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Chronic Pain

If pain is physical, how can a psychologist help?


Pain is an alarm system – it helps us survive. When it persists beyond the point of healing it is called chronic pain, and is not so useful.

Chronic pain is much more complex. It is stressful to live with. It can cause havoc in a person’s life and often affects feelings, behaviours, thoughts, relationships, ability to work, self-image and many other things. Often the stress caused by the pain will in turn make the pain worse and create a vicious circle.

To treat chronic pain effectively it is not just any physical basis that needs to be addressed but also the emotional and behavioural aspects.

Pain patients who are referred to us have usually seen a variety of medical consultants and specialists. A lot of people are referred by these specialists or by their GP. You can refer yourself but we still may need to get in touch with your GP to get some background information about your pain and its medical treatment.

As well as being distressing, chronic pain can be tricky to deal with.

Our brains have evolved to draw on all our experiences to protect us. Most of the time this works well. However, with any pain that becomes persistent the brain can sometimes create associations that are unhelpful in managing it. After six months or more running into problems is extremely common, some would say inevitable.

The physiological basis of pain is incredibly complicated with countless chemical and electrical loops involved. A pain psychologist must try to keep up-to-date with the latest findings by attending international conferences, in the same way that pain doctors are learning more and more about the psychological components of pain.

Over the past ten years in particular, research shows there is a complicated interplay between a person’s pain and their thoughts, beliefs and emotions. How pain is experienced and dealt with is often strongly affected by these and by the social context in which they occur.

Traditionally, pain treatment was largely aimed at reducing pain signals at their source (removing what hurts, healing wounds, reducing inflammation, blocking pain signal transmission and so forth).

Nowadays we understand that in addition to this it is also important to look at what happens after pain signals have reached the brain, where they are processed before being sent back to the pain source again. This processing can change the experience of pain enormously and can both facilitate (increase) and suppress (reduce) pain. Techniques used by pain psychologists are useful in helping your brain suppress the transmission of pain signals.

It is also important to stop the pain nerves becoming too trigger-happy by looking at the interplay between the physical and psychological factors.

Dr Angela Caney has worked in the field of chronic pain since 1999 and has since seen several thousands of pain patients. She works closely with local pain consultants and other medical consultants to help people in pain. Please do get in touch via info@cbtinterventions.com if you think pain psychology may play an important part in your pain treatment too.