How Is Psychological Therapy Used To Relieve Pain?

Dr. Russell Portenoy answers the question: 'Psychological Therapy For Pain?'

— -- Question: How Is Psychological Therapy Used To Relieve Pain?

Answer: Pain is very complex. And patients and physician recognize that there is a physical component to pain and a psychological component to pain. And that exists in virtually everybody who has pain.

Chronic pain in particular can have profound effects on the patient's ability to function psychologically and psycho-socially. Patients with chronic pain often have problems with mood like depression or anxiety. They often have problems with thoughts that can increase the impact of pain. Pain physicians tend to call this "catastrophization" that patients tend to believe that hurt equals harm and every time they feel a significant pain they stop functioning out of concern that they are going to do damage to themselves.

The psychology of pain is very complex and has been an object for pain physicians to investigate over many, many years. We now know that patients who have chronic pain particularly can have very good results if psychological approaches are used to try to help them cope with the pain, adapt to a higher level of function, learn cognitive or thinking techniques that actually reduce the level of the pain, or have psychological problems like depression treated.

Every patient with chronic pain should have an assessment that evaluates the extent to which psychological factors are driving the pain, making it worse and all those patients should then have strategies suggested to them that may help them cope better with the pain and improve their function.

Now, in some cases, those strategies require referral to another health professional. The physician will say to the patient, that to help you cope and adapt, to help you manage the pain and increase your function, you should see a psychologist or a social worker, or a psychiatrist who has experience with health or experience specifically with pain.

Patients should never hesitate to see a health professional with that kind of expertise. Patients should understand that working with that kind of health professional doesn't mean that the pain is not truly experienced, that it's not real. It doesn't mean that the patient is psychiatrically ill. It means that the psychology of pain is complicated and patients who address the pain through a variety of different approaches are likely to benefit the most.

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