Psychological Interventions For Chronic Pain

As experienced Pain Consultants will tell you: “Pain is a complex stressor that presents a significant challenge to most aspects of functioning. It contributes to substantial physical, psychological & occupational issues, particularly in its chronic form. To that end, as medical intervention frequently cannot resolve pain completely, there is a need for management approaches to chronic pain, including psychological intervention” [1]

So What’s the Answer?

Pain doctors who support a holistic approach to treating and resolving chronic pain, are likely to devise a multi-faceted Personalised Treatment Plan (which sometimes includes psychological interventions), after a patient’s first consultation with them. This in-person or online consultation will comprise the Pain Specialist reviewing the patient’s medical history, asking pertinent questions relating to their pain, and conducting (or arranging) an examination, and any necessary tests and scans.

“With regard to long-term pain, psychotherapy primarily targets improvements in physical, emotional, social, & occupational functioning, as opposed to focusing on resolution of the pain itself. Of note, psychological therapies for long-term pain are variable in their goals, duration, & scope, thereby showing well-defined patterns of treatment efficacy” [1]

These therapies can be classed into four categories:

• Operant-behavioural therapy
• Cognitive-behavioural therapy
• Mindfulness-based therapy
• Acceptance and commitment therapy [1]

So What Are Our Psychological Reactions to Pain?

Research shows that recurring pain could contribute to the development of dysfunctional behaviour and cognitions that worsen our daily functioning, elevate our psychiatric distress, or prolong our pain experience. Moreover, patients suffering from long-term pain are inclined to exhibit increased vulnerability to a number of different psychiatric conditions. These comprise:

• Depressive disorders
• Anxiety disorders
• Post-traumatic stress disorder [1]

Different Types of Psychological Interventions Organised By Pain Specialists

These interventions which are regularly recommended by Pain Doctors, include:

• Cognitive-behavioral therapy (also known as CBT): which takes a biopsychosocial approach to treating long-term pain through targeting patients’ dysfunctional cognitive and behavioural responses to pain, environmental and social occurrences, which alter their reaction to pain
• Mindfulness-based stress reduction: which fosters an interventional approach to uncouple the sensory elements of pain from the emotional and evaluative elements of pain, thereby promoting detached awareness of the patient’s psychological and physical body sensations
• Acceptance and commitment therapy (also known as ACT): which takes on a theoretical approach in that patients’ thoughts don’t have to be changed or targeted; but rather, responses to patients’ thoughts can be adjusted, thereby allowing negative consequences to be minimised [1]


[1]. Sturgeon J.A. Psychological therapies for the management of chronic pain. Psychol Res Behav Manag. 2014 Apr 10;7:115-24.