Chronic Pain: What are You Talking About?
by Christopher Cooper
Pain is a dynamic, conflicting, and complex physiological and psychological experience, ranging from acute episodes to chronic disease. Every human in their lifetime will experience pain of some kind or another; a bone fracture from a bicycle accident, headache due to the effects of improper lighting, or a herniated disk in the lumbar spine from repeated heavy lifting. Pain is a part of everyday life, whereby acute is the most common experienced. Acute pain may or may not be a problem to explore with your medical doctor, such as the thumb you hit with a hammer. Chronic pain on the other hand, the thumb you didn’t hit with the hammer, but hurts every day, is the kind you would best be advised to discuss with both your psychologist and medical doctor. Chronic pain of many varieties is estimated to affect up to 40 per cent of people, and for approximately half those individuals there is no definite organic cause. Unlike acute pain, chronic pain becomes a topic of interest and potential concern because it does not respond well to the typical biomedical model of treatment that your bruised thumb would get.
Chronic pain is the kind of pain that lasts months or even years. Generally, it’s diagnosed after three to six months of pain and numerous visits with your MD. With chronic pain, one’s nervous system can actually be altered; referred to as plasticity of mind, making your awareness of the pain even more sensitive and creating biased thinking, or distorted cognition. With this alteration of one’s mind, pain can be fundamentally threatening and interruptive, with potential to interfere with everyday tasks of life. As a result, painful sensations might feel more severe and last longer and have increasingly greater emotional impact.
Prolonged pain will eventually negatively affect mind, body, and spirit. This typically leads to exhaustion and a reduced quality of life overall. In both my experience personally, and in my research and practice with chronic pain patients, I understand thoroughly that a psychosomatic approach, or what may be referred to as an integrative medicine or behavioural medical approach, has the best outcome—it is about learning to live with the pain. Psychosomatic means mind (psyche) and body (soma), and these disorders are conditions that involve both mind and body, but often begin with a real physical problem. Some physical conditions are thought to be particularly prone to be worsened by the mental factors of stress and anxiety, or can even be caused by them, such as heart disease.
One of the most important points I have discovered over my seventeen years of research and practice is that long-lasting pain provokes an important concept of interest; existential crisis. Chronic pain can create difficulty and struggles in making sense of the daily unwanted, stressful experiences connected to pain, creating patterns of avoidance and misplaced blame.
Since approximately twenty percent of our population is under medical care for pain conditions without an objective diagnosis from their doctors or any observable cause or origin, decisions of treatment course and medication choice are difficult. Research had previously indicated a need for clearer diagnoses of pain conditions when there is a lack of objective medical criteria.
In deciding what represents clinically important improvement, the patient’s experience of pain for understanding the indications is necessary together with the medical interpretations. In a dynamic manner, pain and its consequences are intrinsically subjective and influenced greatly by a person’s mood, previous pain experience, and coping resources. Our understanding of pain is still deficient in understanding why the extraordinary complexity associated with long-standing pain presents limitations for satisfactory treatment. Success depends on both clinicians’ and patients’ interpretive criteria, where the patients’ interpretation of their pain is of primary importance. Ultimately, the goal is to investigate how one can cope with chronic pain by recasting it within the frameworks of cognition, life goals, and self-concept, in relation to a subjective sense of well-being.
My areas of interest are how our mind and emotions either maintain and or increase our perception to pain; such as fear, anger, and sadness as related to suffering. Positive changes in the duration, intensity, and quality of pain are associated with reductions of negative thought patterns; related to helplessness and feelings of not being in control. Therefore, anything related to our evaluation of pain, rather than sensory experience, is an important awareness we gain.
People who suffer from chronic pain typically do not have problematic psychological histories; rather, they develop problematic structures as a result of what is called continuous noxious stimuli. These take hold and demand precedence. In this negative pattern, daily activities and expectations that were once enjoyable now become a problem, as expectations lack positive meaning for guidance into them.
What can one expect in a psychological treatment to pain?
The medical profession is often perplexed with the complexity of pain and may consider some untreatable without hope for relief. Since our individual perception is deeply rooted in physical presentation, self-understanding, and societal norms and values, treatment will first identify the key components of “self” that are related to pain, and the outcomes are treatable measures of well-being and cognitive distortion. Through this process you will learn better how to live with your pain and realize less of it.
Christopher Cooper’s background is in clinical and health psychology, providing treatment to individuals, couples, families, and in group settings. He is presently preparing for the defence of his PhD work. He studied Psychosomatic Medicine as part of his doctoral work in Eastern Europe and Oslo, Norway. He has extensive experience with chronic pain, depression, anxiety, trauma, loss/change, relational issues, crisis intervention, and anger management. His work is an integrated value-based cognitive approach supported by best practice, where an understanding of one’s intentions in life for “self” and all with whom they interact is considered. He has seventeen years experience practicing psychology, inclusive of lecturing at the Tallinn University, Audentes University, and Concordia International University in Estonia, and since 2007 lectures at the University of Saskatchewan for the Department of Psychology. In all cases of Christopher’s practice, attending to the person’s current and future sense of well-being for achieving a greater potential is a fundamental objective. Visit www.primarypeople.ca and/or call (306) 222-7297. Also, see the display ad on page 11 of the 22.2 July/August issue of the WHOLifE Journal.