Psychotherapy for Pain
February 12th, 2009 |
A GoodTherapy.org News Update Presented by Jolyn Wells-Moran, PhD, MSW
Pain is a trickster. It can occur when the brain has been hyper-sensitized by a long-term injury, even one that has healed. Pain can also be a result of adjusting the body against the original pain. Further, it may be a warning sign that certain lifestyle tendencies or habits need to change. Robert Kerns, a professor in the Department of Psychiatry, Neurology, and Psychology at Yale University looked at 22 studies on the effects of psychotherapy on low back pain, a condition of the majority of adults at some times in their lives. He concluded that cognitive-behavioral therapy, meditation, guided imagery, hypnosis, biofeedback and other forms of therapy can rid many people of pain or help them manage it.
David Bresler, president of the Academy for Guided Imagery and founder of the UCLA Pain Control Unit, agrees. He says an advantage of these therapies for pain is that they are not addictive as are many pain medications. The effects usually last beyond therapy too and some of the therapies are quite short-term. Stress, poor exercise habits, certain thoughts about the pain, sleep issues and sometimes, accompanying depression, can all cause or worsen low back pain.
Ongoing pain appears to disrupt brain activity in the frontal cortex and there is some speculation among research scientists that it may cause permanent damage there. Some of the therapies may actually increase the brain’s endorphin activity, thereby relieving pain.
Cognitive-behavioral therapy (CBT) can help the person experiencing pain to replace thoughts that lead to and support ongoing stress with alternative thoughts. Whether the stress is a result of overdoing work or something else, sleeping poorly, lack of relaxation or due to other issues, CBT can address the issues one by one. CBT may also help the person think differently about the pain, thereby easing it. Many people with chronic pain become depressed. A significant percentage of people who are depressed experience greater pain than would normally be the case. CBT is a well-regarded and researched psychotherapy for depression.
Guided imagery, hypnosis, biofeedback and other therapies may help with managing and avoiding stress, learning pain tolerance and relaxation. Meditation appears to help with relaxation. The success of any of these techniques relies on staying in therapy long enough to achieve results and, often, the conscientious practice of using the techniques in real life.
Bibliography
Payne, J W In chronic pain? You might need psychotherapy: Talk therapy and biofeedback are two treatment options, US News & World Report. Feb 10, 2009, at http://health.usnews.com/articles/health/2009/02/10/in-chronic-pain-you-might-need-psychotherapy.html?PageNr=2
ScoutNews, LLC Chronic pain harms brain, Health Day. Feb 8, 2008 at http://health.usnews.com/usnews/health/healthday/080208/chronic-pain-harms-brains-wiring.htm?s_cid=related-links:TOP
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5 comments so far
I wish that I had the chance to hear more about this sooner. I have been dealing with chronic back pain as a result of a fall for several years and I have tried everything from cortisone shots to accupuncture. While the accupuncture has been slightly more successful than some other treatments for pain management that I have tried such as the shots and massage therapy, I am hopefully optimistic that I can get further relief through psychological therapy. I hope that this can work for me because I can’t tell you how much of a negative impact this injury has had on my life and my family.
I know that in the past at one time in my life when I was going through my divorce and hurt my knee during the same time frame. I am convinced that it would have never given me as much trouble had I been in a better and more positive state of mind at that time. Now that I am at a better place and stage in my life my knee rarely gives me problems. I think that this is truly a case of mind over matter but the power of positive thinking really does come through for us in the end sometimes.
Yoga (Application) which was based on the control of the body physically and implied that a perfect control over the body and the senses led to knowledge of the ultimate reality. A detailed anatomical knowledge of the human body was necessary to the advancement of yoga and therefore those practising yoga had to keep in touch with medical knowledge. (Romila Thapar, A History of India, volume one).
I suggest : Mind and brain are two distinct things. Brain is anatomical entity whereas mind is functional entity. Mind can be defined as the function of autonomic nervous system (ANS). It is claimed that mind can be brought under conscious control through the practice of meditation. But how? ANS is largely under hypothalamic control which is situated very close to optic chiasma (sixth chakra or ajna chakra). Protracted practice of concentration to meditate at this region brings functions of ANS say mind under one’s conscious control.
ANS is further divided into parasympathetic nervous system (PSNS) and sympathetic nervous system (SNS). On the basis of these facts I have discovered a mathematical relationship for spiritual quotient (S.Q.). Spiritual Quotient can be expressed mathematically as the ratio of Parasympathetic dominance to Sympathetic dominance. PSNS dominates during meditative calm and SNS dominates during stress. In this formula we assign numerical values to the physiological parameters activated or suppressed during autonomic mobilization and put in the formula to describe the state of mind of an individual and also infer his/her level of consciousness.
Meditation is the art of looking within and science of doing nothing. We don’t use anything in meditation. We just try to concentrate to meditate at some point in human anatomy known as ‘chakra’ in Indian System of Yoga. The current of mind is flowing outward through the senses and unconsciously. The mind comes at rest gradually through regular practice of meditation. Then comes self realization and enlightenment. Protracted practice of meditation under qualified guidance will help to manage all sort of psychological problems.
Emotional Quotient can also be expressed mathematically as the product of I.Q. and Wisdom Factor. E.Q. stands for Emotional Quotient. An intelligent person may not be wise. But a wise man will always be intelligent. An intelligent person having certain level of positive emotions can be said as wise. An intelligent person lacking wisdom will turn autocrat. A wise man will always be a democrat who respects others existence.
Some may raise doubt that how could be the Wisdom quantified? The answer is simple -if Mental Age of I.Q. can be quantified then Wisdom can also be quantified, of course, comparatively with more efforts. Wilhelm Stern had given the formula of I.Q.. It is, Mental Age/ Chronological Age x 100. Spiritual Quotient (S.Q.) leverages both E.Q. and I.Q.
Radha Soami Faith is a branch of Religion of Saints like Kabir, Nanak, Paltu, and others. Soamiji Maharaj is the founder of this Faith. You may call It like New Wine in Old Bottle.
Maslow has given Hierarchy of Needs. At the top of it is need for self-actualization or self-realization.
In our society we should learn To Live and Let Live and help to satisfy others need. When the lower order needs, physiological and sociological both, are satisfied then only a person think to satisfy need for self-realization in true sense. Else he/she may spend all his/her life to satisfy at the most the need for self-expression instead of self-realization.
It is, therefore, the duty of every responsible person of our society to give serious thought over it.
For the satisfaction of need for self-realization i.e. establishment of harmony of individual consciousness with that of universal consciousness we need following three things:
1. Mater or Guru (A Self-Realized Soul)
2. Secret of Levels of Universal Consciousness
3. Method for traversing the path.
I have fibromyalgia and my doctor has never suggested anything like yoga or psychotherapy for pain management. Do you think this could help me?
I am bedridden for the last 6 months with severe rheumatoid arthritis. I havent been given or suggested to take up psychotherapy. This makes me wonder if I need to see some one in private practise. I dont have words to describe my mental state.