part in order for you to do something to make yourself safe?

So what it does is sends down a pain signal because nobody ignores pain. You've sliced your finger open and you go to A& E. They say you need sutures. Once the finger's been sutured the pain goes away because the brain now determines that it's safe. It doesn't need to send pain anymore. What happens in chronic pain is that the brain goes from safe, protective mode into overprotective mode where it is sending out pain signals and it's getting it wrong. It's sending out messages that are incorrect. There's a reason for that and that reason is very closely correlated to the state of your autonomic nervous system, and that can present itself much, much later in life. And if I think about my own story, I don't have any trauma that I could base my life on. I've never had any form of therapy or suffered with any mental health issues whatsoever. But those years that I was in Canada. My autonomic nervous system would have been on 24/7.

Charlie: It's just such interesting stuff. I think I've mentioned to you, but for listeners, I suffered form migraine level head pain for about three or four years after having a brain hemorrhage and I had the exact same thing after a year of it. I was going, can I really be feeling proper brain pain this badly all the time . So I ended up much like you going on a journey of self discovery, right? Reading up a lot about pain, trying to understand about how you manage pain. using kind of psychological tools to manage your pain, huge amount of stuff on like how you change your lifestyle, change diet, how do you keep your immune system relaxed, all sorts of things until eventually I've managed to work out.

I could control pain, but the only two things that I really learned on that experience, and this is why I find you so fascinating because you speak so eloquently and so scientifically and so knowledgeably about it, but when you're in it, it's exhausting and it's stressful, right? So I can't imagine it was that easy a process to take a scientific approach to testing your own pain when you were so tired and the effect on you and your family must have been immense. So, how did you keep a kind of scientific process when you were in it?

Wayne: The way that I did it was I needed to find an anchor point where I could start calming down my autonomic nervous system that had to be my anchor point. Interestingly there's a couple of other principles which are very interesting to think about. The first one sounds a bit morbid, but it's important because it's factual. And that is that at the time of death, every single human being dies from the same thing a lack of oxygen to the brain. That's principle number one. The second principle is that all human beings wake up in the morning, slightly hypoxic that's also a well accepted medical fact. The third principle is that it's well recognized that the presence of oxygen is directly correlated to the absence of disease. Then if you think about the Western model of medicine, which is in the diagnosis and treatment of disease. And then you think about Eastern philosophy and just take that same word disease. And they look at it in terms of the body being in a system of dis ease. If you marry those two together, it literally is that dis ease part of thing is really your autonomic nervous system that is driving the part of your brain the limbic fear circuitry, your amygdala and your limbic system. You have to zone in on seeing what can I do to start addressing that? And for me trying to do mindfulness based stuff and trying to meditate and all of that sort of stuff when you're in that amount of pain is impossible but what I could do was I could breathe. I could find a way of breathing, which I could focus in on. And so what I would do is I would, I mean, literally I would wake up at two o'clock in the morning. I would fall out of bed because I couldn't walk and I would crawl to the next bedroom and I would lie on my back, earplugs in so I could zone out all noise. I would close my eyes and literally what I would do is, for 15 minutes I would visualize and focus in on just breathing. So actually visualize my diaphragm and my lungs filling up and emptying. I just focus on that and visualize and visualize and visualize. That's all I did. I emptied my mind of everything else. And as I did that, I could start feeling the pain ease. I persisted with that and eventually it got to the point where not only was I able to feel the pain ease, I was then able to get up and start walking. Set myself a target of seeing how far I could walk. And, and then every day I'd walk a little bit further and walk a little bit further. But it was the breathing really that started to control my own autonomic nervous system.

Charlie: I'm trying not to get too emotional. I didn't realize we were going to go quite so deep into kind of personal pain stories, but everything you say rings so true with me. I ended up having a thing called tutting when pain was so bad.

I would just take a big breath in and just talk to that. And I do that for, as you said, 10, 50 minutes just to try and get over peaks of pain when I was getting down, getting better pain. I had this idea of breathing, visualizing my pain being centralized in my lungs to get the pain into a ball in my lungs and then like breathe it out. And then I could keep it out of my body for a little while. And then I could experience no pain. I had to let it back in. I had to accept it back in. And then the moment for me where I realized that I might be able to get over pain was I collapsed when I was running so running was scary for me But I went I decided to go for a run one day and while I was running I experienced no pain I went how is it possible that I have not moved for a long time because I've been in so much pain but when I go running I can experience zero pain like this can't just be physiological.

Wayne: What you're saying there is being able to identify and name your pain and give it a texture and give it a color and describe it, et cetera, is so crucial in that process. It's about identifying and actually changing your relationship with your pain.

​

Charlie: You've basically gone from a personal experience of pain, but with medical knowledge to becoming a systems thinker about pain. You're trying to work out how do you solve this for everyone. So tell us a little bit about how you're approaching pain in the clinic?

Wayne: I can honestly say that I have learned more in the last couple of years from people who are not doctors. From all of the allied health specialists who've been doing such good work for such a long period of time. And then also if you just look at fundamental Buddhist principles in terms of self care the principle is you can't serve others until you've served yourself. The self care routine part of things is absolutely crucial. It involves paradigm shift in thinking and accepting that Western medicine doesn't have all of the answers. They're very good at some things, but there are blind spots that exist medicine. And we need to merge the principles of Eastern philosophy and look at what so many therapists are doing in terms of mindfulness based practices and you look at the work of Peter Levine and read all the stuff Bessel van der Kolk speaks about in terms of the body storing trauma and then you look at Stephen Porges in terms of polyvagal theory, and you look at putting all of these things together, showing that, one needs approach that's working top down and bottom up, and including movement, including breathing, including stuff that previously we used to think was ridiculous.

For example people going outside and hugging trees kind of thing. Actually, there's so much research that shows how important grounding is in helping befriend your autonomic nervous system. We can learn so much from allied health professionals, from other cultures, ayurvedic medicine, what they really are doing in principle is they're all befriending their autonomic nervous systems in a way that we need to do better.

Charlie: You speak about all these different philosophies, but you're pulling them back to trying to create an understandable model about how these things may affect our lives. In the kind of clinic and the service you offer, measurement is an important part of what you do, but you're bringing all these philosophies together.

So ultimately, I guess, pain management, in the future will be about understanding someone's individual pain and creating the right combination of interventions that allow that person to be both proactive and reactive to their pain management. How do you approach a patient's pain in the clinic at the moment?

Wayne: This is not about pain management, okay? Because pain management indicates that there's structural physical cause for it. The aim is always to get people pain free, medication free, pill free and a normal life. So it's not about pain management. With pain management, interventions are introduced that help people get stuck in that cycle that there's a structural cause for their pain and interventions are the worst thing, actually, because they reinforce acupuncture and physiotherapy and, all of those things reinforce that there's a structural problem to your pain.

The only intervention really that we encourage is lymphatic massage because we know that addressing the lymphatic system is so closely correlated with the immune system is so closely correlated with the autonomic nervous system, and actually, they're not going to any particular part of the body where there's pain.

I've had lymphatic massages done and got the actual lymphatic massage therapist to explain to me exactly what they're doing and how they're doing it. So that's the only real intervention that people on our pain program can have.

Wayne: And the other thing as well is. They're not allowed to talk about their pain, which is of the hardest things because by talking about their pain the response you get from other people is the response that they would get that forges a little bit of a learned helplessness model in its worst case scenario.

It's really about working very closely with people and showing them how they can change their thinking in everyday life. That's the key.

Charlie: Completely agree. Something that we're big believer in HelloSelf as well How do you how do you change someone's thinking and their behaviors and the way they approach their lives? More holistically forever rather than just treat people and then put them through a revolving door of mental health conditions. Presumably your results are fantastic?

Wayne: I encourage people to actually go on to the pain recovery program website and read the success stories. Because those success stories are as a person's finished the program we put their feedback on. They're all very heartwarming to read but one of the recent ones was a guy that came to us. He had to sell his car to do the program. He's in a wheelchair and when they completed the program he sent us a video of him back squatting 200 kilograms from a guy from a guy that came to us in a wheelchair and those are the sort of heartwarming things that you really think to yourself this works.

Charlie: People need to hear that it can be better right you there can be less pain in your life

​

Charlie: I think it's really interesting that not only have you built the pain service but you've now started looking at okay what could be the newer interventions that could help. You're a big interest in psychedelics, in ketamine assisted therapies, in cannabis assisted therapies. It's quite a new niche that everyone's got a lot of interest in, but it's got some really interesting emerging results.

Wayne: It's amazing because I've been a psychiatrist now for 30 years and in my career there's not been one new psychiatric drug brought to market, not one. I think the first antidepressants were discovered in about 1957 but when I started out in psychiatry, the new kids on the block with the SSRIs and since then they've tweaked some of the medications venlafaxine and duloxetine and created vortioxetine but there's no new, really new novel drugs bought to market. Probably since the turn of the century the psychedelic renaissance has really started happening. There's been an incredible amount of research that has been done in terms of psychedelic assisted therapy.

And if you only look at other cultures, particularly shamanism and see that they've been using plant based stuff in the proper way for a long, long time, very, very effectively. And that's the key is all of the psychedelics that are coming have got a really bad rep because of the recreational use in the Western world. MDMA, psilocybin, LSD, cannabis, ketamine, all of these have got a very bad reputation. But when used properly and when used in the correct way, they are going to form an enormous part of the future of psychiatry. Since I've been running the ketamine program, I've never seen a medication that is more effective for suicidality than ketamine.

I've saved so many people's lives with ketamine, particularly during lockdown where the only thing that was operating was emergency services. I actually had to phone an anesthetist friend of mine in London. I even say to him, if I actually got this person to you, would you give them intravenous ketamine? Anesthetist use Ketamine every single day as part of general anesthetics because it doesn't cause respiratory depression. It's a very very safe and a very clean drug and he actually phoned me up and said Wayne I just want to check on the dose that you're prescribing because it doesn't seem very big compared to what I normally prescribed as part of a general anesthetic I said no, just give it exactly as i've said a slow intravenous infusion over 40 minutes for somebody who had bipolar disorder.

We know that people with bipolar disorder go depressed very quickly and these are the people that historically you would need to have admitted into hospital and would have got ECT often against their will. Two intravenous sessions of ketamine and she was cured. I'm not saying that psychedelics are the panacea of treatment for everything. I think that they need to be incorporated into our practice but the future of psychiatry is very much going to involved psychedelic assisted therapy. The United States and Australia have just approved psilocybin and MDMA as two drugs. Those are the two that will be coming to the UK next. We tend to follow what's going on around the rest of the world and I think that we'll see psilocybin and MDMA and then subsequent to that, I think many of the others will start to slowly come through things like DMT, things like ayahuasca.

Charlie: Incredibly exciting time when you look at the new medicines that are coming down the pipe, there's obviously new talk therapy treatments, new understanding of psychologies and then exact same time our access to neuroimaging and our understanding of neurobiology is getting exponentially faster as, you know, fMRI and EEG scanners are starting to pick up. Our understanding and treatment, proactive treatment of self will be fascinating. We'll be able to do personalized self intervention.

Wayne: I just read some stuff yesterday on a therapist in the state who are combining EMDR with ketamine. So the traditional therapies that we use and that we know are very good, I think that you're gonna see these combined with psychedelics.

Charlie: ​ I've got two last big questions. The first one is, Wayne, you do a lot of stuff, right? You're running a pain clinic.

You're doing all sorts of interesting things. You're trying to change the world. You're running conferences. And what does Wayne do to look after Wayne these days?

Wayne: I've got a self care routine that I follow every single day. I start my day with that. That's the most important thing. And I think that, everything in life is about connection and everything in life is about relationships. And I think that the most important thing is focusing on those first and foremost.

So I always view things on a day to day basis is first I'm a human, then I'm a husband, then I'm a father and then I'm a doctor and focus on those things in that order. The first three things are the most important. The relationship I have with myself in terms of befriending my autonomic nervous system, the relationship I have with my wife and with my son and with my family, the connection there is the most important thing in the world. Then after that, by being able to nurture, and do those, then I can be a better doctor. I can serve others better. I have to serve myself first. A lot of people might come at it from the perspective of that's selfish. I see it the exact opposite way. It's actually a way of being able to better serve others.

Charlie: I completely agree. Serve yourself, serve the relationships around you and then you serve your positive impact in the world. And if you can build that kind of pyramid structure that you can be very resilient to all sorts of things that life throws at you. So the last big one, we always like to ask people at the end of the podcast, if you were the prime minister of the day, or you had a magic wand or you were the president of the world and you could change one thing that you think would have a positive impact on the mental healthcare system, what would it be?

Wayne: I really do think that we need to target GPs. You have that 10 minute consultation with their patient. There are a couple of blind spots in medicine, okay? And the blind spots in medicine is medically unexplained symptoms, chronic primary pain, over focused ADD that's missed in women, the perimenopause and menopausal time is also blind spots in medicine. I think that if GPs asked the questions, could this be? Just ask that question. Could this be chronic primary pain? Could this be a medically unexplained symptom that's not due to disease process? I think that it would get them curious and it would get them to start viewing things from their own perspective through a different lens. And obviously, if your perception changes, then your perspective changes. It really is about educating, the people that people see the first and that is their GPS. There's far too much medical gaslighting going on in terms of people going back and back and back and GP just putting their hands up and saying it's all in your head kind of thing, which ironically it actually is. That's the biggest irony because all pain actually does stem from the brain's decision on whether or not it's going to send the pain signal, but if there was one thing I could change, it would be about the doctors having a higher index of suspicion and being curious and being open to the fact that we don't know all the answers and we need to look at what other cultures are doing and embrace it. Embrace what other people are doing, because by doing that you're able to have a proper, more holistic approach. And also there's no point in talking the talk unless you walk the walk you've got to do it yourself.

Charlie: Well said curiosity is probably my favorite human trait and so more curious gps is a fantastic way to change the world quickly. It's been fascinating. We could have done two or three more hours. Thank you so much for your time Dr. Wayne Kampers

. Absolutely, my pleasure..

Speaker: ​ Thanks for listening to Self Matters. We've got new episodes out every two weeks, so make sure you hit follow and subscribe so you never miss an episode. You can listen to us on Spotify and Apple Podcasts, and of course watch us on YouTube. As always, head over to our social media channels to find out who'll be joining us in the next episode.

That's all for today though. See you next time.