Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Discussing Pain with Others

At a pain center, one of our patients was told not to discuss his pain except when at the center. That is, he should avoid discussing the pain with family and friends and reserve those discussions for when he is seen at the pain center every three weeks.

This is not a valid concept. A study at Duke University (Pain Prevention and Treatment Research Program) suggests that avoiding open discussion of pain and limitations actually exacerbates, or worsens, the pain experience.

When the patient or the spouse feel unable to discuss the changes brought about by pain or injury, the patient then dwells on the experience internally. This increases the perceived intensity of subjective pain.

Research indicates that both patient and family members benefit from being able to discuss pain its effect upon their lives. Direct communication helps prevent the commonly seen passive behaviors utilized by patients to control their environment, and helps the patient become an active manager of their disorder, rather than a victim.

Communication also increases the likelihood that a patient will try something new to manage their pain, such as biofeedback, relaxation therapies, change in medications etc. rather than attempting to convince others that nothing can help them feel better.

Learning to change the way one thinks about pain has been successfully approached through CBT (Cognitive Behavioral Therapy). CBT is utilized to restructure how one thinks about and interprets pain. Curbing negative thinking is critical to changing perceptions. Instead of catastrophizing an acute flare up as a sign of permanent decline, patients can learn to see this for what it is _ a temporary and manageable event that will subside.

Along with CBT, patients benefit from becoming aware of how they communicate distress. Habitual grimaces, moaning, groaning and limping are sometimes just that _ habits which do not reflect how they feel at a given point in time, but communicate dire distress to family and others.

Rather than see themselves as victims of pain or injury, patients undergoing Cognitive Behavior Therapy can learn ways to control the experience of pain and moderate their expression to family. This, in turn, changes how they see themselves.

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