Chronic Pain

Overview of Chronic Pain: Chronic pain is a more common symptom for therapy client than many people may realize. Although it is important to first rule out medical conditions by talking to a physician, chronic pain can be a sign of untreated depression, anxiety, trauma, or other suppressed emotions, such as grief or anger. Muscle pain or fatigue, shooting nerve pains, back tension and pain, and headaches are quite typical reactions to unexpressed emotions, needs, or desires. In the lingo of the profession, this is called “somaticizing” and can lead to a diagnosis of somatic disorder/pain disorder.

Clients with chronic pain are often resistant to exploring the possibility that their pain has an emotional root. Sometimes they fear they are being accused of making up the symptoms or causing them on purpose, but as the diagnosis above makes clear, this is not the case with true somaticizing. The pain is real, and may be a result of emotions that are literally stuck in the body. Emotions are, in large part, chemicals that released into our muscles and organs, and if they stay there, they can cause very real pain, as real as any pain caused by a medical condition.

Clients may also fear admitting their pain has emotions roots because it deprives them of the hope that there is a medical cure. Instead, if the pain is emotionally based, it means they must confront the very emotions that they avoided to being with, which is what caused the pain.

The Medical Model and Chronic Pain: Fortunately, confronting those emotions and achieving “catharsis”, the release of pent-up emotion, can provide relief in both the short and long term. Unfortunately, it may not be enough, as emotions held for a long time in the body can actually become primarily physical symptoms and may not always be relieved by emotional release. Talking with a physician about an appropriate exercise regime can provide additional help if this is the case.

Case Examples of Chronic Pain:

Judith, 47, complains of several chronic pain issues, including muscle aches, headaches, and a stiff back. She refused the therapists suggestion that the pain may have emotional roots, and prefers to talk instead about her friendships, which are conflicted and troubling to her. The therapist backs off the interpretation about her pain, and simply explores her emotions about her relationships. After several weeks, Judith begins crying regularly in session, and reveals that she feels ashamed of herself for doing so. After normalizing the need to cry, the therapist is able to uncover deep feelings of fear of abandonment, about which Judith continues to cry. Soon, she reports her physical pains are diminishing, although, because the pains have led her to adopt a sedentary lifestyle, leading to muscle atrophy, they do not disappear entirely. The therapist recommends physical therapy for this issue.

Paul, 56, is depressed and anxious ever since his mother died two years ago. He also reports muscle aches and shooting nerve pain, but does not make any connection between the two. He is open to the therapist’s suggestion that they are related, and is willing to talk about his mother, although he has usually avoided doing this. By fully grieving his loss – as well as the loss of his father five years earlier – and by talking about his guilt over some unresolved issues in his relationship to his parents, Paul is able to relieve his physical symptoms.

Therapy for Chronic Pain: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of chronic pain. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for chronic pain or any other issue, it is helpful to familiarize oneself with these elements.

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Chronic Pain Article Summaries