Helping people deal with chronic pain is one of the many services provided by a psychotherapist. In fact, there are some therapists who specialize in the treatment of chronic pain.
As a practicing pain psychologist for the past 24 years, I understand the role psychotherapy can play in treating chronic pain. I’m aware of the value of pain medication in treating pain, but psychological and social factors also need to be addressed.
When is the best time for a health care provider to consider the psychological and social aspects of chronic pain? When they’re considering treatment options prior to beginning treatment.
Having a good understanding of the psycho-social aspects of pain helps providers in a few different ways:
- Gives them insight into how people are likely to respond to various pain treatments
- Gives them an idea of who may be at risk for developing problematic behaviors with pain medications
- Gives them some alternatives to consider when the patient is experiencing minimal treatment progress or developing a sense of hopelessness about the pain
Here are some ideas I often share with chronic pain sufferers:
- Your chronic pain experience is a combination of biological, psychological and social factors — and it can be decreased by addressing any one or a combination of those elements.
- Your brain is not a passive recipient of pain. There are various ways patients can influence their experience of pain.
- Psychological and social interventions may reduce pain and the effect it’s having on your life.
- Information like this is especially important to keep in mind considering the opioid epidemic that’s sweeping the country. Ninety-one Americans die every day from an opioid overdose (including heroin and prescription opioids).
- According to the Centers for Disease Control, doctors need to communicate with patients about safe and effective pain management, including opioid use. Here are some key points from a CDC fact sheet on this topic:
- Opioids can reduce pain in the short term, but there’s not enough evidence to suggest that opioids control chronic pain long term.
- Non-opioid treatments, including non-opioid medications and cognitive behavioral therapy, can be effective in relieving pain with less risk. In a column in Blue Cross Blue Shield of Michigan’s Hospital and Physician Update newsletter, I provided some examples of non-opioid treatments, and would like to share them here.
Examples of psychological approaches
- Relaxation training
- Mindfulness exercises
- Cognitive restructuring
- Addressing barriers to physical activity
- Addressing emotional reactions to pain
- Improving the patient’s understanding of how the mind and body are interconnected
Examples of social approaches
- Re-engagement in social activities and support systems
- Increased involvement in family life
- Volunteer work
- Return to work
While the approaches selected by a psychotherapist need to be individualized to fit the needs, values and perspectives of the patient, efforts such as these can be effective as they shift the focus away from the pain toward improving the quality of life. And when the quality of life improves, so does the pain experience.
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