Medicine:Pain psychology

Pain psychology is a specialty in the field of clinical psychology focused on the treatment of pain. It is the study of psychological and behavioral processes in chronic pain. Pain psychology involves the implementation of treatments for chronic pain, which include traditional therapeutic techniques (e.g. active listening, reflection, empathy) and behavioral techniques like guided imagery or meditation. Pain psychology can also be regarded as a branch of medical psychology, as many conditions associated with chronic pain have significant medical outcomes.

Mental health-related difficulties can arise as a result of pain, or can pre-exist and worsen during the course of chronic pain, thus causing one to seek out or be referred by the patient’s healthcare provider for pain-relief treatment. Pain psychology aims to treat the person in pain rather than strictly the pain itself. A pain psychologist’s job is to work with the mental health issues that can be feeding into the physical pain that the patient is experiencing, and help them manage and reduce the effect it has on their lives.

Pain psychotherapy has helped reduce patients’ pain, increased the contentment of their lives, and has lowered the pain medication intake. An example of this presents itself in a study that was conducted on a group of workers in 1998 with chronic pain issues, and once they went through psychotherapy treatment, it resulted in decreased levels of depression and other conflicts, along with better control of their lives. What is learned from the therapy sessions can become useful tools for patients to use for future conflicts with chronic pain due to injury and/or a surgical procedure.

According to the American Psychological Association (APA), when chronic pain patient goes for treatment from a pain psychologist, they are asked various questions about their mental and physical health, their concerns about the pain they are experiencing, and a questionnaire may follow to keep track of any other information that may be needed to take note of. Once this initial process is done, a treatment plan is made specifically to meet the needs of the patient. Various treatments include cognitive-behavioral therapy (CBT), acceptance and commitment therapy, mindfulness training, meditation and relaxation therapies, and chronic pain rehabilitation programs .  To look at these various treatments more in-depth, Practical Pain Management.com’s The Role of Psychology in Pain Management article lists the many treatments that go hand-in-hand with CBT:

1. Biofeedback and relaxation training (e.g., diaphragmatic breathing, progressive muscle relaxation, autogenic training, self-hypnosis, guided visual imagery) to reduce muscle tension and promote the body’s calming response
2. General stress management techniques (e.g., time management, problem-solving skills, assertive communication)
3. Health promotion (e.g., nutrition and exercise, sleep hygiene)
4. Anger management skills training
5. Increasing understanding of personality style and its contribution to the pain experience
6. Activity pacing and reducing fear of pain and/or activity avoidance
7. Increasing acceptance of the chronic nature of pain condition
8. Reinforcement (i.e., “operant”) techniques to increase adaptive behaviors and decrease maladaptive pain behaviors
9. Cognitive approaches to manage clinical depression and anxiety disorders
10. Cognitive approaches to foster thoughts, emotions and actions that are adaptive for managing a life with pain

The longevity of seeking pain psychotherapy varies from patient to patient. Some who are experiencing severe psychological issues alongside their medical issues may need to stay in therapy for a little bit longer. It is up to the patient and the psychologist to discuss how extensive the treatment needs to be.

• Pain management
• Psychogenic pain
• Pain Catastrophizing Scale

External links

• Science Advances in Pain Research
• How psychologists can help with pain management
• The Psychology of Pain