One of the ironic things about working with people who suffer from chronic pain is that I frequently hear them tell me how isolated and alone they feel.  Indeed, dealing with pain can certainly limit someone’s level of activity, decreasing their social connections and sometimes straining relationships with their loved ones.   The irony, however, lies in the fact that chronic pain is prevalent.  In this sense, the person who suffers from chronic pain has a great deal of company.  As of 2003, over 20% of medical visits and 10% of drug sales are directly related to the experience of pain (Max, 2003).  In 2006, the Center for Disease Control noted that one in 10 adults indicated that they had experienced pain that lasted for one year or longer.

With this kind of prevalence, one wonders whether there may be more help available to the person in pain.  Often, someone will go to a psychologist for help with any number of emotional problems, but the idea of visiting a psychologist for help with something as physical as pain may seem a bit odd.  Interestingly, there is a great deal of clinical data to support the idea that a visit to the psychologist may pay off in terms of helping a person cope with pain.  Not only has psychotherapy been shown to help someone deal with the mental and emotional aspects of living with pain, but reductions have been shown with regard to reducing people’s reports of actual, physical experiences of pain (e.g, Morely, Eccleson, & Williams, 1999). 

Each psychologist who works with pain may approach things a bit differently.  Some might use biofeedback while others may use hypnosis, and yet others will teach you meditative skills.  Many will use a combination of these things while utilizing the psychotherapeutic techniques.  Almost all, however, will teach you some reliable relaxation techniques that usually helps when practiced regularly.  There are several exercises that trigger the “relaxation response” which often helps to lessen a person’s sensation of pain.  This, of course, is only one trick in the psychologists’ bag aimed at helping people cope with pain.  Try this exercise a few times a day, each day for about a week, to see if you notice a difference:

• Find a quiet place where you won’t be disturbed for about 15-20 minutes
• Turn off the music, turn off the radio, unplug the phone, and generally make sure that you won’t be disturbed for this period of time.
• Get yourself in a comfortable position (you can move around for comfort while you’re doing this if you need to).
• Now think about your breath.  Take an nice deep breath in and focus your attention on how it feels for your breath to go in through your nostrils, down your windpipe, and fill your lungs.  Keep your attention on the way your chest feels as your lungs fill with air.
• Of course, you’ll want to exhale.  Simply let your chest muscles relax and allow your breath to escape, and pay close attention to how it feels as the air moves up your windpipe and out your nostrils (or mouth). 
• If your mind begins to wander, that’s fine.  Simply acknowledge that you’ve had a thought, don’t judge it, don’t ponder it, just let it go and return your attention back to your breath.
• Keep this very simple exercise up for several minutes.  Pay very close attention to every detail as to how it feels to breathe. 

This is a fairly standard, very simple, relaxation exercise based on the concept of mindfulness, which is a meditative practice that involves paying close attention to your moment-to-moment experiences.  This sort of practice has been found to be helpful in dealing with both  emotional and physical aspects of chronic pain. (e.g., Plews-Ogan et al., 2005; Smith et al., 2008; Zatura et al., 2008, Grossman et al., 2007). 

I’m often asked if seeing a psychologist for chronic pain is, in and of itself, painful.  It is true that, in psychotherapy, people tend to address issues that are emotionally distressing.  However, a person seeing a psychologist for issues around chronic pain may find him or herself becoming more physically active, and thus experiencing some soreness.  Finally, as your functioning improves, it is quite possible that your role in your family or the roles of some people around you may change.  These changes can be wonderful and—at first—a bit uncomfortable all at the same time.

References

Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper, U. (2007). Mindfulness training as an intervention for fibromyalgia: Evidence of post intervention and 3-year follow-up benefits in well-being. Psychotherapy and Psychosomatics, 76, 226–233.

Max, M.B. (2003).  How to move pain research from the margin to the mainstream.  Journal of Pain, 4, 355-360.

Morley, S., Eccleston, C., & Williams, A. (1999).  Systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for chronic pain adults, excluding headache.  Pain, 80, 1-13.

Plews-Ogan, M., Owens, J., Goodman, M., Wolfe, P., Schorling, J. (2005). A pilot study evaluating mindfulness-based stress reduction and massage for the management of chronic pain. Journal of General and Internal Medicine, 20, 1136-1138.

Smith, B.W., Shelley, B.M., Dalen, J., Wiggins, K., Tooley, E. & Bernard, J. (2008).  A

pilot study comparing the effects of mindfulness-based and cogntive-behavioral stress reduction.  Journal of Alternative and Complementary Medicine, 14, 251-258.

Zautra, A.J., Davis, M.C., Reich, J.W., Nicassio, P., Tennen, H., Finnan, P., Kratz, A.,

Parrish, B. & Irwin, M.R. (2008).  Comparison of cognitive-behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression.  Journal of Consulting and Clinical Psychology, 76, 408-421.