What do psychologists do to treat chronic pain?
Chronic pain is a type of health disorder in which the pain lasts for a long time (months or years), or even never goes away. In turn, the persistence of this unpleasant sensation is capable of generating the appearance of other forms of discomfort and health problems; above all, anxiety and mood disorders.
In this article we will know the fundamental characteristics of chronic pain and its associated psychological treatment , that is, what psychologists do to limit the discomfort that this disorder generates.
What is chronic pain?
Pain can be classified into two main categories. On the one hand there is the acute pain, which informs us that there has been recent damage to one or more tissues in the body, and which disappears over days or weeks.
On the other hand, there is the chronic pain, which persists most of the time for periods longer than 3 months .
This last form of discomfort, in turn, can be divided into chronic neuropathic pain, in which there is no problem beyond the nervous system that can explain the pain, and chronic nociceptive pain, in which a mechanism is known by which the cells that receive painful stimuli are activated, but these persistent processes cannot be stopped and are likely never to disappear completely.
Thus, chronic pain is a type of pain that goes from being a symptom to being a disorder in itself, because although on most occasions pain has the adaptive function of warning us that something is wrong with our body, in this case the inconveniences far outweigh the possible biological utility (sometimes non-existent, as in the case of neuropathic pain) that this warning signal provides.
One of the characteristics of chronic pain that make it a very complex phenomenon is that its causes can be very variable , and it is possible to attribute the problem to alterations of the nerves, the spinal cord or even the brain. That is, its appearance can be due to dysfunctions in almost any stretch of the pain perception route, from nociceptors to the integration of pain perception in the brain.
What is clear is that chronic pain often occurs in the absence of damaged body tissue , so it is not a useful warning signal for the body, as it is not evidence that there is something wrong beyond the pain itself.
In other cases, chronic pain arises as a consequence of a chronic disease or whose main cause is not completely eliminated because it is not possible with the available technology or is too risky. The latter is often the case with certain types of tumours.
Psychologists and the Psychological Treatment of Chronic Pain
These are some of the most used strategies in patients with chronic pain, when they go to the psychologist.
1. Cognitive-behavioral therapy
When offering psychological treatment for chronic pain, it is not only the way in which the pain is perceived in the here and now that needs to be addressed; it is also the fact that this health disturbance can favour the emergence of psychological disorders linked to anxiety and depression.
The professionals of the Institute of Psycho-psychology , with presence in Madrid and Alicante, point out that the adoption of bad habits of life unleashed by the bad management of these emotions on the part of the patients can increase the intensity and duration of the pain, and that therefore it is necessary to avoid the problem from worsening by training the person to live with this type of stimuli.
For example, chronic pain has been shown to be associated with a somewhat higher rate of heart disease, possibly as a result of the challenge of dealing with high amounts of stress and the lifestyles to which this anxiety or distress can give rise (binge eating, sedentary living, etc.).
Thus, Psicode points out that it is important to get patients to adopt patterns of behaviour and ways of perceiving chronic pain that do not lead to a loss of control over one’s health.
To do this, we work with the ideas of patients through cognitive restructuring, questioning those ideas that are not realistic and encouraging the emergence of other more constructive ideas.
In addition, with regard to the behavioural part, the maintenance of routines of interaction with the environment that are stimulating and absorbing is favoured, so that not all the subjective experience of the subject revolves around the pain.
2. Acceptance and Commitment Therapy
Pain is not a phenomenon that we perceive as passive subjects, but rather part of its qualities as a subjective experience are given by the ideas that we associate with these stimuli .
Acceptance and Commitment Therapy, by focusing on the idea that we should not eliminate everything imperfect in our lives but that in many cases we should accept a certain level of imperfection , helps to integrate pain into the consciousness by limiting its harmful potential. In Psicode we are reminded that, although it is paradoxical, giving much importance to not feeling any kind of discomfort in the here and now is, in cases of chronic pain, part of the problem.
In psychological therapy there are a series of tools aimed at training patients in the management of their attention focus . The level of pain in the face of the same stimulus arriving through a nerve can vary greatly depending on what we do with our attention processes.
Mindfulness is one of the most widely used resources at the Institute of Psycho-psychology, and it helps to ensure that pain is not an obsessive source of attention that leads a person to “get hooked” on that discomfort. In this way, it is possible to value more other elements that are also present in the conscious experience and that are of a much more neutral or positively stimulating character.
- Elkins, Gary; Johnson, Aimee; Fisher, William (2012). Cognitive Hypnotherapy for Pain Management. American Journal of Clinical Hypnosis. 54 (4): 294–310.
- Jensen, M.P.; Sherlin, L.H.; Hakiman, S.; Fregni, F. (2009). Neuromodulatory approaches for chronic pain management: research findings and clinical implications. Journal of Neurotherapy. 13 (4): 196–213.
- Leo, R. (2007). Clinical manual of pain management in psychiatry. Washington: American Psychiatric Publishing.
- Moore, R.A.; Derry, S.; Aldington, D.; Cole, P.; Wiffen, P.J. (2015). “Amitriptyline for neuropathic pain in adults.” Cochrane Database Syst Rev. 7 (7): CD008242.