What do psychologists do to treat 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; especially anxiety and mood disorders.

In this article we will know the fundamental characteristics of chronic pain and its associated psychological treatment, that is, what psychologists do to limit the discomfort generated by this alteration.

• Related article: "The 13 types of pain: classification and characteristics"

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 body, and that it disappears over days or weeks.

On the other, there is chronic pain, which persists for most of the time for periods greater than 3 months.

This last form of discomfort, in turn, can be divided into chronic pain of the neuropathic type, in which there is no problem beyond of the nervous system that can explain pain, and chronic nociceptive pain, in which a mechanism is known by which cells receptors of painful stimuli are activated, but these persistent processes cannot be stopped and they will probably never disappear from the everything.

Thus, chronic pain is a type of pain that goes from being a symptom to being a disorder in itself, because although in the Most of the times, pain has the adaptive function of warning us that something is wrong in our body, in this case drawbacks far outweigh possible biological utility (sometimes non-existent, as in the case of neuropathic pain) that provides this alert signal.

Causes

One of the characteristics of chronic pain that makes it a very complex phenomenon is that its causes can be very variable, and it is possible to attribute the problem to alterations of the nerves, the spinal cord or even the brain. That is, its appearance can be due to dysfunctions in almost any section of the route of the pain perception, from nociceptors to the integration of pain perception in the brain.

What is clear is that chronic pain often occurs in the absence of a damaged body tissueTherefore, it is not a useful warning sign for 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 whose main cause is not completely eliminated because you cannot with the available technology or it is too risky The latter is what happens many times with certain types of tumors.

Psychologists and the psychological treatment of chronic pain

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

1. Cognitive behavioral therapy

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

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

For example, it has been seen that chronic pain is associated with a somewhat higher rate of heart disease, possibly a consequence of the challenge that It involves dealing with high amounts of stress and with the ways of life to which this anxiety or anguish can give rise (bingeing, sedentary life, etc.).

A) Yes, in Psicode point out that it is important to get patients to adopt behavior patterns and ways of perceiving chronic pain that do not lead to loss of control on one's own health.

To do this, we work with the ideas of the patients through cognitive restructuring, questioning those ideas that are not realistic and favoring the appearance of more constructive ones. In addition, with regard to the behavioral part, the maintenance of routines of interaction with the environment is favored stimulating and absorbing, so that not all the subjective experience of the subject revolves around the pain.

2. Acceptance and commitment therapy

Pain is not a phenomenon that we perceive as passive subjects, but rather 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 we do not have to eliminate everything imperfect in our lives but that in many cases you have to accept a certain level of imperfection, helps integrate pain into consciousness limiting its harmful potential. In Psicode they remind 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.

• You may be interested: "Acceptance and Commitment Therapy (ACT): principles and characteristics"

3. Mindfulness

In psychological therapy there are a series of tools aimed at training patients in managing your attention focus. And it is that the level of pain before the same stimulus that arrives through a nerve can vary a lot depending on what we do with our attentional processes.

Mindfulness is one of the most used resources at the Institute of Psychode Psychology, and contributes that pain is not an obsessive source of attention that leads the person to "get hooked" on that discomfort. In this way, it is possible to further value other elements that are also present in the conscious experience and that are of a much more neutral or positively stimulating character.

Bibliographic 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.