Psychotherapy and Chronic Pain

Developing chronic pain can interfere with your enjoyment of life, your ability to work, and your relationships with the people you love. It is a helpless feeling knowing that pain is an unavoidable reality and that no matter what you do, a sensation you hate will be present, or an ability you used to have will be absent. It can seem downright unfair and can make you angry to notice that other people do not have to suffer the same burdens created by your chronic pain. It can also make you really sad to know that the things you used to love to do may have to be eliminated or changed due to your chronic pain. Opiate pain medication is an unattractive option for many due to the risk of addiction, and others want to remain clear-headed in the face of pain. You should, of course, discuss pain management with your medical doctor, but if you find yourself still unable to cope with the pain after all the medical options you have explored, you may want to try psychotherapy. 

Psychotherapy for chronic pain may seem like an odd suggestion, and you may find yourself in disbelief. Common statements made by psychotherapy patients with chronic pain include: 

The pain is not going to go away; why would talking help?

You cannot give me back my life; why am I talking to you?

I am willing to try anything to get this pain to go away, and I do not think this will help!

After attempting many different ways to deal with chronic pain, it makes sense that feelings of discouragement and skepticism are your first reaction to any suggested way of coping. 


Reflection on the perception of pain may help to address your reservations about therapy for chronic pain. How bad pain feels is oddly dependent upon many psychological factors. People who are suffering from feelings of grief, sadness, or depression report that feelings of pain of the same intensity are less tolerable than people who are feeling better. Search your experience; you know that if you feel grumpy or irritable and hit your arm or leg, it can seem intolerable, and other times, you can stub your toe, and you barely notice it! You may also find yourself avoiding daily activities out of anxious beliefs that you cannot tolerate the pain or may have distorted views about what you can and cannot enjoy now. People with chronic pain reduce their enjoyment of life by avoiding situations out of fear that they cannot fully engage in them. Learning that you can feel pain and joy, pain and engagement, pain, and a wide range of emotional experiences can help you gain back parts of your life you thought you surrendered forever to chronic pain. A variety of techniques can aid in the process of living with chronic pain, including mindfulness, relaxation exercises, changing maladaptive beliefs about pain, and learning to use activity to reduce depressive symptoms (behavioral activation). Finding techniques to reduce depression, having a space to learn to cope with losing the life you used to live, and finding meaning in your life despite your diminished capacity can help you accept and live with chronic pain. 


By Christopher Grandits Ph.D.


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