How psychologists can help with pain management

While pain serves a purpose in alerting you to an injury such as a sprain or burn, chronic pain (also known as persistent pain) relates to pain that persists for more than three months. 

People with ongoing, persistent pain often feel their pain is out of their control. A change in mental perspective and behaviour can help people to own their pain instead of feeling that their pain owns them. 

The connection between pain and psychological factors 

Chronic pain is a complex phenomenon. Many people are stuck on an outdated view of pain as a biological problem. However, our understanding of chronic and persistent pain is slowly increasing, and we are learning to understand the influence of psychological variables and the role the brain plays in our experience of pain.  

Pain is now understood to be an output of the brain, as in, the brain creates the sensation of pain, rather than the brain receiving pain sensation passively from the body.  

How a person thinks and feels about their pain is important. An individual may experience unhelpful thinking patterns that increase their experience of pain. For example: 

• Do they catastrophise and think, “my pain will never stop” or “nothing can help improve my pain”?  
• Does the person believe they have some level of control or ability to cope with their pain?  
• How do they feel about their pain or how do they feel in general?  

Anger, depression, and anxiety can worsen the experience of pain, and can contribute to an individual ‘turning up the volume’ on their pain. 

As an example, a person stands up from a table and feels pain in their back. They think to themselves, “well I was going to go to the gym but now I am too scared I’ll hurt myself.” They might feel frustrated, sad, and worried and as a result they sit on the couch all day watching TV, ruminating over their back injury, thinking how their life is now over. This behaviour may put themselves at risk of further pain, further slowing their recovery due to inactivity or weakening muscles.  

This example provides a brief overview of the interplay of thoughts, feelings, and behaviour and how it’s crucial to understand this cycle and how people perceive, cope, and respond to their pain. 

Working with a psychologist to manage your pain 

Psychological factors play a huge role in the development and maintenance of chronic pain. Working with a psychologist who specialises in persistent pain can help to identify and address these factors which will differ from person to person.  

The goal of therapy is not to remove pain but improve a person’s ability to function, decrease any challenges associated with chronic pain, and improve their quality of life – it is possible to change one's pain experience physically and emotionally.  

Therapy may include: 

• Learning how to respond differently to pain (which will change the way pain is processed in our brains) 
• Relaxation training to ease stress, muscle tension and autonomic arousal (e.g., racing heart) 
• Improving sleep hygiene and creating a comfortable sleep environment in your bedroom 
• Learning activity pacing to increase engagement in pleasant activities without increasing pain  
• Learning how to identify unhelpful thoughts and beliefs about pain and how to manage them 

Other frequent interventions include coping with family and marital issues related to the pain; anger management; and learning strategies for managing setbacks. Some of these areas of treatment may cross over with other health professionals. 

Support at Mates4Mates 

Chronic pain is complex and requires a multi-faceted approach  – working with a psychologist, working with an exercise physiologist, as well as other relevant health professionals. There is no one size fits all when working with chronic pain. 

If you are a veteran or family member who has been impacted by service who is looking to manage their chronic pain, please call 1300 4 MATES (62 837) to book an appointment with a Mates4Mates psychologist or exercise physiologist.  

Written by Hannah Jarrold, Psychologist  

References

Murphy, J.L., McKellar, J.D., Raffa, S.D., Clark, M.E., Kerns, R.D., & Karlin, B.E. (n.d.). Cognitive behavioral therapy for chronic pain among veterans: Therapist manual. Washington, DC: U.S. Department of Veterans Affairs.

Veteran Affairs. (n.d.). Seven things you should know about pain.