Does Health psychology management matter in chronic pain?


Do you feel like the whole world is on top of you? Do you feel so worried about your pain that you are not sure if the pain of the worry of the pain is a bigger issue? Well, every person who experiences chronic pain will experience increased anxiety, fear and worry. This is a very normal response but over time this anxiety can become a significant factor in the individual’s recovery. In fact it can become a vicious circle a lot sooner than you think. Thus health psychology has a very important role in containing and reversing the silent impact chronic pain can have on individuals.

Anxiety can be difficult to treat and it has different levels for everyone. Although anxiety is a factor in everyone’s life, debilitating anxiety requires treatment. Medications may be advised. Sometimes the “fear’ of relying on medication in itself creates “anxiety”.

Research has shown that exploring the sources of this anxiety is the best type of therapy for anxiety. Helping people identify their underlying issues and dealing with them through more constructive thoughts and behaviors can create permanent results.

The term "Psychotherapy” is the umbrella term for this therapy. The term implies the main method of care is through verbal interaction with the therapist. While talking is the most prevalent type of psychotherapy, other, more tactical therapies might also be included under this term, including things like equine therapy, art therapy, wilderness therapy, etc.

Dr. Dominic Hegarty (Clinical Director, Pain Relief Ireland) emphasizes the fact that “irrespective of the type of therapy each individual may need the benefits are not seen immediately, changes happen slowly and can take months to be noticeable and maybe even years to become permanent”. It also requires constant awareness by the individual to ensure the best outcome. Moreover at Pain Relief Ireland we recognize the need to address this aspect that we have a leading specialist Noirin Nealson Lennox as part of our team to help individuals who require this support.

What is the principle in psychotherapy?

All psychotherapy programs have the goal of changing thought patterns and thus behavior to increase happiness. The negative thought patterns that exist are called “distortions” by psychotherapists.

Types of distortions:

  • Awfulising - thinking only of the possible negative effects of an event
  • Drawing conclusions – predicting what another might say or do
  • Exaggerating – also called “catastrophising”
  • Black and white thinking – seeing things as either perfect or perfectly awful
  • Over generalisation – applying the results of one situation to all situations
  • Dismissing the positive – believing that positive experiences are an anomaly, or were not as positive as they were.

Is Psychotherapy and Cognitive Behavioral Therapy the same thing?

Sigmund Freud was the “father of psychotherapy.” Freud initiated talk therapy, where the inner world of the client is explored. Freud was focused almost entirely on the client’s past and how relationships and experiences affected the person’s feelings and perceptions. “Psychoanalysis” was the term used to indicate how this type of discovery was initially used. Psychotherapy has branched out considerably from that point.

Psychotherapy relies heavily on the relationship between the client and the practitioner. The difference between psychotherapy and “counseling” in the vernacular is that “psychotherapy” implies treatment of a clinical problem where “counseling” may be discussions with someone with no diagnosable problems. Counselors also may be qualified specific to a discipline, such as school counselors or alcohol recovery counselors.

Cognitive behavioral therapy can be done individually or in a group, similarly to other types of psychotherapy. Sessions will explore how the individual feels about others, their life and the world. Actions affect thoughts and feelings, so they will be analyzed, too. Unlike some other forms of psychotherapy, and in contrast to Freud’s vision, CBT does not put much emphasis on the past, but looks at the immediate beliefs and behaviors of the client.

Cognitive behavioral therapy is the dominant therapy used today and influences the other major techniques. Since CBT is a subset of psychotherapy, if someone says, “Are you going to have cognitive behavioral therapy or psychotherapy?” they are likely ignorant of the nomenclature in the field of counseling psychology, or they might really be asking, “Are you going to have cognitive behavioral therapy or traditional psychoanalysis?”

What are the various Types of Therapy possible?

Cognitive Behavioral Therapy (CBT)

CBT looks at the connection between thoughts and behaviors and operates on the assumption that our thoughts structure the way we respond to the world, that if we can change our thoughts, then it will change our responses to and perceptions of the world. In cognitive behavioral therapy the client is asked to identify their negative thoughts, then the therapist will challenge them in various ways to see if they are valid or useful. Finally these thoughts are replaced with true and useful ways of thinking.

Exposure Therapy

This therapy was designed to treat phobia and obsessive compulsive disorder. It works by exposing the client to the feared stimulus over and over in a gradual and supportive way until the fear is extinguished. It is a type of CBT.

Acceptance and Commitment Therapy (ACT)

ACT teaches the patient to live with their own life and live in the moment they are in. Noirin Nealson Lennox (Health Psychologist, Pain Relief Ireland) says ‘ACT It is a type of cognitive behavioral therapy, in which judgment is suspended and the goal is just to “notice.”” Acceptance and Commitment Therapy (ACT) is a form of Cognitive Behavioral Therapy that promotes a therapeutic process known as “Psychological Flexibility”.  A key feature of this treatment for chronic pain is that it focuses on behavior change in line with people’s own values, rather than struggling with and focusing on symptom reduction. ACT has been shown to reduce pain related anxiety and depression whilst promoting a greater quality of life for those living with chronic pain and disease.

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