Typically, Chronic Pain Syndrome patients come to see a psychologist after being seen by a number of other health professionals to no avail, including internal medicine physicians, orthopedists, surgeons, orthopedic surgeons, neurosurgeons, physical therapists, chiropractors, acupuncturists, emergency room doctors (for late-night injections of powerful pain killing drugs) and others. Typically, a Chronic Pain evaluation consists of several approaches to discovering which factors play the largest role in maintaining the pain. We ask patients to keep a Pain Diary for a week or two, which helps us pinpoint which activities or emotional states are related to an increase in pain level. This also helps us observe how they are actually taking their medications. We may also perform psychological testing to determine any underlying causes of depression or anxiety which should be treated in addition to the Chronic Pain and which could be helping to maintain it. At least one Family Session is held to explore whether there have been unconscious payoffs within the family for being in pain.