Chronic Pain

Understanding Chronic Pain

Chronic pain is a multifaceted condition that comes in many forms, including headaches, back and neck pain, arthritis, neurogenic pain (pain resulting from damage to nerves), and psychogenic pain (pain existing without medical explanation). Its unrelenting and debilitating nature can rob you of the life you once knew, as it hinders your ability to engage in routine activities, such as going to work and running errands, and can prevent you from exercising, socializing, and getting restful sleep. Increased dependency on others for support can make those who suffer from chronic pain feel like a burden, which may negatively impact relationships as well.

Seeking treatment for chronic pain often adds another level of frustration, requiring the investment of time and money to find the most effective remedies. Despite medications, steroid injections, procedures, variations of TENS units, and visits with physical therapists, the pain seems to return with a vengeance. Chronic pain’s impediment to daily functioning, combined with seemingly futile attempts towards relief, often leave sufferers feeling hopeless with a diminished sense of identity and self-worth.

What does Chronic Pain have to do with Mental Health?

It can be easy to underestimate the significance that psychological factors have on pain, especially since chronic pain is broadly viewed as a purely physical problem. In fact, this widespread belief has caused sufferers of psychogenic pain, in particular, to feel stigmatized as their experience is often invalidated. However, the International Association for the Study of Pain (IASP) defines the experience of chronic pain as being both a physiological and psychological/emotional phenomenon. More specifically, evidence demonstrates that our thoughts and feelings about pain can actually influence our sensory perception at the neural level, which indicates a powerful mind-body connection between pain and our emotions.

The mind-body connection can also be seen in the vicious cycle between chronic pain and anxiety and/or depression. In many cases, as pain increases, a person’s engagement in activity decreases in an attempt to stop discomfort or prevent reinjury, leading to maladaptive thoughts about his or her limitations and overall situation. The resulting anxiety and/or depression reinforce immobility through avoidance and withdrawal, which perpetuates the physical experience of pain, and in turn, feeds feelings of hopelessness, uncertainty, and despair; the cycle continues again and again. Learning how to end this ongoing cycle and better manage your experience of chronic pain begins with learning how to identify and regulate one's thoughts and emotions.

What does psychotherapy for chronic pain entail?

Research shows that one of the most effective approaches for treating chronic pain is a combination of managing the condition and engaging in therapy to address related emotional distress. Dr. Kimberly Fishbach uses Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) as a foundation of  her treatment; this evidence-based approach to chronic and acute pain has been corroborated by over 30 years of empirical support. To promote the most effective outcome for her clients, she incorporates additional therapeutic modalities, such as Acceptance and Commitment Therapy (ACT), interpersonal therapy, mindfulness techniques, and hypnosis to help redefine patients' relationship with pain, increase acceptance, accomplish a deeper state of relaxation, and minimize the severity of  pain symptoms. While hypnosis is never a quick fix, the use of hypnotic techniques in conjunction with the aforementioned therapies can further facilitate relief by redirecting the mind away from pain, learning to relax, and mitigating the mental anguish associated with physical pain.

In addition to addressing patients' personal experience with chronic pain, Dr. Fishbach will help identify the cognitive and behavioral factors that contribute to the pain cycle, teach adaptive strategies to overcome them, and empower patients to reclaim their lives so they can live more fully once again.

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