Chronic or persistent pain: Seeing a psychologist can help you

~ By Arissa Brunelli, Psychologist  

“The mind is not separate from the body. My belief, is that the only way you can really separate mind and body is verbally. They are two aspects of the same underlying reality”

~ Dr Andrew Well (MD), founder and director of Arizona Centre for Integrative Medicine, University of Arizona College of Medicine, Jones/Lovell Professor of Integrative Rheumatology

  Seeking professional help for a problem can sometimes seem a bit daunting, especially if you’ve fallen into the trap of thinking that everyone else has it ‘all together’ or that you have to be on the brink of a breakdown to seek professional help.Many people with chronic pain do not seek help from health professionals and suffer in silence for many years. Untreated chronic pain can lead to increased disability, increased risk of fall, depression, sleep deprivation, reduced quality of life and social isolation (Cornally & McCarthy, 2011).  Chronic pain is more common than many realize, in fact studies have indicated that the prevalence of people living with chronic pain is greater than cardiovascular disease and cancer combined. So, you are not alone in your suffering!Pain itself is not a “bad” thing per se, as it serves an important purpose by alerting you to injuries such as a sprained ankle or burned hand. However, chronic pain is often more complex, and unfortunately, alleviating it isn’t always straightforward.  Many people who suffer with chronic or persistent pain (eg. Fibromyalgia, low back pain) often don’t feel as though others understand the extent of their pain. Having thoughts that “nothing works” and feelings of hopelessness are very common among sufferers. Chronic pain is real, and affects more than just the person in pain, it can significantly affect their work life, social life and family life too.  

“People often think of pain as a purely physical sensation. However, pain has biological, psychological and emotional factors. Furthermore, chronic pain can cause feelings such as anger, hopelessness, sadness and anxiety. To treat pain effectively, you must address the physical, emotional and psychological aspects.”

~ American Psychological Association

 Chronic pain can often develop as a result of a mental health condition, and it is a more common symptom of psychological concerns than many people may realize. Chronic pain and depression are also strongly correlated; the stress of living with chronic pain can often lead to depression, and because some people may manifest depression in the form of physical symptoms instead of psychological ones, depression can also result in chronic pain.Headaches, muscle fatigue or pain, shooting nerve pains, back pain or tension can often be reactions to unexpressed or suppressed emotions, needs, or desires. This unconscious conversion of a mental state into physical symptoms is known as somatization. This results in actual physical pain, and the symptoms may be severe enough to affect your work, relationships, and daily life. Furthermore, the pain can lead you to feel more stressed, tense, anxious, or depressed which in turn causes more pain.  So, it can be very helpful to discuss all of this with a professional, such as a psychologist, who is familiar with pain.  Undergoing psychological care can help you better understand and manage the triggers, thoughts, emotions and behaviours that accompany your discomfort and can help you cope more effectively with your pain – and can often help reduce the intensity of your pain.  In addition, training the brain to think about pain in different ways and practicing various non-pharmacological strategies can make a big difference to the way you experience your pain.One misconception is that meeting with a psychologist says that your pain lacks a physical cause. None of us wants an encounter that might suggest our pain is not real.Psychologists do focus on the brain functioning and mind, but they also know that pain is not just ‘in your mind’.  Psychologists understand that there is a physical basis to chronic pain and are involved in the treatment because they know your pain is real. They can offer effective strategies for the management of this pain, and they also know that many people that suffer from chronic pain are stuck in a vicious cycle.Another common misconception is that seeing a psychologist for ‘pain management’ means terminating the relationship you have with your medical provider, or that a psychologist will not support the use of medication in the treatment of chronic pain. Psychologists who specialise in the treatment of pain are not against the use of pharmacological treatments – even though their treatment does not involve drugs – they support a comprehensive, multidisciplinary team approach.  Furthermore, insights from research and clinical practice on the best treatment for chronic or persistent pain strongly recommends a team-based, multi-disciplinary and holistic approach.  In all cases, the basic goal is to improve functioning and help people live more meaningful lives, as opposed to just eliminating pain symptoms. 

What to expect when seeing a psychologist

When working with a psychologist, you can expect to discuss your physical and emotional health.  You’ll be asked about the pain you experience, where and when it occurs, and what factors may affect it (eg. Lifestyle choices, relationships, work, diet, exercise etc).  You may also be asked to discuss any associated worries, stresses or concerns, including those related to your pain.  You may also be asked to complete some questionnaires that allow you to record your own thoughts and feelings about your pain.  The purpose is to have a comprehensive understanding of your concerns that will help you and your psychologist begin developing an appropriate care plan that will help meet your needs.  

What you can do

If you or a loved one is suffering with chronic or persistent pain, check out a few of the helpful APA tips noted below – these are a few of the pieces necessary to solve the puzzle of chronic or persistent pain. Manage your stressEmotional and physical pain are closely related, and persistent pain can lead to increased levels of stress. Learning how to deal with your stress in healthy ways can position you to cope more effectively with your chronic pain. Eating well, getting plenty of sleep and engaging in approved physical activity are all positive ways for you to handle your stress and pain. Talk to yourself constructivelyPositive thinking is a powerful tool. By focusing on the improvements you are making (i.e., the pain is less today than yesterday or you feel better than you did a week ago) you can make a difference in your perceived comfort level. For example, instead of considering yourself powerless and thinking that you absolutely cannot deal with the pain, remind yourself that you are uncomfortable, but that you are working toward finding a healthy way to deal with it and living a productive and fulfilling life. Become active and engagedDistracting yourself from your pain by engaging in activities you enjoy will help you highlight the positive aspects of your life. Isolating yourself from others fosters a negative attitude and may increase your perception of your pain. Consider finding a hobby or a pastime that makes you feel good and helps you connect with family, friends or other people via your local community groups or the Internet. Find support Going through the daily struggle of your pain can be extremely trying, especially if you’re doing it alone. Reach out to other people who are in your same position and who can share and understand your highs and lows. Search the internet or your local community for support groups, which can reduce your burden by helping you understand that you’re not alone. Consult a professionalIf you continue to feel overwhelmed by chronic pain at a level that keeps you from performing your daily routine, you may want to talk with a mental health professional, such as a psychologist, who can help you handle the physical and psychological repercussions of your condition.   

Talk to a psychologist

Contact one of our friendly staff today to make a booking (07) 5679 5593

      ReferencesCornally, N. & McCarthy, G. (2011). Help-seeking behavior for the treatment of chronic pain. Br J Community Nurs. 16 (2), 90-8.Gopinath, B. (2015). Understanding Chronic Pain Following Injury – Epidemiological Perspectives. John Walsh Centre for Rehabilitation Research.Nicholas, M. K., Linton, S. J., Watson, P. J., & Main, C. J. (2011). Early identification and management of psychological risk factors (“Yellow Flags”) in patients with low back pain: A reappraisal. Physical Therapy, 91(5), 737-753. doi: 10.2522/ptj.20100224Melzack, R., & Wall, P. (1965). Pain mechanisms: A new theory. Science, 150, 971-979.Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., & Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133(4), 581-624.Boundless. “The Biopsychosocial Model of Health and Illness.” Boundless Psychology. Boundless, 15 Aug. 2016. Retrieved 25 Aug. 2016 from https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/stress-and-health-psychology-17/introduction-to-health-psychology-85/the-biopsychosocial-model-of-health-and-illness-326-12861/”