Integrated Health Psychology

Exploring the

connections between

physical and psychological

well-being

Integrated Health Psychology

 

Pain and Trauma

 

Chronic Pain

 

Chronic pain is pain that doesn’t go away. When pain lasts longer than three to six months and continues to cause distress after the expected time for recovery, it is said to be chronic. Unlike acute pain which comes on suddenly and can usually be traced directly to a cause [ie broken leg, burned hand], chronic pain lingers.

 

There are different types of chronic pain, many of which are not clearly understood. Researchers have found that pain is as individual as the people who experience it, and that the assessment of pain levels do not necessarily match the degree of actual body damage.

 

Chronic pain may be associated with an illness or disability such as cancer, a phantom limb or arthritis. Some types of pain start after an injury or accident and become chronic over time. Others may begin gradually, for example, low back pain. Sometimes pain such as migraine, is recurrent rather than constant. Other forms of chronic pain include fibromyalgia, myofascial, post-surgical and neuropathic pain. In some cases, the cause of chronic pain is not known and may be more a result of trauma, e.g. PTSD, than physical injury.

 

Pain is the most common reason that people seek medical help.

 

Chronic pain may come and go and may contribute to the development of maladaptive conditions including depression, lethargy, anxiety, anger, fear and post-traumatic stress disorder. Further, chronic pain may negatively impact on sufferers’ quality of life including:

 

  • Sleep disturbance
  • Fatigue
  • Substance abuse
  • Obesity
  • Dependency on medications
  • Behavioural avoidance
  • Decreased physical functioning
  • Social isolation
  • Changes in family dynamics
  • Loss of employment
  • Financial hardship
  • Forced lifestyle changes

 

Unfortunately, as medical interventions frequently cannot resolve pain, there is an increasing need for management approaches that address many of the above symptoms.

Psychology and Pain

 

Psychological interventions are a mainstay of modern pain management practice and help clients cope with the various aspects of chronic pain.

 

Being referred to a psychologist who specialises in chronic pain as part of your treatment plan does not mean that your doctor thinks that your pain is all in your head, or that your pain is not real.

 

Psychologists who specialise in the treatment of chronic pain and are part of an integrated team approach ……

 

  • know that the pain is real
  • realise that clients who suffer chronic pain can be trapped in a vicious cycle of pain    & medication
  • understand that chronic pain may cause stress, tension, anxiety or depression, and may impact on the client’s overall well-being and quality of life
  • offer effective strategies for the management of the pain
  • appreciate that at times, clients need a continued relationship with their medical provider[s] and where necessary, closely monitored prescribed medications
  • contribute to an integrated multi-disciplinary pain management approach

 

As a client, what can you expect?

 

A client who actively engages in, and negotiates a therapy program with a psychologist who specialises in a multi-disciplinary approach to the management of chronic pain can expect:

 

  • reduced levels of pain
  • reduced dependency on medication
  • improved ability to focus and concentrate
  • reduced levels of anxiety, stress and depression
  • reduced catastrophic thought processes
  • improved sleep patterns and reduced fatigue
  • increased participation in social and recreational activities
  • improved capacity in handling relationship and family challenges
  • potentially more positive attitudes to work and work options
  • a sense of achievement in actively participating in an agreed therapeutic program to improve their quality of life

Trauma, Post Traumatic Stress Disorder and Pain

 

Coping with chronic pain is a difficult challenge at the best of times that requires a lifestyle management approach focussed on the physical, psychological and social aspects of the body, mind and spirit.

 

The challenge becomes even more demanding when the cause of the pain involves a trauma such as a motor vehicle accident, combat-related injury, or complications from a surgical procedure. In many instances, chronic pain may have its origins in, or be exacerbated by, acute early childhood traumatic experiences.

 

Evidence shows that individuals with both PTSD and chronic pain experience more intense pain, greater difficulty coping with that pain, more emotional distress, poor sleep patterns and overall poorer quality of life than those with no PTSD or trauma symptoms.

 

Adult survivors of physical, psychological or sexual abuse are often more at risk of developing certain types of chronic pain later in life. The most common forms of chronic pain for survivors of these types of trauma involve persistent pain in the lower back, face, pelvis, neck and shoulder, and fibromyalgia and irritable bowel syndrome.

 

Due to the complexity and interaction of PTSD and chronic pain conditions, treatment can be challenging for the client and may often require extended time frames for recovery.

 

The role of the psychologist in these difficult and complex cases is to work as part of a multi-disciplinary team in the role of an educator, a coach and therapist, leading to an improved quality of life for the individual.

 

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