Pain Management Psychology

JOHNSEY THOMAS Consultant Clinical Psychologist

Pain Management Psychology

Defining PainAn unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

International Association for the Study of Pain 1979

Mind-Body- Soul Healing

Almost everything deals with

mind-body issues, but it would

be rational to say that a

principal focus is self change

and ways that Psychology can

help with this…

Mind-Body- Soul Healing

Psychology can help with this,

especially with regard to enabling

greater happiness and better

health. It helps to believe", Mind

over matter" and "all in the mind"

look at the role of thinking

processes in self-healing.

Key Concepts

Most people think of pain as resulting

from physical injury or disease, but

psychological factors play a huge role

in pain perception. Pain is intimately

tied to brain functions that govern

behavior and decision making,

including expectation, attention and

learning.

Psychology

plays a major role

in

Pain Management

My doctor

recommended I should

see a psychologist for

Pain Management.

Why would I see a

psychologist? This pain

is not in my head and I

am not crazy!

No it unlikely to be in your

head - the pain is most

likely very real. However

there are many

psychological techniques

which have been shown to

assist people in coping

with chronic pain.

Pain Psychologists are

part of the treatment

team for patients

suffering from chronic

pain (including cancer

pain) as well as other

chronic conditions.

Recent research suggests that

pain is mismanaged in up to

50% of cases. For example,

irrational fears about addiction,

underreporting of pain,

inadequate communication

between patient and doctor,

lack of knowledge, etc.

Pain is disturbing my

Life-Sleep-Work

Sleep as a Medicine

Sleep is an essential part of our

lives. It’s an opportunity for

your body to repair itself, both

physically (e.g., repairing

muscles) and psychologically

(working through anxiety).

I can sit at ease And relax

Guided imagery involves

having the person with pain

imagine (using all or as many

as possible of their senses, not

just the visual) something that

contributes to relaxation,

healing, or the lowering of pain

and suffering.

This could be going to a

relaxing place such as the

beach or imagining what your

pain looks (sounds, smells,

tastes, feels) like and changing

the image!

I have cut

down my

routine activity

drastically

When pain persists over

time, a person may avoid

doing regular activities for

fear of further injury or

increased pain. This can

include work, social

activities, or hobbies.

As the individual withdraws and becomes less active, their muscles may become weaker, they may begin to gain or lose weight, and their overall physical conditioning may decline. This can contribute to the belief that one is disabled.

Do I need to live and suffer

lifelong with pain?

They say, I don’t have any problem

pain, but I know; what I am going

through

I getting easily

frustrated and

irritated

Sometimes I feel

Pain is demanding

† It feels like I've been drained of all energy and that to do just about anything will take more effort than I can summon.

Not at all 

Very seldom 

Sometimes 

Most of the time 

All of the time

† I feel like I've lost interest in activities that were once

enjoyable for me.

Not at all

Very seldom

Sometimes

Most of the time

All of the time

† When the phone rings, I tend to ignore it even when I know it

may be a good friend calling.

  Not at all

  Very seldom

  Sometimes

  Most of the time

  All of the time

† I've noticed a change in my sleeping pattern such as difficulty falling asleep, waking up frequently throughout the night, or oversleeping in the morning.

  Not at all

 Very seldom/ Rarely

 Sometimes

 Most of the time

  All of the time

† It's been taking longer and has seemed harder than usual to make decisions. 

Not at all

  Very seldom

  Sometimes

  Most of the time

  All of the time

† It seems as though everything is going wrong no matter how hard I'm trying.

  Not at all

  Very seldom

  Sometimes

  Most of the time

  All of the time

† I've been turning down invitations

to get together with friends because

trying to socialize feels like it will

take more energy than I have or

because I think my "down“ mood will

just depress everyone else. 

Not at all

  Very seldom

  Sometimes

  Most of the time

† I've been getting headaches, stomach- aches, backaches, or pains in my joints or muscles that can’t be traced to a physical illness or injury.

  Not at all

  Very seldom

 Sometimes

  Most of the time

  All of the time

† I've been feeling restless and/or irritable.

  Not at all

 Very seldom

 Sometimes

  Most of the time

  All of the time

Psychology in

Managing Pain

… is tailored to the individual needs

† Relaxation Therapy

† Cognitive Behavior Therapy

† Cognitive Restructuring

† Stress and Anger Management

† Sleep Hygiene

† Activity Pacing

Relaxation Therapy- is that

blissful state of being at peace with

oneself and with the world.

It creates measurable changes in the body,

such as a reduction in oxygen consumption,

heart and respiratory rate, blood pressure,

blood cortisol levels, and muscle tension, and

an increase in the production in the brain of

serotonin which leads to feelings of calmness

and well-being.

Cognitive behavior

Therapy- CBT for pain management has

three basic components.

1. treatment rationale that helps

patients understand that

cognitions and behavior can affect

the pain experience and

emphasizes the role that patients

can play in controlling their own

pain.

2. Coping skills- Progressive

relaxation and cue-controlled

brief relaxation exercises are

used to decrease muscle

tension, reduce emotional

distress, and divert attention

from pain.

Activity pacing and

pleasant activity

scheduling are used to

help patients increase the

level and range of their

activities.

Training in distraction

techniques such as pleasant

imagery, counting methods,

and use of a focal point

helps patients learn to

divert attention away from

severe pain episodes.

Cognitive restructuring is

used to help patients

identify and challenge

overly negative pain-related

thoughts and to replace

these thoughts with more

adaptive, coping thoughts.

The third component of

CBT involves the

application and

maintenance of learned

coping skills.

Problem solving methods are

taught that enable to analyze

and develop plans for dealing

with pain flares and other

challenging situations.

Self-monitoring and

behavioral contracting

methods also are used to

prompt and reinforce

frequent coping skills

practice.

If sleep is disrupted for an

extended period of time it can lead

to the following effects:

† Increased emotional

distress and irritability

† Increased clumsiness and

poor coordination

If sleep is disrupted for an

extended period of time it can lead

to the following effects:

† Decreased work

performance and memory

lapses

† Increased risk of

automobile accidents

† Difficulty concentrating

Ways to Improve Sleep

† Timing: Establish same pattern

† Sleep Behavior:

† Bedroom Environment Tips:

† Ingestion:

† Mental Control:

† Say NO to Coffee /Tea…

Guided Imagery?

During guided imagery, you

control your breathing and relax

your muscles. You focus on

something specific – such as a

therapist’s voice or the

instructions on a DVD or audio

tape. You enter into a state of

deep relaxation, success, and

wholeness – similar to

meditation.

Pain Psychology will help you to…

feel betterconquer Pain to lead quality life