Managing the Emotional Impact of Chronic Pain
Those who suffer from chronic pain know the toll that it takes on our mental, emotional and spiritual beings. It’s exhausting. It drains our patience within our relationships and with life in general. It’s depressing and often times creates anxiety. We wonder: Will life always be like this? How will we cope? If we have a relationship with God, we may struggle and doubt his goodness and care. Often, we feel very alone since those without pain just don’t quite understand what it’s like.
Here at Stenzel Clinical, you’re not alone. We understand. We offer a structured therapy with the potential to improve your mood, decrease your anxiety, improve your functioning, decrease your pain and better your relationships that may be strained due to your pain (Otis, 2007). These are the aspects of suffering that lie on top of the pain itself. Have you ever thought about it that way? Pain is the physical sensation and suffering is our perception and response to the pain. The surprising discovery for many pain patients is that they have some control over the dynamic interaction between the two.
This is known as the Gate Control theory of pain, developed in the 1960s by Ronald Melzack and Patrick Wall (1965 cited Otis 2007). When injury occurs, a nerve carries a signal through the spinal cord to the brain. The brain interprets the signal about the tissue damage and you feel pain. In some types of pain, such as headaches, there may not be tissue damage, but triggers such as stress, dietary factors, lack of sleep or environmental factors may begin the signaling process. Evidence shows that other things can modify these pain messages before getting to the brain.
In other words, there is a “gate” that we can open and close with changes in our thoughts, emotions, activities, social support and muscle tension. (Otis, 2007) For example, a chronic pain patient immersed in a fun activity won’t be nearly as aware of the pain as when they are sitting alone trying to work quietly. Similarly, when a migraine starts to come on, thinking frantically serves to open the gate for increasing tension, pain, anxiety and subsequent suffering. An opposite, calmer thought such as “well, let me try to take a break, relax, and see if I can let some things go right now. I’ll come back to them later,” will help ease tension, pain, anxiety and suffering.
How do we get away from the panicked thoughts to the calmer, more positive ones? It can be hard, especially when chronic pain has been around awhile. There is hope. Cognitive-behavioral therapy (CBT) can be effective for many types of chronic pain. There are numerous studies to support its effectiveness. (Otis, 2007). Back pain, headaches and fibromyalgia are three very common categories of pain, but other types of pain can respond to this therapy as well. CBT may be in conjunction with medications and or other physical or occupational therapies. Therapists may find it helpful to be in touch with medical providers.
Once pain cycles have set in, patients will typically slow down their activity levels due to the fatigue and limitations they face. Additionally, some come to think of themselves as “disabled,” which reinforces feelings of helplessness and depression. In CBT therapy, we work to slowly increase the physical activity level and challenge these maladaptive (but seemingly true!) beliefs. We want to shift the perspective away from helplessness and toward one of personal responsibility, self-control and confidence (Otis, 2007). For example, we work to challenge and shift “pain has ruined my life forever,” to “I can still have a meaningful life with my pain.”
Additionally, we teach relaxation methods like deep breathing, visualization and time-based pacing activity, such as how to be active without over-doing it. Someone who suffers back pain and limits all physical activity would, with medical permission, begin gentle activity in slow increments we monitor as their weekly progress.
CBT therapy for chronic pain requires a commitment of time and effort to practice what is taught in session. Development of new skills takes practice. Sometimes it is also helpful for other key family members to attend sessions periodically to become educated and informed about key goals or treatment methods so they can become encouragers at home.
If you or someone you know suffers chronic pain, please have them call us at 630-588-1201 x313 for further information and/or evaluation.
Reference: Otis, John (2007). Managing Chronic Pain. New York: Oxford University Press.