The psychology
of pain

An important part of any pain treatment is the realization that pain is not what defines you as a person, rather what you make of yourself despite it.

The psychology
of pain

An important part of any pain treatment is the realization that pain is not what defines you as a person, rather what you make of yourself despite it.

Anyone suffering from chronic pain can attest that it affects every aspect of his or her life. Existing research has well established that persistent pain interferes in four predominant areas. It can affect:

Mood

Memory & Concentration

Interpersonal Relationships

Sleep

With these four major areas being affected, it is no wonder that as many as half of all individuals who suffer from chronic pain also have recurrent depression1. Although more attention has been placed on helping patients lower their pain as well as diagnosing and treating depression, little focus has been given to addressing the medical and societal attitudes, behaviors, and stressors that promote hopelessness within the chronic pain community today. It is understandable then why some pain patients have a fear of being judged negatively, experience mental defeat, and have higher levels of shame and guilt than people who are healthy due to a medical community that has stigmatized them for using opiates as one treatment modality2.

This is not to say that the war on opiates does not have a place, but to brand and tarnish a whole group of sufferers has a psychological impact. To avoid feeling victimized, chronic pain patients have a role to play in acting as an “equal partner” with their medical practitioner by sharing such concerns.

Let’s face it, being a chronic pain patient is a long-term slog measured in years, not days or weeks. The quality of your life and your emotional well-being is tied to how well your loved ones understand your pain over time.

To have them empathize with your pain, it must be verbalized, physical limitations need to be mutually understood, emotions and feelings expressed, and a partnership developed with your loved ones. If this does not come naturally, psychologists versed in pain management can create a bridge via counseling.

No pain patient is an “island unto themselves,” and you often need loved ones to act as advocates and problem-solvers during times when you don’t have the inner resources to confront problems. While communication with your loved ones is vital in staying emotionally healthy, there are other psychological techniques that can help. A couple of which are shared below.

 

Christopher L Hayes PHD. 

Co-Founder of Frame 

With these four major areas being affected, it is no wonder that as many as half of all individuals who suffer from chronic pain also have recurrent depression1. Although more attention has been placed on helping patients lower their pain as well as diagnosing and treating depression, little focus has been given to addressing the medical and societal attitudes, behaviors, and stressors that promote hopelessness within the chronic pain community today. It is understandable then why some pain patients have a fear of being judged negatively, experience mental defeat, and have higher levels of shame and guilt than people who are healthy due to a medical community that has stigmatized them for using opiates as one treatment modality2.

This is not to say that the war on opiates does not have a place, but to brand and tarnish a whole group of sufferers has a psychological impact. To avoid feeling victimized, chronic pain patients have a role to play in acting as an “equal partner” with their medical practitioner by sharing such concerns.

Let’s face it, being a chronic pain patient is a long-term slog measured in years, not days or weeks. The quality of your life and your emotional well-being is tied to how well your loved ones understand your pain over time.

To have them empathize with your pain, it must be verbalized, physical limitations need to be mutually understood, emotions and feelings expressed, and a partnership developed with your loved ones.

If this does not come naturally, psychologists versed in pain management can create a bridge via counseling. No pain patient is an “island unto themselves,” and you often need loved ones to act as advocates and problem-solvers during times when you don’t have the inner resources to confront problems. While communication with your loved ones is vital in staying emotionally healthy, there are other psychological techniques that can help. A couple of which are shared below.

Christopher L Hayes PHD.
Co-Founder of Frame 

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Managing your pain

Despite the advances in pain management over the past 150 years, only 25% of patients with chronic pain feel better after 1 year of treatment3. Based on this discouraging finding, pain management professionals are encouraging a multi-disciplinary approach to address chronic pain.

One of these approaches from the field of psychology is called Guided Imagery or Mindful Meditation. Although more research on its benefits needs to be conducted, pain management specialists view it as a promising intervention.

Guided Imagery

In its most simplistic form, guided imagery is a technique that redirects thoughts away from pain through visualizing a calming scene or relaxing situation. One of the primary reasons it helps in reducing pain is that you are immediately introducing a visual modality that relaxes muscles and reduces stress and anxiety, which are hallmarks in the pain process. Put a different way, pain triggers the “fight or flight” response in many patients.

When this response occurs repeatedly, a patient’s mind and body become overly sensitive to pain. With guided imagery we change the “fight or flight” to a more calming meditative bodily state that lowers breathing, relaxes muscles, and quiets the mind via memories associated with positive feelings. Many pain practitioners now recommend guided imagery as one critical tool in lowering a patient’s pain level.

Mindful Engagement

Mindful Engagement means to stay actively engaged in all aspects of your life and encourage hopefulness. As stated earlier, depression and disengagement are a profound problem among chronic pain patients. It is so easy to allow your pain to increase in size and influence so that it drives your goals, activities, and life aspirations. An important part of any pain treatment is the realization that pain is not what defines you as a person, rather what you make of yourself despite it.

Mindful Engagement is a commitment to stay active and refusing to allow yourself or others to label you as ‘disabled’ or ‘limited’ (one can acknowledge their physical limitations without giving up the desire to become self-fulfilled). This is not easy to do because there are so many societal traps that encourage defining you based on a medical diagnosis. With the right kind of psychological treatment and support, your life can be as fulfilling and engaging as you want it to be…. it’s your choice.

The Future

A short article of this type cannot possibly cover all the advances currently underway in the field of psychology that can help a chronic pain sufferer. Biofeedback, hypnosis, lifestyle enhancements, and transcutaneous electrical nerve stimulation (TENS) are all demonstrating merit in reducing pain. In fact, studies have found that some psychotherapy techniques can be as effective as surgery for relieving chronic pain by altering how the brain processes pain signals4.

It is incumbent on a pain sufferer to continue educating oneself on what the field of psychology has to offer. By continuing your education in this area, you will lessen your pain, enhance your well-being, and derive more control in your life.

*The viewpoints expressed in this article are solely those of the author and do not represent the viewpoints of the Foundation for Research and Advocacy for Muscle Pain Education (FRAME).

References

1 Jacques, E. (2019, November 30). The Link Between Depression and Chronic Pain. Retrieved from https://www.verywellhealth.com/depression-and-chronic-pain-2564443.

2 Turner-Cobb, JM., Michalaki , M., & Osborn, M. (2015). Self-conscious emotions in patients suffering from chronic musculoskeletal pain: a brief report. Psychology & Health30(4), 495–501.

3 McAllister, MJ. (2015). What is Chronic Pain: Types of Pain. Retrieved from http://www.instituteforchronicpain.org/understanding-chronic-pain/.

4 Bruns, D., & Kerns, R. (2013, December). Managing Chronic Pain: How psychologists can help with pain management. American Psychological Association.