What psychological therapies can help chronic pain patients?

What psychological therapies can help chronic pain patients?

Imagine having constant pain for more than 3 months . Do you think it would affect your mood? Do you think psychological therapy could help you?

The Malaga psychologist Ana Claudia Alda, from the cabinet Psychologists Malaga PsicoAbreu, informs us about how Psychology can help people who suffer from chronic pain.

What is chronic pain? Psychological consequences

Chronic pain is pain that lasts more than 3 months and is associated with some chronic disease (osteoarthritis, fibromyalgia, etc.). This type of pain is a stressful experience for the person who suffers it, therefore, the person suffers changes on a psychological level:

  • Emotional area . Emotions such as fear or anxiety appear in this situation. Fear begins to develop due to the appearance of pain and anticipatory anxiety is experienced. It is common for sadness to appear because of the situation experienced.

  • Cognitive area . There are cognitive patterns that are common to the patient with chronic pain present and that, in addition, increase and maintain the pain. The catastrophic interpretation of pain and its consequences, the unrealistic expectations about the progression of pain or disease and the belief that it is appropriate to avoid activity in order to reduce the possibility of pain are some of the cognitions involved in the maintenance of pain.

  • Behavioral area . One of the most frequent responses to chronic pain is avoidance. The person avoids situations or behaviours because he thinks that if he does them the pain will increase. This implies a total deactivation of the person, a decrease in pleasant activities and the weakening of the muscles.

Effects on the social and labor level

The person also suffers changes in the family, social and work areas . Faced with a situation such as chronic pain, it is to be expected that the social and family life of the person suffering from it will be modified: decrease in activities, feeling of incomprehension by others, etc.

Similarly, it is common for the person to have to stop working or reduce working hours. The person feels that he or she is no longer useful, that he or she is not as valid as before, and these changes also influence the economic environment. All of these become stressful factors that increase the person’s emotional discomfort and pain.

What is the role of psychotherapy?

This medical problem is approached from the biopsychosocial model . This model establishes that not only medical or biological variables must be considered, but also other variables such as psychological and social ones play a great role in the modulation of pain. Thus, it is established that the best way to work in these cases is with a multidisciplinary intervention, including psychology.

As psychologist Ana Claudia Alda has previously commented, chronic pain causes changes on a psychological level (emotional, cognitive and behavioural) that can maintain or increase pain. The role of psychotherapy is to help the person adapt to this new situation through effective coping strategies such as active coping or acceptance.

What psychological interventions are used in chronic pain?

The psychological intervention that has been classically used in chronic pain to achieve the adaptation of the person has been the Cognitive-Behavioral Therapy.

However, in recent years another approach has appeared that is beginning to be evident in this area, namely Acceptance and Commitment Therapy.

1. Cognitive-Behavioral Therapy

From this perspective, we work on the understanding of how dysfunctional thoughts and beliefs affect emotions and behaviours that appear in the face of pain.

They seek to change or modify maladaptive beliefs and thoughts and train the person in adaptive behaviors in coping with pain through the use of techniques such as: cognitive restructuring, relaxation, behavioral exposure, communication skills training and problem solving.

2. Acceptance and Commitment Therapy

This type of approach focuses on the acceptance of pain in order to change behavioral avoidance patterns . The therapist exposes the person to acceptance as a form of active coping, which allows involvement in life goals outside the realm of pain.

In this way, we would enter the field of commitment. The goal is for the person to have a meaningful, committed life, even though pain, negative thoughts and unpleasant emotions are present. It is common to use metaphors that facilitate the understanding of what is happening.

In addition, behavioral and relaxation techniques are used as in Cognitive-Behavioral Therapy such as improving communication skills, training in problem solving and progressive relaxation.

Bibliographic references:

  • Esteve, R. and Ramirez C. (2003). The challenge of chronic pain. Málaga: Aljibe.
  • González, M. (2014). Chronic pain and psychology: update. Rev. Clin. Condes, 25(4), 610-617.

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