Many of us grow up believing that pain is the result of a disease or a physical injury to our bodies. We stub our toe and a few seconds later, we’re howling in pain. We suddenly feel a sharp, shooting pain in our lower abdomen, and we immediately wonder if maybe we have appendicitis. We don’t expect pain to occur without a corresponding reason for it, and we expect it to subside once the illness has gone away or the wound has healed.
But then how do we explain chronic pain that persists even when doctors can’t find anything structurally wrong with our body? As we age and maybe experience this different, persistent type of pain, we begin to question where this pain comes from and why it just won’t go away. This is when we need to explore the idea that chronic pain may have some psychological roots. (For more information about this type of pain and how to unlearn it, check out this article.)
Although chronic pain might occasionally be caused by our brain instead of a physical injury or illness, this does not mean that the pain we feel isn’t real. We know it’s real because we feel it! It hurts. But incorporating some psychological pain management techniques into your life - rather than just masking symptoms with pain medication - may be just what you need to overcome it.
If you’re frustrated because your doctor hasn’t been able to diagnose the reason for your pain, consider trying some psychological chronic pain interventions (see below). As part of a multidisciplinary pain management plan, these methods have the potential to help you move past your chronic pain.
What is the Psychological Approach to Pain Management?
In many cases, after an injury has healed, the pain disappears. But in others, the pain persists. Why is this? The reason often has very much to do with our brains and the neural pathways that are established (and then heavily traveled) during an experience of acute (short-term) pain.
After the illness has been cured or the wound has healed, these neural circuits in our brain remain, which may lead to ongoing pain unless we can “unlearn” or “rewire” these pathways. In addition, many traditional pain remedies - like surgery and pain medication - don’t address this issue, which means that the pain will continue unless we consider engaging in psychological treatment for chronic pain instead.
Psychological factors have also been found to impact the onset, duration, and severity of recurrent pain (1). So approaching your pain management from a psychological perspective can potentially give you a better quality of life, either lessening your pain or eliminating it entirely and quicker than other non-psychological methods might.
What Are Some Common Psychological Pain Relief Methods?
What are the interventions for chronic pain, you ask? Great question. There are several psychological treatments that have been found by researchers to be effective in managing and healing chronic pain. See below.
Chronic Pain Therapy #1: Relaxation Training
A type of psychotherapy for chronic pain called relaxation training refers to any method or activity that helps you feel calm. This consequently leads to lower levels of pain, stress, and anxiety (2). Examples include deep breathing, progressive muscle relaxation, and visual imagery, all of which can be done anywhere and can have a profound impact on how you feel.
Chronic Pain Therapy #2: Supportive Psychotherapy
Supportive psychotherapy is a form of therapy that aims to improve one’s self-esteem and self-acceptance of their experience of pain. It encourages physicians to be empathetic, understanding, reassuring, and encouraging (3), while patients are taught to reframe their thoughts more positively. It also teaches the concept of normalization, which means understanding that your thoughts, experiences, and emotions are not out of the ordinary. This realization - along with the other aspects of supportive psychotherapy - can free you from worry and unnecessary stress about your pain situation.
Chronic Pain Therapy #3: Cognitive Behavioral Therapy (CBT)
Developed in the 1960s, CBT is another psychotherapy for pain management that also teaches and encourages patients to reframe their thoughts (like supportive psychotherapy above) but in conjunction with identifying and eliminating what is referred to as cognitive distortions (negative thinking patterns - there are 10 of them, according to CBT). If you start utilizing CBT, you’ll also learn ways to better cope with your pain and strategies to change behaviors that aren’t serving you (like being inactive or isolating yourself).
Chronic Pain Therapy #4: Biofeedback
Biofeedback is a method that involves learning how to control certain bodily functions, including heart rate, breathing, and muscle tension. By controlling these physiological responses to pain and stress, you can teach yourself to feel more relaxed and to experience less pain and anxiousness (4). During the biofeedback process, functions that also include brain waves, sweating, and body temperature are monitored by electrical devices and sensors.
Chronic Pain Therapy #5: Mindfulness
Another psychological therapy for pain management is mindfulness, which refers to exercises like meditation that teach patients to stay present in the current moment and to dismiss negative thoughts about their pain. While there are multiple mindfulness techniques out there, a popular one is called STOP, which stands for Stop what you’re doing, Take a breath, Observe your emotions and thoughts, and Proceed with an activity that supports your mental wellbeing (5).
Chronic Pain Therapy #6: Hypnosis
Most of us are familiar with the concept of hypnosis but don’t necessarily realize that over the years it’s been found to help alleviate chronic pain symptoms. Research shows that 75% of people with arthritis experience meaningful pain relief from hypnosis (6). Hypnosis causes changes in how people process and perceive pain and is frequently paired with relaxation training as well.
Chronic Pain Therapy #7: Psychologically Informed Physical Therapy (PIPT)
This non-drug treatment for pain incorporates both regular physical therapy and elements of cognitive-behavioral therapies like CBT. (For more information about using physical therapy to treat pain, take a look at this article.) This approach allows therapists to address both the physical aspect of pain as well as psychological factors. They use cognitive-behavioral methods like mindfulness, relaxation training, reframing, coping skills, and breathing techniques to tackle the psychological aspects of pain (7).
So, as you can see, there are a variety of different psychological pain relief interventions that you can use to overcome chronic pain. Some might work better for you than others, and in some cases, you might want to participate in several of them to achieve the type of results you’re seeking. In most instances, pursuing a holistic care plan, like the kind Lin offers, will be your best bet since it will address all of the different aspects that are related to and are likely contributing to the chronic pain in your life (from stress and sleep management to nutrition and weight loss to your mental health and so on). Lin will pair you with a compassionate and knowledgeable health coach who will work with you to create a customized pain management care plan. Contact Lin today to learn more and to start living your best pain-free life yet!