What do psychologists do to treat chronic pain?

How can psychotherapy help patients with 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 disappears. 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 learn about the fundamental characteristics of chronic pain and its associated psychological treatment, i.e. what chronic pain sufferers do to treat it.The psychologists do to limit the discomfort that generates this alteration.

What is chronic pain?

Pain can be classified into two main categories. On the one hand, there is acute pain, which informs us that there has recently been damage to one or more tissues of the organism, and which disappears over the course of days or weeks.

On the other hand, there is chronic pain, which persists for most of the time for periods of more 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 there is a known mechanism by which the cells that receive painful stimuli are activated, but these persistent processes cannot be stopped and will probably never 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 alerting us that something is wrong with our body, in this case the disadvantages far outweigh the possible Biological usefulness of pain. (sometimes non-existent, as in the case of neuropathic pain) that this warning signal provides.

Causes

One of the characteristics of chronic pain that make it a very complex phenomenon is that its causes can be very variable. its causes can be very variableIt is possible to attribute the problem to alterations of the nerves, the spinal cord or even the brain. In other words, its appearance may be due to dysfunctions in almost any part of the pain perception pathway, from the nociceptors to the integration of pain perception in the brain.

What is clear is that chronic pain often results from in the absence of a body tissue that is damagedIt is therefore not a useful warning signal to 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 one whose root cause is not completely eliminated because it cannot be eliminated with the available technology or it is too risky. The latter is often the case with certain types of tumors.

Psychologists and the psychological treatment of chronic pain

These are some of the strategies most commonly used in patients with chronic pain when they go to a psychologist.

1. Cognitive-behavioral therapy

When it comes to offering psychological treatment for chronic pain, it is not only the way in which pain is perceived in the here and now that must be addressed; it is also necessary to deal with the fact that this health alteration can favor the appearance of psychological disorders linked to anxiety and depression.

The professionals of the Psychology Institute Psicodewith a presence in Madrid and Alicante, point out that the adoption of bad lifestyle habits triggered by poor management of these emotions by patients can increase the intensity and duration of pain, and that it is therefore necessary to prevent the problem from worsening by training the person to coexist with this type of stimuli.

For example, chronic pain has been found 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 that this anxiety or distress can lead to (binge eating, sedentary lifestyle, etc.).

Thus, at Psicode they point out that it is important to get patients to adopt behavior patterns and ways of perceiving chronic pain that do not lead to a loss of control over one's own health. over their own health.

To this end, they work with patients' ideas through cognitive restructuring, questioning those ideas that are unrealistic and encouraging the emergence of more constructive ones. In addition, with regard to the behavioral part, the maintenance of routines of interaction with the environment that are stimulating and absorbing is favored, so that not all of the subject's subjective experience revolves around pain.

2. Acceptance and Commitment Therapy

Pain is not a phenomenon that we perceive as passive subjects, but as a subjective experience. 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 not everything imperfect in our lives must be eliminated, but that in many cases we must accept a certain level of imperfection. accept a certain level of imperfectionhelps to integrate pain into consciousness by limiting its harmful potential. Psicode reminds us that, although it may seem paradoxical, giving great importance to not feeling any kind of discomfort in the here and now is, in cases of chronic pain, part of the problem.

Mindfulness

In psychological therapy there is a series of tools oriented to train patients in the management of their attentional focus. The fact is that the level of pain before the same stimulus that arrives through a nerve can vary greatly depending on what we do with our attentional processes.

Mindfulness is one of the most widely used resources at the Psicode Institute of Psychology, and helps to ensure that pain is not an obsessive source of attention that leads the person to become "hooked" on this 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.

Bibliographical references:

• 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.