It’s Not Just Physical - Treating the Emotional and Psychological Components of Chronic Pain
Pain. There’s no way to live life without experiencing it at some point. It’s a part of the deal.
In the medical domain, pain is put into one of two boxes - acute pain or chronic pain. Acute pain happens when tissues are damaged, and our brains process that information. For example, if you put your finger on a hot stove, the intense heat damages the tissues of your finger, and your brain gets a swift hit of OUCH!, which it sends down to your finger causing you to pull away from the burner. Acute pain typically lasts, generally decreasing in intensity, for as long as it takes the specific tissues to heal. That stove burn might hurt for a day or maybe two.
Chronic pain is a different animal. According to the International Association for the Study of Pain, chronic pain persists or recurs for more than 3 months – beyond the usual amount of time it takes most tissue to heal from damage. While pain may begin as a symptom of an injury or illness, chronic pain often becomes the primary issue for patients seeking medical care.
Approximately 21% of adults in the United States report experiencing chronic pain.
No matter what part of the body is affected, chronic pain can negatively impact mental health, relationships, work performance, and general well-being. All pain, whether acute or chronic, has biological, emotional, and psychological components, and when pain goes on for a long time or recurs over and over again, it can bring up additional feelings of anger, hopelessness, and fear or anxiety.
Chronic pain has been associated with depressive symptoms, anxiety, and substance abuse and has a big role to play in the opioid crisis. The relationship between chronic pain and mental health doesn’t just go one way either. For instance, research studies have indicated that while chronic pain increases the risk of developing depression, having depression predicts the development of chronic pain. It can be a complicated cycle.
While the first line of treatment for chronic pain may be physical - medication and physical therapy are often go-tos, it’s important to remember that pain goes beyond biology. Feelings and thoughts – emotional and psychological factors are at play too. That means that helping those with chronic pain goes beyond biology as well. Hope, pain acceptance, and optimism – all positive psychological factors – impact adjustment to persistent pain. That means that psychological interventions can be important parts of an effective pain management treatment plan.
Talk-therapy can be a great addition to the treatment plan. Chronic pain is a burden, and it may be difficult for loved ones to understand or even empathize with at times. Therapists and counselors are trained listeners who can provide a safe place to lay that burden. They can also help process complicated thoughts and emotions that can accompany and contribute to chronic pain. Unconditional positive regard and empathic listening can go quite a ways for people struggling with pain of any kind. Chronic physical pain is no exception. Therapists can also offer specific tools and skills to address negative thinking, manage difficult emotions, decrease stress, and increase relaxation. Specific interventions like Cognitive Behavioral Therapy and Mindfulness may be especially impactful.
Cognitive Behavioral Therapy (CBT), at its most basic, asserts that thoughts, feelings, and behaviors are connected. CBT teaches patients to identify and shift or change destructive thought patterns that have a negative impact on their lives. Patients learn about the maladaptive patterns of thinking, feeling, and behaving disrupting their lives, and they learn to replace those with more adaptive patterns. Since pain has emotional, cognitive, and behavioral components, CBT is a great fit. As CBT has also been noted for its effectiveness with depression, anxiety, and substance use disorders, it is one form of traditional talk therapy that may be ideally suited to help those managing chronic pain.
Mindfulness practice is another psychological intervention that may be helpful, on its own or in concert with CBT. Mindfulness is a quality or trait associated with greater acceptance and compassion toward self and others. It is possible to build mindfulness with practice, often called mindfulness meditation. In addition to increasing mindfulness as a trait or quality, mindfulness meditation has benefits of its own. Practiced over the long-term, mindfulness meditation has been associated with better sleep, decreased negative thinking, improved mood, cognitive flexibility, and decreased stress. Here’s more good news – meditators have reported improved mood and decreased stress after just one meditation session.
When it comes to chronic pain, it’s so important to consider the mind/body connection. While we often think of pain as being solely physical in nature, it also has emotional and cognitive facets that are equally important. Pain impacts how we think and feel, and our thoughts and feelings impact pain. Medication and physical therapy may help manage chronic pain, but sometimes they fall short. They may not provide complete relief of the physical pain, and they don’t address the psychological and emotional components at all. Talk-therapy and specific psychological interventions like CBT and mindfulness can balance a pain management treatment plan by providing the space to process feelings about the pain as well as any underlying issues that may be present and by imparting skills and tools to manage negative thinking, disruptive behavioral patterns, difficult emotions, and stress.
If you or someone you love struggles with chronic pain, ask your doctor about a referral for counseling or therapy. If depression, anxiety, or substance abuse are part of your chronic pain experience, we may be able to help. Contact us at 888-448-LUNA to learn about our programs.
