Chronic pain can be extremely debilitating. Sadly, one in five Australians experience chronic pain. It is associated with 40% of early retirements in Australia and is the third most costly health burden. Chronic pain is when a person experiences pain that can range from intense, to a milder level that still significantly impedes functioning. The origin of chronic pain can usually be attributed to an injury or illness that occurred in a person’s life, and the pain they initially feel is a result of this. Sometimes the chronic pain is the result of an unresolvable physical health problem, however, often the extended period of pain has no obvious physical cause, as the pain has extended beyond the normal healing period.
Initially, it can be very difficult for those who experience chronic pain to understand it. At times the pain unexplainably extends from its original source to other areas of the body, and can leave sufferers confused as to why their pain is continuing or spreading. Chronic pain can last from a few months to potentially the rest of a person’s life.
Chronic pain can also be attributed to various biological factors. The nervous system plays a large role in chronic pain, as does movements, thoughts and emotional reactions to the pain. Chemicals within the body can also affect the pain experience, which can have either an excitatory or calming effect on the nervous system.
Though chronic pain has obvious physical effects (i.e. painful sensations), it also often leads to, or is exacerbated by, psychological problems. For instance, those with chronic pain are 20% more likely to experience depression, usually as a result of the chronic pain condition. Because chronic pain can affect both physical and mental wellbeing, it is important for sufferers to seek psychological help as well as medical intervention, in order to understand the numerous ways of reducing the debilitating effects of chronic pain and improving quality of life.
In fact, many studies have found that the most effective way of managing chronic pain is to treat comorbid psychological conditions, rather than to target the pain symptoms themselves. This is because, though the initial cause of the chronic pain may be physical, the factors maintaining the pain beyond the normal healing period are often psychological processes such as attitudes to pain and unhelpful patterns of behaviour modification.
How is chronic pain treated and managed?
Often Cognitive Behavioural Therapy (CBT) is used for chronic pain management. CBT aims to challenge and modify the internal psychological processes, behaviour patterns and negative thoughts often associated with chronic pain. Whilst this can be helpful temporarily, at times when pain levels or psychological distress are very high, it can be very difficult for people to implement techniques such as thought-challenging and realistic thinking. Additionally, many of the negative thoughts associated with chronic pain may be realistic, and the process of challenging them may actually be unhelpful.
Another ‘new-wave’ approach to managing chronic pain is Acceptance and Commitment Therapy (ACT), which aims to observe negative or painful emotions and thoughts with a different attitude involving defusion and acceptance, rather than control attempts and avoidance. These concepts aim to assist people to accept and tolerate their pain, rather than completely eradicate it. This process can then open a person up to engaging in meaningful, values-consistent living whilst being aware of their pain and carrying the distressing thoughts and feelings with them. Often engaging in more meaningful and values-consistent activities can inadvertently result in reduced psychological distress and reduced focus on the pain; though this is not the principle aim of ACT. ACT aims to increase functioning and meaningful engagement in life, rather than symptom reduction.
If you live in the Canberra region and you are experiencing difficulties with chronic pain, you can contact Strategic Psychology to arrange to see a psychologist. We can assist you in identifying the issues that are contributing to your difficulties and recommend strategies that draw on your strengths and passions in order to improve your social, emotional and occupational functioning.
Pain Australia. (2015). Prevalence and the Human and Social Cost of Pain. Retrieved from http://www.painaustralia.org.au/healthcare-professionals/patient-resources.html