September is Chronic Pain awareness month, and unfortunately, in my experience as a therapist, rarely do therapists ask their patients about chronic pain or their experiences with physical pain. In addition, rarely do clients feel that therapy is the place to speak about physical pain issues. That’s what medical doctors are for right? My hope in this blog post is to debunk the myth that psychotherapy is only for emotional pain and how psychotherapy can be extremely beneficial for treating physical pain, especially chronic pain.
So, let’s look at the facts. According to the National Institute of Health, 25.3 million adults suffer from daily pain, and 23.4 million adults in the United States experience “a lot of pain” on a daily basis. Chronic pain is a public health crisis. The US pain foundation has done extensive research within the medical community. Unfortunately, the struggles of those suffering from chronic pain are often overlooked. There are not enough board-certified pain specialists for individuals diagnosed with chronic pain. Right now, for every 10,000 people suffering from chronic pain, there is only one board-certified chronic pain specialist. In addition, funding for chronic pain studies and research for new treatments are highly underrepresented. The treatments that do exist only leave patients to feel an average of 30% reduction in their pain.
Now, my purpose for the above paragraph was not to diminish the excellent care of our medical system. I myself suffer from chronic pain and have a wonderful team of medical professionals, all of whom have helped me find effective treatments time and time again. However, during my experience being diagnosed with chronic pain from a very young age, other treatments rather than physical therapy and medication were never suggested to me until I was an adult. Even though I have found effective treatment, the intermittent times where medications were not working left me frustrated, angry, sad, and sometimes even hopeless that my pain would go away. And rarely, did I have anyone to discuss this emotional impact with. In my professional career, my clients have voiced similar concerns about how their pain level affects their mental health. More treatment interventions such as acupuncture, massage therapy, yoga, and even psychotherapy need to be suggested to help individuals find effective relief from their symptoms.
From a psychotherapy perspective, there is a clear distinction between how the mind and body are highly connected and correlated with one another. Daily functioning and mental health can be affected significantly due to pain. The more pain that individual experiences, the more likely an individual will experience significant mental health decline and overall daily functioning regression, which leads to increased emotional dysfunction. Individuals’ that suffer from high levels of pain suffer from more suicidal ideation, sleep disturbances, family dysfunction, impacts to independent living, depression, anxiety, loneliness/isolation, grief, as well as discrimination.
Throughout my years as a chronic pain patient, I became aware of how the mind/body connection is a reciprocal relationship. This means that in the same way that pain affects emotional discomfort, learning how to accept the emotions related to chronic pain can help ease physical pain. The goal of psychotherapy for chronic pain is to help clients not only gain support and relief from their pain but also to accept the pain as part of life to ease psychological and emotional effects.
One form of therapeutic intervention that can be helpful for mitigating the effects of chronic pain is Acceptance and Commitment Therapy (ACT). ACT helps distinguish not only acceptance of the illness and chronic pain, but helps individuals distinguish between “clean pain” and “dirty pain”. Clean pain is the actual physical sensation that is associated with an individual’s pain. Please see the picture to the right. Dirty pain, are the negative beliefs that we associate with our pain, such as “I’m lazy due to my pain” or “I’m not good enough due to my pain”, which can lead to continued emotional discomfort, shame, and suffering. Learning to label emotional pain separate from physical pain can be helpful to begin healing.
How Therapy can Help Chronic Pain
In addition, I work with my clients to continue not only to learn the distinction from their clean pain and dirty pain but also how to cope with the differences. Here are some following ways that therapy can be helpful when coping with the effects of chronic pain:
- Developing a plan that allows for value-oriented activities. The client may need to “dose” their activities as to not impact pain. Clients should not avoid these value-oriented activities fully, as this may increase emotional suffering and therefore, pain.
- Implementing self-compassion strategies.
- Learning to find flexibility in beliefs related to “dirty pain” and increasing positive self-talk.
- Developing mindfulness strategies to implement during pain flare-ups.
- Understanding triggers to chronic pain flare-ups.
- Finding ways to soothe the body during flare-ups, versus chastising the body when in pain with negative belief systems.
- Allowing self to utilize day-to-day strategies i.e. back pillow that allows for increased comfort.
- Developing new meaning as someone that suffers from chronic pain as well as working through any grief and loss associated with chronic pain.
- Finding ways to celebrate what the body can do even when the pain feels as though it has taken away so much.
- Allowing self to find healthy ways of expressing emotions associated with chronic pain, such as anger, frustration, sadness, loneliness, etc.
- Learning how to label both emotions and physical sensations. Sometimes, learning how to name sensations can help tame these sensations in therapy.
- Psychotropic medication to deal with the effects of any depression, anxiety, or other mental health diagnoses.
Although these are only a few strategies implemented within the therapeutic setting for chronic pain, many more exist within a personal therapeutic setting. If you are an individual suffering from chronic pain, please reach out to your doctor or other professional to see if seeing a psychotherapist may be beneficial to your treatment. In addition, if you are currently in treatment with your therapist, it can be a very brave thing to bring up your chronic pain and I encourage you to do so! You deserve to live a life without suffering!