Pain management psychology
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Transcript of Pain management psychology
Pain Management Psychology
JOHNSEY THOMAS Consultant Clinical Psychologist
Pain Management Psychology
Defining PainAn unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
International Association for the Study of Pain 1979
Mind-Body- Soul Healing
Almost everything deals with
mind-body issues, but it would
be rational to say that a
principal focus is self change
and ways that Psychology can
help with this…
Mind-Body- Soul Healing
Psychology can help with this,
especially with regard to enabling
greater happiness and better
health. It helps to believe", Mind
over matter" and "all in the mind"
look at the role of thinking
processes in self-healing.
Key Concepts
Most people think of pain as resulting
from physical injury or disease, but
psychological factors play a huge role
in pain perception. Pain is intimately
tied to brain functions that govern
behavior and decision making,
including expectation, attention and
learning.
Psychology
plays a major role
in
Pain Management
My doctor
recommended I should
see a psychologist for
Pain Management.
Why would I see a
psychologist? This pain
is not in my head and I
am not crazy!
No it unlikely to be in your
head - the pain is most
likely very real. However
there are many
psychological techniques
which have been shown to
assist people in coping
with chronic pain.
Pain Psychologists are
part of the treatment
team for patients
suffering from chronic
pain (including cancer
pain) as well as other
chronic conditions.
Recent research suggests that
pain is mismanaged in up to
50% of cases. For example,
irrational fears about addiction,
underreporting of pain,
inadequate communication
between patient and doctor,
lack of knowledge, etc.
Pain is disturbing my
Life-Sleep-Work
Sleep as a Medicine
Sleep is an essential part of our
lives. It’s an opportunity for
your body to repair itself, both
physically (e.g., repairing
muscles) and psychologically
(working through anxiety).
I can sit at ease And relax
Guided imagery involves
having the person with pain
imagine (using all or as many
as possible of their senses, not
just the visual) something that
contributes to relaxation,
healing, or the lowering of pain
and suffering.
This could be going to a
relaxing place such as the
beach or imagining what your
pain looks (sounds, smells,
tastes, feels) like and changing
the image!
I have cut
down my
routine activity
drastically
When pain persists over
time, a person may avoid
doing regular activities for
fear of further injury or
increased pain. This can
include work, social
activities, or hobbies.
As the individual withdraws and becomes less active, their muscles may become weaker, they may begin to gain or lose weight, and their overall physical conditioning may decline. This can contribute to the belief that one is disabled.
Do I need to live and suffer
lifelong with pain?
They say, I don’t have any problem
pain, but I know; what I am going
through
I getting easily
frustrated and
irritated
Sometimes I feel
Pain is demanding
† It feels like I've been drained of all energy and that to do just about anything will take more effort than I can summon.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
† I feel like I've lost interest in activities that were once
enjoyable for me.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
† When the phone rings, I tend to ignore it even when I know it
may be a good friend calling.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
† I've noticed a change in my sleeping pattern such as difficulty falling asleep, waking up frequently throughout the night, or oversleeping in the morning.
Not at all
Very seldom/ Rarely
Sometimes
Most of the time
All of the time
† It's been taking longer and has seemed harder than usual to make decisions.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
† It seems as though everything is going wrong no matter how hard I'm trying.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
† I've been turning down invitations
to get together with friends because
trying to socialize feels like it will
take more energy than I have or
because I think my "down“ mood will
just depress everyone else.
Not at all
Very seldom
Sometimes
Most of the time
† I've been getting headaches, stomach- aches, backaches, or pains in my joints or muscles that can’t be traced to a physical illness or injury.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
† I've been feeling restless and/or irritable.
Not at all
Very seldom
Sometimes
Most of the time
All of the time
Psychology in
Managing Pain
… is tailored to the individual needs
† Relaxation Therapy
† Cognitive Behavior Therapy
† Cognitive Restructuring
† Stress and Anger Management
† Sleep Hygiene
† Activity Pacing
Relaxation Therapy- is that
blissful state of being at peace with
oneself and with the world.
It creates measurable changes in the body,
such as a reduction in oxygen consumption,
heart and respiratory rate, blood pressure,
blood cortisol levels, and muscle tension, and
an increase in the production in the brain of
serotonin which leads to feelings of calmness
and well-being.
Cognitive behavior
Therapy- CBT for pain management has
three basic components.
1. treatment rationale that helps
patients understand that
cognitions and behavior can affect
the pain experience and
emphasizes the role that patients
can play in controlling their own
pain.
2. Coping skills- Progressive
relaxation and cue-controlled
brief relaxation exercises are
used to decrease muscle
tension, reduce emotional
distress, and divert attention
from pain.
Activity pacing and
pleasant activity
scheduling are used to
help patients increase the
level and range of their
activities.
Training in distraction
techniques such as pleasant
imagery, counting methods,
and use of a focal point
helps patients learn to
divert attention away from
severe pain episodes.
Cognitive restructuring is
used to help patients
identify and challenge
overly negative pain-related
thoughts and to replace
these thoughts with more
adaptive, coping thoughts.
The third component of
CBT involves the
application and
maintenance of learned
coping skills.
Problem solving methods are
taught that enable to analyze
and develop plans for dealing
with pain flares and other
challenging situations.
Self-monitoring and
behavioral contracting
methods also are used to
prompt and reinforce
frequent coping skills
practice.
If sleep is disrupted for an
extended period of time it can lead
to the following effects:
† Increased emotional
distress and irritability
† Increased clumsiness and
poor coordination
If sleep is disrupted for an
extended period of time it can lead
to the following effects:
† Decreased work
performance and memory
lapses
† Increased risk of
automobile accidents
† Difficulty concentrating
Ways to Improve Sleep
† Timing: Establish same pattern
† Sleep Behavior:
† Bedroom Environment Tips:
† Ingestion:
† Mental Control:
† Say NO to Coffee /Tea…
Guided Imagery?
During guided imagery, you
control your breathing and relax
your muscles. You focus on
something specific – such as a
therapist’s voice or the
instructions on a DVD or audio
tape. You enter into a state of
deep relaxation, success, and
wholeness – similar to
meditation.
Pain Psychology will help you to…
feel betterconquer Pain to lead quality life