Pain is an all-too-familiar problem and the most common reason that people visit a doctor. Pain alerts you to injuries such as a sprained leg. Chronic pain is complex. People think that pain is only physical. But, pain has many emotional effects such as anger and sadness. Hence, it is important to know pain psychology and also to see a chronic pain psychologist if needed.

A chronic pain psychologist understands that pain is not only physical but also emotional. Hence, various treatment options are looked at to heal you. This not  only includes medical treatments but also dealing with emotions and behaviours which help to cope with chronic pain. This holistic approach reduces the intensity of pain.

 

Chronic pain causes a lot of unhelpful thoughts and negative patterns of thinking. A chronic pain psychologist involves looking at how our thoughts and emotions
influence our daily choices and therefore our pain. This makes it more difficult to manage the pain. It also stops from developing healthy habits to cope with it.

Knowing the common patterns and unhelpful thoughts can help you to manage them. It helps you recognise and challenge them before they hurt you. Many patterns of unhelpful thinking are responsible for increasing your pain and also affecting you emotionally. Your chronic pain psychologist helps you learn to these patterns and work on them.

Here are some common patterns of unhelpful thinking:

1. Emotional reasoning: This means treating emotions as if they’re facts. For example, “I feel I am lazy- I must be worthless.”
2. Catastrophising: People feel worried about the pain and how it has affected them. They can feel like something far worse has happened than it is. For example, ” I had a good day today but I am going to feel terrible tomorrow.”
3. Black and white thinking: People often see things as extreme rather than ‘in between’ when in pain. For example, ” I am not active hence I am a bad parent.”
4. Must and should statements: People often set fixed rules for themselves and be hard on themselves if they do not meet these expectations. For example, ” I must clean the whole house every day.”
5. Jumping to conclusions: People often think they know what others are thinking and this is usually negative. For example, ” People think I am mean because I am not very active.”
6. Over-generalising: This is assuming all future events will follow a similar pattern. For example, ” I could not walk for 15 minutes today so I will never be able to go for a walk.”
7. Dismissing the positives: People often ignore the positives and focus only on the negatives. ” I cleaned the house today, but I feelterrible because I could not cook.“
8. Labelling: People who feel low often label themselves negatively. For example, ” I am a burden on earth.”

Many of the above thoughts keep coming to us every day because of chronic pain. This not only makes us feel sad but also impacts our daily life. Hence, we should learn how to deal with this. We can challenge these unhelpful thoughts by asking questions. Initially, it might be difficult to challenge but if you do is consistently then you will notice most of the pain lies in your mind than in our body. This exercise is also done by your chronic pain psychologist.

Let us take one example and try to challenge it:

Unhelpful thought: “I was not able to do any cleaning today and the house is a mess. My husband is going to be annoyed with me. I’m a burden.”

1. Is there any evidence against this thought?

• “I have done house work on other days.”
• “My husband is understanding.”
• “My husband tells me I’m not a burden and it is okay if I do not do cleaning.”

2. Is there any evidence for this thought (based in fact)?

• “The house is a little messy.”

3. Can you identify any patterns of unhelpful thinking?

• “I’m labelling myself in a negative way by saying I’m a burden.”
• “By assuming how my husband will feel, I’m jumping to conclusions.”
• “I’m using must and should statements. I’m setting fixed rules for myself.”

4. What would you say to a friend who had this thought in a similar situation?

• “I would say they are being too hard on themselves. I would also remind them that they have been in pain all day and hence it is understandable that they will not be able to clean everything.”

5. Is there another way of looking at this situation?

• “This is a good opportunity to try pacing and spacing of activities.”
• ” I can discuss with my husband about how to manage cleaning.”

6. Is there any solution to this unhelpful thought
?

• “I’ll try to do some cleaning without making my pain flare up. It is okay if I cannot do much.”

A chronic pain psychologist is an expert in helping people cope with the thoughts, feelings and behaviors that accompany chronic pain. Patients with chronic pain may be referred to a chronic pain psychologist. A comprehensive understanding of your chronic pain will help the pain psychologist to develop a treatment plan. Most patients find they can better manage their pain after just a few sessions with a psychologist. Together with your chronic pain psychologist, you can plan how long treatment should last. The goal is to help you develop skills to cope with your pain and live a full life.

When working with a chronic pain psychologist-

1. You can discuss your physical and emotional health.
2. The psychologist will ask about the pain. You will have to describe in detail your experience, where and when it occurs and also the triggers.
3. You will also be asked about your worries or stresses related to pain.
4. Aquestionnaire might be given to you to fill in that allows you to record your own thoughts and feelings about your pain.

The chronic pain psychologist will design a plan best suited to the needs of the person. This is a holistic plan. It can focus on-

1. Learning how to relax your body.
2. Changing old beliefs about pain.
3. Learning new coping skills.
4. Addressing your emotions related to pain.
5. Challenging unhelpful thoughts about pain.
6. Developing new ways to think about pain.
7. Lifestyle changes such as recreational activities.
8. Ways to sleep better.

Chronic pain psychologists are helpful. To know more pain psychology and how pain affects your mental health, enrol for a course on chronic pain management on Epsychonline which helps you to learn various coping skills.