Pain and your Patient’s Mental Health
Do you your patients appears to struggle with pain?
People who live with chronic pain often experience mental health issues including depression, anxiety and problems sleeping¹. It is useful for people who suffer with chronic pain to see a psychologist; for treatment of the pain itself and for any other mental health issues that may be present. This is important because mental health issues may exist because of the chronic pain, and negative emotion will often make the pain worse. Treatment by a psychologist may lead to the experience of less chronic pain for the patient.
Do your patient’s appear to struggle with pain and what can a psychologist offer?
Psychologists may work with patients to reduce their chronic pain by assisting them with basic techniques and strategies to calm their central nervous system. A variety of methods can be used assist the chronic pain sufferer by helping to reduce tension in the muscles, which can increase pain symptoms³. Psychologists also encourage patients with chronic pain to think differently about their pain in an attempt to assist them to better understand and manage better. The presence of pain does not always mean there is something wrong and it is important for sufferers of chronic pain to acknowledge this and believe that they can get through it. Distraction can also be a useful tool in reducing chronic pain. The more a person thinks about their pain, the worse it tends to be. Therefore if sufferers of chronic pain can focus on something else and put the pain to the back of their mind, they can experience a reduction in symptoms as a result³.
Do your patients appear to have allowed pain to control their lives?
Research has shown only modest benefits from traditional medical, pharmacological and surgical interventions in the treatment of chronic pain³. It is important when treating chronic pain, that the whole person is considered. “To treat pain effectively, you must address its physical, emotional and psychological aspects”². This is approach is referred to as the biopsychosocial model and is used by psychologists to treat chronic pain.
Psychologists: a non-opioid option for effective pain management
Psychologists can treat chronic pain in a number of different ways depending upon the needs of their patient. Operant conditioning describes the process whereby people and animals increasingly engage in behaviours which are accompanied by rewards. In the case of acute pain after an injury, the behaviour of resting is rewarding as it assists with pain reduction. However, if this behaviour continues after the injury has healed it may be problematic, as it may lead to physical deconditioning and muscle breakdown, contributing to the development and maintenance of chronic pain. The role of the psychologist in cases like this would be to recognise the persistence of this behaviour-reward relationship and work on strategies to break it down, such as ending the reward of pain behaviours (i.e. resting) and starting to reward well behaviours such as increases in strength and activity tolerance³.
 Australian Institute of Health and Welfare (AIHW) (2020). Chronic Pain in Australia. https://www.aihw.gov.au/getmedia/10434b6f-2147-46ab-b654-a90f05592d35/aihw-phe-267.pdf.aspx?inline=true#:~:text=How%20many%20Australians%20have%20chronic,%25)%20aged%2085%20and%20over. Date accessed: 21/6/2022.
 Jensen, M.P. & Turk, D. C. (2014). Contributions of psychology to the understanding and treatment of people with chronic pain. Why it matters to all psychologists. American Psychological Association, 69(2), p.105-118.