John Graham is regarded as the father of headache medicine in this country. The words he wrote more than half a century ago have not lost their importance, despite the many breakthroughs in headache treatments of the last 20 years

How to Progress to Successful Independent Self-Care

'Ten Commandments of Migraine Prevention'

Created by the “father of headache management,” John R. Graham, (1909-1990)
Provided by Egilius L.H. Spierings, MD PhD; Harvard Medical School; Headache 2002; 42: 152-153

I. At present, there is no magic medicine or formula of treatment that universally “cures” headache.

II. The patient is not to “blame” for having inherited migraine predispostion.

III. The pain and misery of the migraine attack are very real and not “imaginary,” but this biology is strongly influenced by psychosocial influences.

IV. Neither the patient, doctor, nor patient’s spouse should be intolerant, but rather all should work for a better understanding of one another.

V.    The patient and the family have the greater burden in therapy, with the doctor to serve as a friendly guide rather than as a “miracle man.”

VI. The management program will require changes in thinking, behavior, exercise and probably medication over a considerable period of time, with frequent reviews of progress, temporary setbacks, changes in therapy, and re-education. 

VII. The most rewarding long-term therapy will result from an adjustment in patient’s means of living within his or her capacities, rather than an endless round of medication.

VIII. The patient cannot be expected to make all the necessary adjustments overnight, but is expected to continually strive to promote change.

IX.  Changes in psychological attitudes (thought processing) and stress responses become real only through actual practice, not through repetitive verbal instruction or admonition.

 X. There is definite hope for improvement through conscientious effort by both patient and physician, but any therapeutic program rarely achieves complete freedom from migraine.

Used with permission of Frederick R. Taylor MD. - Park Nicollet HeadacheCenter