At least 50 million Americans suffer from chronic pain, according to a 2016 report by the Centers for Disease Control (CDC). This chronic pain can affect everyday living, work and quality of life—especially in the unemployed, disabled and elderly populations. Differing from acute pain, chronic pain can last months and years, altering an individual’s personality, disrupting sleep and interfering with relationships.
Something most don’t realize about pain is that it is not simply a physical aspect: it is also psychological. That doesn’t mean that the pain is “just in your head;” it means that it has psychological, emotional and behavioral effects and can be impacted by those aspects as well, creating a cycle of pain and depression, stress and anxiety, which in turn cause more pain. Because of this mind-body connection, holistic treatments involving psychological principles can be more successful than medical and surgical treatments alone.
What Psychologists Can Help With
Some of the things that accompany pain, like negative emotions, thoughts and behaviors, are psychological issues that can be taught to be self-managed. Additionally, psychologists can help reframe thoughts about pain so that the patient can regain control of their life, accept the pain and cope with it. Though psychologists may not be able to take the pain away, they can lessen the effects it has on a patient’s life and ultimately be safer than surgery and drugs.
Stress and Chronic Pain
The cycle of stress and pain must be stopped to make any headway in alleviating pain. Stress elevates blood pressure; increases risk for heart disease, obesity and diabetes; and induces painful muscle spasms. Managing stress can ultimately improve health and pain, according to the American Psychological Association (APA). Pain management begins with psychologists teaching their patients to manage the negative thoughts and feelings that create stress.
According to the U.S. Department of Health & Human Services, 11.4 million people misuse prescription opioids. Though opioids can be effective in fighting pain, they promote dependency very easily without being as effective in the long term, especially since dosages must be increased as patients develop tolerance. Overall, opioids may dull pain, but patients still suffer from a lower quality of life through their dependence. The APA states that psychologists can help patients overcome opioid dependency with medication-assisted treatment and rehabilitation and overcome pain through therapy that includes cognitive behavioral therapy, motivational interviewing and stress reduction.
Pain Management Psychology Techniques
Psychological treatment for pain is evolving with new information and changing beliefs about pain that point toward psychology and cognition-based solutions. According to a 2018 review in JAMA International, studies indicate that older adults with chronic pain experience small but statistically significant improvements using psychological therapies. More importantly, this can lead to improved pain management treatment for the future. According to American Psychologist, pain management is preferred by adults 65 and older for the minimal risks treatment poses as opposed to surgery and drug treatments.
Cognitive Behavior Therapy (CBT)
CBT has been studied and tested for pain management in multiple contexts, according to a study in NeuroImage: Clinical, and is becoming a mainstream treatment. In CBT, psychologists work with patients to reshape negative thoughts, feelings and behaviors regarding pain into thoughts, feelings and behaviors that work to accept and properly cope with existing pain in a safe and successful way. For example, patients may mistakenly believe they are weak and become afraid to move; however, exercise and movement are often encouraged to help pain and to help patients live regularly despite it.
Mindfulness & Relaxation Training
Being mindful of your body is essential to understanding pain. Realizing that pain can come from tension, repeated behavior and even moods can help patients reduce and manage their pain. Practicing meditation and breathing exercises can aid in pain management by making patients more self-aware of psychological and physiological factors. Psychologists can teach patients exercises that promote relaxation like diaphragmatic breathing, progressive muscle relaxation and autogenic training, which requires repeating a positive phrase, concentration, visualization and deep breathing.
This treatment requires patients to use sensors that detect and track bodily functions that are associated with stress and pain but has results similar to meditation and relaxing. Biofeedback allows individuals to see how they can control tensions in their body by focusing on relaxing specific areas. By understanding the correlation between tension and pain, patients can develop ways of reducing pain in pinpointed areas. This treatment is especially useful for headaches and migraines, according to the Australian Pain Management Association.