Millions of Americans struggle with chronic pain every day. This unrelenting pain can be caused by a variety of factors. Pharmaceutical interventions are the most common form of treatment. Prescription opioids are frequently used to manage pain; however, many people become addicted and these medications often become less effective over time. Addiction is a very serious consequence of opioid treatment for chronic pain.
Fortunately, alternative treatments are available to successfully manage pain. Three effective psychological treatments for chronic pain are Cognitive Behavioral Therapy (CBT), Biofeedback and Hypnosis. These therapies provide a natural way to relieve chronic pain and to address mental health issues often associated with pain.
What is Defined as Chronic Pain?
Chronic pain is considered as lasting pain beyond 6 months or after a normal period of healing and severity that interferes with daily activities. Pain often arises because of direct tissue damage, inflammation, or a medical disease.
What Causes Chronic Pain?
A biopsychosocial model of understanding pain provides an understanding of the experience of pain. This refers to the biological, psychological, and social contributors of pain on an individual.
- Biological factors of chronic pain include the sensory experience of pain because of an injury, inflammation or medical condition.
- Psychological factors refer to the mental processes that contribute to the sensation of pain. Negative thinking patterns, emotional dysregulation, and co-occurring mental health disorders are all psychological processes that can exacerbate pain.
- Social factors that may impact an individual dealing with chronic pain are interpersonal relationships, medical care access, and community support resources. Childhood experiences, including trauma and abuse, increase risk of chronic pain.
Psychological Treatments for Chronic Pain
Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are the most common psychological interventions for chronic pain. Research studies have demonstrated the effectiveness of pain management with CBT and ACT. Both therapies for chronic pain rely on multiple treatment components to help patients manage their condition.
- Psychoeducation: Learning more about how the brain and body identify and interprets pain and the theories about pain (e.g. Gate Control/Neuromatrix Model of Pain/Biopsychosocial Model empowers patients to understand the nature of chronic pain and to provide scientific answers. This knowledge may help to relieve some of the frustration about why the person is suffering. Learning about the terminology may help in discussions with healthcare providers.
- Stress Management: Stress can be a contributor to chronic pain. When your body is activated by stress, it physically reacts to manage the stress. Identifying what stressors are bothering you and ways to handle them can lead to a reduction in pain intensity.
- Addressing Negative Thinking Patterns: Even though we think of pain as a physical sensation, pain can contribute to incessant, negative thoughts. These thoughts, in turn, may intensify the sensations of pain and lead to unproductive behaviors. For example, a person with chronic pain may constantly think, “This will never get better” or “I am unhealthy and will never lead a normal life.” These thoughts then lead to sleeping in bed all day, socially isolating from friends, giving up on work and hobbies, or avoiding important healthcare appointments. In CBT, you learn how to replace these negative thoughts with adaptive cognitions. When you continually utilize these adaptive thoughts, this will lead to enduring and positive emotions and behaviors.
- Learning Relaxation Techniques: Progressive muscle relaxation, diaphragmatic breathing, guided visualization, and grounding techniques are all helpful exercises to change your experience of pain. They facilitate stress reduction and relaxation in the body. This calming effect of the nervous system and engagement of the parasympathetic system has been shown to reduce pain.
- Mindfulness and Acceptance: In mindfulness training, you will learn how to let go and accept disturbing and intrusive thoughts, emotions, and sensations. This can be a powerful habit to change how you manage your chronic pain. Instead of actively changing negative thoughts, for example, you learn how to simply notice them and let them go. By accepting your experience as it is rather than struggling to change it, you can focus on what is important to you instead. For instance, you may decide to play with your children even though you are feeling depressed and having thinking “I am not a good parent.”
- Lifestyle Guidance: Proper nutrition and exercise are important to address when dealing with chronic pain. A diet filled with unhealthy foods and a sedentary lifestyle is likely to exacerbate health problems. Even though you may not be able to engage in intense exercise, you may find that taking a short, outdoor walk helps clear your mind and improves your mood. Partaking in a small physical activity allows you to engage in pleasurable activities and attain your goals. Exercise is a natural way to reduce anxiety and depression often experienced by chronic pain sufferers. Additionally, giving your body proper nutrients can help your body heal by strengthening the immune system and improving cellular health.
Hypnosis for Chronic Pain
Hypnotherapy is another helpful therapy to manage chronic pain. Hypnosis targets changing the subconscious thought processes related to pain. One study found that hypnosis reduced abdominal pain for individuals with Crohn’s Disease and other studies have demonstrated hypnosis as an effective treatment for chronic pain. Within a trance-like state, your hypnotherapist gives you specific suggestions to alleviate your experience of pain. Many people find that hypnosis helps to deal with the negative thought processes and emotions of pain. While this therapy does not heal injuries or tissue damage, it can relieve the negative mental state often associated with chronic pain.
Biofeedback for Chronic Pain
Biofeedback is a technique that uses sophisticated computer monitoring to train an individual to acquire voluntary control over a physiological process. During a biofeedback session, certain bodily functions, such as heart rate or muscle contraction, is monitored on a computer. You are guided through either audio or visual feedback to behave in a way that reduces tension and stress and promotes relaxation and vitality.
Chronic Pain Psychologist
Dr. Mazzei has worked with many individuals suffering from chronic pain and she has found that integrating multiple therapies is most effective. Rather than relying on just one modality, incorporating CBT, hypnosis and biofeedback can be especially helpful. When she meets with you, together you will discuss your concerns and goals and then decide on a treatment plan together. You may find that one therapy works better than another and you focus on that during your sessions.