Pain psychology

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Pain psychology is the study of psychological and behavioral processes in chronic pain. Pain psychology involves the implementation of treatments for chronic pain. Pain psychology can also be regarded as a branch of medical psychology, as many conditions associated with chronic pain have significant medical outcomes. Untreated pain or ineffective treatment of pain can result in symptoms of anxiety, depression, and suicidal thoughts, thus it is vital that appropriate pain management occur in a timely fashion following symptom onset.

Contents

Mental health-related difficulties can arise as a result of pain, or can pre-exist and worsen during the course of chronic pain, thus causing one to seek out or be referred by the patient’s healthcare provider for pain-relief treatment. Pain psychology aims to treat the person in pain rather than strictly the pain itself. A pain psychologist’s job is to work with the mental health issues that can be feeding into the physical pain that the patient is experiencing, and help them manage and reduce the effect it has on their lives. [ citation needed ]

Introduction

Pain [1] is one of the most common sensations for which individuals seek medical attention. [2]  Pain is an uncomfortable physical sensation that may manifest with different presentations. Coping with intense forms of pain can lead to psychological feelings like depression, anxiety, and stress. [3]

Treatments

Pain treatments include a host of therapeutic techniques and methods such as active listening, medication, reflection, empathy as well as behavioral techniques like guided imagery or meditation. A common treatment for pain is psychotherapy also known as talk therapy. [4] It has helped reduce patients’ pain, increased the contentment of their lives, and has lowered the pain medication intake. An example of this presents itself in a study that was conducted on a group of workers in 1998 with chronic pain issues, and once they went through psychotherapy treatment, it resulted in decreased levels of depression and other conflicts, along with better control of their lives. [5] What is learned from the therapy sessions can become useful tools for patients to use for future conflicts with chronic pain due to injury and/or a surgical procedure.

Pain Psychologist vs Physician

Individuals experiencing chronic pain typically contact a physician first. A physician is able to provide a prescription to medications to treat chronic pain. The medications commonly prescribed are acetaminophen, topical creams/sprays (applied to the skin) that contain pain relievers, opioids (narcotics), sedatives to help with insomnia, and medical marijuana. [6] These medications are temporary pain relievers that are highly addictive therefore, it is common for a physician to recommend a pain psychologist. A pain psychologist will help you address the mental effects that chronic pain causes. According to the American Psychological Association (APA), when a chronic pain patient goes in for treatment from a pain psychologist, they are asked various questions about their mental and physical health, their concerns about the pain they are experiencing, and a questionnaire may follow to keep track of any other information that may be needed to take note of. Once this initial process is done, a treatment plan is made specifically to meet the needs of the patient. Pain psychologist offer various mental therapies that include cognitive-behavioral therapy (CBT) [7] acceptance and commitment therapy, mindfulness training, meditation and relaxation therapies. To look at the therapies offered by a pain psychologist more in-depth, Practical Pain Management.com’s The Role of Psychology in Pain Management article lists the many treatments associated with CBT: [8]

  1. Biofeedback and relaxation training (e.g., diaphragmatic breathing, progressive muscle relaxation, autogenic training, self-hypnosis, guided visual imagery) to reduce muscle tension and promote the body’s calming response
  2. General stress management techniques (e.g., time management, problem-solving skills, assertive communication)
  3. Health promotion (e.g., nutrition and exercise, sleep hygiene)
  4. Anger management skills training
  5. Increasing understanding of personality style and its contribution to the pain experience
  6. Activity pacing and reducing fear of pain and/or activity avoidance
  7. Increasing acceptance of the chronic nature of pain condition
  8. Reinforcement (i.e., “operant”) techniques to increase adaptive behaviors and decrease maladaptive pain behaviors
  9. Cognitive approaches to manage clinical depression and anxiety disorders
  10. Cognitive approaches to foster thoughts, emotions and actions that are adaptive for managing a life with pain

The longevity of seeking pain psychotherapy varies from patient to patient. Some who are experiencing severe psychological issues alongside their medical issues may need to stay in therapy for a little bit longer. It is up to the patient and the psychologist to discuss how extensive the treatment needs to be.

Prevention

Chronic pain is a public health problem that is difficult and costly to treat. [9] Chronic pain can be induced from nerve damage, injury, and even repeated strain. There are very few findings on prevention of chronic pain. Treatment in acute pain can prevent chronic pain from developing. Many prevention studies suggest oral medications between 1 hour and 1 day prior to surgery. [10] Other studies suggests that pain can be managed through dieting. A diet of anti-inflammatory foods supports chronic pain management. [11]

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

<span class="mw-page-title-main">Medical psychology</span> Application of psychological principles to the practice of medicine

Medical psychology or medico-psychology is the application of psychological principles to the practice of medicine, primarily drug-oriented, for both physical and mental disorders.

<span class="mw-page-title-main">Psychotherapy</span> Clinically applied psychology for desired behavior change

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.

<span class="mw-page-title-main">Psychologist</span> Professional who evaluates, diagnoses, treats and studies behavior and mental processes

A psychologist is a professional who practices psychology and studies mental states, perceptual, cognitive, emotional, and social processes and behavior. Their work often involves the experimentation, observation, and interpretation of how individuals relate to each other and to their environments.

<span class="mw-page-title-main">Pain management</span> Interdisciplinary approach for easing pain

Pain management is an aspect of medicine and health care involving relief of pain in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals provide some pain control in the normal course of their practice, and for the more complex instances of pain, they also call on additional help from a specific medical specialty devoted to pain, which is called pain medicine.

<span class="mw-page-title-main">Anger management</span> Therapy for anger prevention and control

Anger management is a psycho-therapeutic program for anger prevention and control. It has been described as deploying anger successfully. Anger is frequently a result of frustration, or of feeling blocked or thwarted from something the subject feels is important. Anger can also be a defensive response to underlying fear or feelings of vulnerability or powerlessness. Anger management programs consider anger to be a motivation caused by an identifiable reason which can be logically analyzed and addressed.

<span class="mw-page-title-main">Clinical psychology</span> Branch of medicine devoted to mental disorders

Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession. Please note, a clinical psychologist is not a therapist, although they surpass the necessary skills to be one.

<span class="mw-page-title-main">Health psychology</span> Study of psychological and behavioral processes in health, illness, and healthcare

Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. The discipline is concerned with understanding how psychological, behavioral, and cultural factors contribute to physical health and illness. Psychological factors can affect health directly. For example, chronically occurring environmental stressors affecting the hypothalamic–pituitary–adrenal axis, cumulatively, can harm health. Behavioral factors can also affect a person's health. For example, certain behaviors can, over time, harm or enhance health. Health psychologists take a biopsychosocial approach. In other words, health psychologists understand health to be the product not only of biological processes but also of psychological, behavioral, and social processes.

Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or other people's mental states, influences those behaviours, and consists of techniques based on behaviorism’s theory of learning: respondent or operant conditioning. Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists. They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method, but it has a wide range of techniques that can be used to treat a person's psychological problems.

Pain disorder is chronic pain experienced by a patient in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age, and occurs more frequently in girls than boys. This disorder often occurs after an accident, during an illness that has caused pain, or after withdrawing from use during drug addiction, which then takes on a 'life' of its own.

Behavioral medicine is concerned with the integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness. These sciences include epidemiology, anthropology, sociology, psychology, physiology, pharmacology, nutrition, neuroanatomy, endocrinology, and immunology. The term is often used interchangeably, but incorrectly, with health psychology. The practice of behavioral medicine encompasses health psychology, but also includes applied psychophysiological therapies such as biofeedback, hypnosis, and bio-behavioral therapy of physical disorders, aspects of occupational therapy, rehabilitation medicine, and physiatry, as well as preventive medicine. In contrast, health psychology represents a stronger emphasis specifically on psychology's role in both behavioral medicine and behavioral health.

Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with certain mental disorders can be unable to function normally in society. Mental disorders may consist of several affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures. There are still variations in the definition, classification, and treatment of mental disorders.

Psycho-oncology is an interdisciplinary field at the intersection of physical, psychological, social, and behavioral aspects of the cancer experience for both patients and caregivers. Also known as psychiatric oncology or psychosocial oncology, researchers and practitioners in the field are concerned with aspects of individuals' experience with cancer beyond medical treatment, and across the cancer trajectory, including at diagnosis, during treatment, transitioning to and throughout survivorship, and approaching the end-of-life. Founded by Jimmie Holland in 1977 via the incorporation of a psychiatric service within the Memorial Sloan Kettering Cancer Center in New York, the field has expanded drastically since and is now universally recognized as an integral component of quality cancer care. Cancer centers in major academic medical centers across the country now uniformly incorporate a psycho-oncology service into their clinical care, and provide infrastructure to support research efforts to advance knowledge in the field.

Psychogenic pain is physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors.

Supportive psychotherapy is a psychotherapeutic approach that integrates various therapeutic schools such as psychodynamic and cognitive-behavioral, as well as interpersonal conceptual models and techniques.

The primary care behavioral health (PCBH) consultation model is a psychological approach to population-based clinical health care that is simultaneously co-located, collaborative, and integrated within the primary care clinic. The goal of PCBH is to improve and promote overall health within the general population. This approach is important because approximately half of all patients in primary care present with psychiatric comorbidities, and 60% of psychiatric illness is treated in primary care.

A psychological injury is the psychological or psychiatric consequence of a traumatic event or physical injury. Such an injury might result from events such as abusive behavior, whistleblower retaliation, bullying, kidnapping, rape, motor vehicular collision or other negligent action. It may cause impairments, disorders, and disabilities perhaps as an exacerbation of a pre-existing condition.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

Pediatric psychology is a multidisciplinary field of both scientific research and clinical practice which attempts to address the psychological aspects of illness, injury, and the promotion of health behaviors in children, adolescents, and families in a pediatric health setting. Psychological issues are addressed in a developmental framework and emphasize the dynamic relationships which exist between children, their families, and the health delivery system as a whole.

Audio therapy is the clinical use of recorded sound, music, or spoken words, or a combination thereof, recorded on a physical medium such as a compact disc (CD), or a digital file, including those formatted as MP3, which patients or participants play on a suitable device, and to which they listen with intent to experience a subsequent beneficial physiological, psychological, or social effect.

References

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  2. "Chronic Pain: What Is It, Causes, Symptoms & Treatment". Cleveland Clinic. Retrieved 2022-07-03.
  3. Gorczyca, Rafał; Filip, Rafał; Walczak, Ewa (2013). "Psychological aspects of pain". Annals of Agricultural and Environmental Medicine: AAEM. Spec no. 1: 23–27. ISSN   1898-2263. PMID   25000837.
  4. www.apa.org https://www.apa.org/topics/pain/management . Retrieved 2022-07-03.{{cite web}}: Missing or empty |title= (help)
  5. Cole, Jimmie D. (1998). "Psychotherapy with the chronic pain patient using coping skills development: Outcome study". Journal of Occupational Health Psychology. 3 (3): 217–226. doi:10.1037/1076-8998.3.3.217. ISSN   1939-1307. PMID   9684213.
  6. "Chronic Pain: What Is It, Causes, Symptoms & Treatment". Cleveland Clinic. Retrieved 2022-07-31.
  7. Denecke, Kerstin; Schmid, Nicole; Nüssli, Stephan (2022-03-10). "Implementation of Cognitive Behavioral Therapy in e–Mental Health Apps: Literature Review". Journal of Medical Internet Research. 24 (3): e27791. doi: 10.2196/27791 .
  8. "The Role of Psychology in Pain Management". Practical Pain Management.{{cite web}}: CS1 maint: url-status (link)
  9. Medicine, Institute of (2011-06-29). Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. ISBN   978-0-309-25627-8.
  10. Gewandter, Jennifer (July 2015). "Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations". PMC   5769693 .{{cite web}}: Missing or empty |url= (help)
  11. "Anti-Inflammatory Diet to Relieve Pain". Cleveland Clinic. 2019-09-27. Retrieved 2022-07-31.