How is psychological intervention used to manage chronic pain?

These are the most commonly used forms of psychological intervention for cases of chronic pain.

The existence of Pain is part of an evolutionary mechanism that allows us to react quickly when something goes wrong with our health. In fact, it is so useful that all vertebrate animals and a good part of invertebrates have the capacity to feel it, and people with pathologies that prevent them from feeling pain are at a much greater risk of further compromising their physical integrity.

However, in the same way that the parts of the body responsible for the sensation of pain can be affected by a disease that suppresses it, the opposite case can also occur: that due to an alteration, the pain is practically constant, without there being an element that is damaging the cellular tissues of the body or without being able to do anything to remedy the problem that generates it. In such situations we speak of chronic painIn this article we will see how it is approached in psychotherapy.

What is chronic pain?

Chronic pain is the subjective and localized perception of a more or less intense pain that is maintained in a relatively constant way beyond the time of cureIt can last weeks, several months or even years.

The causes of this alteration can be infections, by subjecting certain nerves to pressure or pinching (for example, due to a tumor or an operation with complications) associated with chronic pathologies, or it can be neuropathic, which occurs when the problem is the functioning of the nervous system itself.

These sensations of discomfort can present themselves through various subjective experiences: from prickling, to tingling, burning, or a deep pain that affects more or less large areas of the body. Likewise, these symptoms can vary in a matter of hours and intensify under certain conditionsThe symptoms can also vary in a matter of hours and intensify under certain conditions: for example, on days of increased physical activity or at times when the person cannot stop thinking about his or her own pain.

Techniques of psychological intervention in chronic pain

Since the sensation caused by pain varies from one person to another, psychological interventions must always be adapted to the needs of each patient and the type of discomfort he or she is experiencing. But going beyond individual cases, there are a number of therapeutic procedures that have been statistically shown to be effective for chronic pain.. We will see them below.

1. Relaxation techniques

Relaxation techniques aim to reduce the person's levels of tension, stress and anxiety, and allow the focus of attention to be shifted beyond the discomfort.

This type of procedure are based on the assumption that pain is increased by anxiety, stress and excessive activation of the person's body, both at the cardiac and cardiac levels.The pain is caused by anxiety, stress and excessive activation of the person's body, both at the cardiac level and in the levels of general tension.

2. Biofeedback

Biofeedback consists of creating a context in which the patient can obtain information in real time about his level of activation (thanks to sensors applied on his skin), especially regarding his nervous activity. (thanks to sensors applied to their skin), especially in relation to their nervous activity.

This allows the person with chronic pain to incorporate a series of useful strategies for emotional management and regulation of certain physiological processes; in this way, he/she is able to normalize the altered activation and physiological regulation systems.

3. Hypnosis

Clinical hypnosis is another of the psychological therapies that have demonstrated positive effects in managing and mitigating chronic pain. It is a procedure based on suggestion and the establishment of a state of consciousness similar to that which appears just before sleep, which allows to abstract from the discomfort and direct the mind to other sources of stimulation.

4. Mindfulness

Mindfulness is a series of practices that favor the emergence of a psychological state known as Mindfulness, which allows us to let go of intrusive thoughts and emotional dynamics that perpetuate discomfort.which allows us to let go of intrusive thoughts and emotional dynamics that perpetuate discomfort. It is inspired by Vipassana meditation.

5. Techniques linked to the cognitive-behavioral model and ACT

Chronic pain is often linked to psychological problems that go beyond the pain itself and take the form of anxiety and depressive symptoms; both sources of discomfort reinforce each other. For this reason, in therapy we also work to weaken the alteration due to its purely emotional facet and associated with certain beliefs and feelings about oneself and the disease one is suffering from.

Cognitive-behavioral therapy is one of the most widely used by psychologists.Its application combined with an appropriate medical treatment has proven successful in effectively reducing the pain of the person and the negative moods that cause it. It consists of a modification of belief systems, thought patterns, thoughts and habits that without us realizing are reinforcing and perpetuating the disorder that affects us.

Acceptance and Commitment Therapy, or ACT (Acceptance and commitment therapy) is part of the contextual therapies, which in turn are based on the cognitive-behavioral model. This is based on the importance of not adopting behavioral patterns associated with the avoidance of discomfort at all costs, since this strategy gives rise to the paradoxical effect of paying more attention to what makes us feel bad. Thus, it proposes ways to accept the existence of physical and/or emotional pain, at least to some extent, so that the rest of the experiences and sensations of everyday life take the spotlight off it and favor its mitigation.

Are you looking for treatment for chronic pain?

If you are interested in starting a therapy process for chronic pain, please contact our team of professionals. In Cribecca Psychology we have many years of experience addressing this kind of disorders and psychopathologies associated with it. We offer face-to-face sessions and also in the format of online therapy.

Bibliographical references:

• IsHak W.W.; Wen, R.Y., Naghdechi, L.; Vanle, B.; Dang, J.; Knosp, M. et al. (2018). Pain and Depression: A Systematic Review. Harvard Review of Psychiatry, 26(6): pp. 352 - 363.
• Main, C.J.; Spanswick, C.C. (2001). Pain management: an interdisciplinary approach. New York: Elsevier.