What psychological therapies can help patients with chronic pain?

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

Malaga psychologist Ana Claudia Alda, from the Malaga psychology practice PsicoAbreu, explains how psychology can help people with chronic pain.

    What is chronic pain? psychological consequences

    Chronic pain lasts more than 3 months and is associated with certain chronic diseases (osteoarthritis, fibromyalgia, etc.). This type of pain is a stressful experience for the person suffering from it, therefore the person undergoes changes at the psychological level:

    • emotional zone. Emotions such as fear or anxiety appear in this situation. Fear of the onset of pain begins to develop and anticipatory anxiety is felt. Sadness about the situation is also common.

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

    • behavioral zone. One of the most common responses to chronic pain is avoidance. The person avoids situations or behaviors because they think that if they do, the pain will increase. This implies a total deactivation of the person, a decrease in pleasant activities and a weakening of the muscles.

    Social and labor effects

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

    Likewise, it is common for the person to have to stop working or reduce their working hours. The person feels that he is no longer useful, that he is no longer as valuable as before and, moreover, these changes influence the economic sphere. All of this becomes stressful factors which increase the emotional distress and pain of the person.

    What role does psychotherapy play?

    The approach to this medical problem is based on the biopsychosocial model. This model states that not only medical or biological variables need to be addressed, but other variables such as psychological and social variables also play a major role in the modulation of pain. Thus, it is established that the best way to work in these cases is with multidisciplinary intervention, including psychology.

    As discussed above by psychologist Ana Claudia Alda, chronic pain causes changes at the psychological level (emotional, cognitive, and behavioral) that can maintain or increase pain. The role of psychotherapy is to help the person adjust to this new situation through effective coping strategies such as active adaptation or acceptance.

    What psychological interventions are used in chronic pain?

    The psychological intervention that has traditionally been used in chronic pain to achieve individual adjustment has been cognitive behavioral therapy.

    However, in recent years, another approach has emerged that is starting to have evidence in this area, and that is acceptance and engagement therapy.

    1. Cognitive behavioral therapy

    From this perspective, work to understand how dysfunctional thoughts and beliefs affect emotions and the behaviors that appear in the face of pain.

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

    2. Acceptance and commitment therapy

    This type of approach focuses on accepting pain to change behavioral avoidance patterns. The therapist exposes the person to acceptance as a form of active adaptation, which allows one to become involved in vital 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 and engaged life, even if pain, negative thoughts and unpleasant emotions are present. The use of metaphors to make it easier to understand what is going on is common.

    In addition, behavioral and relaxation techniques such as cognitive behavioral therapy are used to improve communication skills, problem-solving training, and progressive relaxation.

    Bibliographical references:

    • Esteve, R. and Ramírez C. (2003). The challenge of chronic pain. Malaga: Aljub.
    • González, M. (2014). Chronic pain and psychology: update. Tower. Med. Clin. Accounts, 25 (4), 610-617.

    Leave a Comment