You’ve dealt with chronic back pain for many years. After trying many treatment options, you and your physician have decided that a surgical procedure followed by physical therapy is your best course of action.
While reluctantly agreeing, you are surprised by the next words out of your physician’s mouth:
“Let’s get you an appointment set up with a pain psychologist.”
The idea of seeing a psychologist of any kind had never crossed your mind. After all, you are struggling with back pain…not a mental issue. But what your physician suggested is not really that unusual – and many pain sufferers have found working with a pain psychologist an extremely beneficial part of getting through a treatment protocol (as well as just living with a chronic pain condition).
What is a pain psychologist?
Pain psychology is a specialty within psychology. People who practice pain psychology typically have a Ph.D. in clinical psychology and have completed an APA-accredited post-doctoral fellowship that specializes in chronic pain.
Pain psychologists are experts in helping people cope with the thoughts, feelings and behaviors that accompany chronic pain. Many pain sufferers don’t realize that:
- How you think and feel impacts pain processing
- How you think and your emotions influence your daily choices (and therefore your pain)
According to the International Association for the Study of Pain, pain is both a sensory and an emotional experience. This means that psychology is built into the very definition of pain. The way you think and feel impacts how you process pain in the brain…and is fundamental in the mind-body connection we know exists with pain. Psychologists help teach techniques for regulating our thoughts and emotions to impact a better sensory experience.
Understanding and managing the thoughts, emotions and behaviors that accompany the discomfort you have can improve how you cope with your pain and even reduce the intensity of your pain.
What can a pain psychologist do for you?
Pain psychologists can be beneficial in a variety of roles and at various points in your treatment process. Four key roles include:
Consultant or evaluation role
A pain psychologist can augment the data collected by your physician as it relates to your pain. This information helps fill in the larger picture and assists in goal-setting for treatment as well as metrics for the improvements experienced. At the same time, the psychologist can provide you with pre-screening before treatment to indicate a need for additional education on the treatment protocol and risks. Once treatment begins, he/she can provide a safeguard for the prescribing physician by monitoring compliance and assess a your mental “fitness” for resuming normal activities.
Therapy or counseling role
During pre-treatment, pain psychologists can provide education to reduce your fear and anxiety and increase your motivation to stick with the protocol. But often, you simply need a counselor to talk to throughout the treatment process. A psychologist can offer cognitive-behavioral therapy to:
- Help you understand the dynamic interaction between pain and mood
- Assist in reducing any emotional distress associated with your chronic pain experience
- Address your psychological concerns stemming from genetics, biology, social or other causes
- Help you develop adaptive strategies and skills to cope with stress and pain
Protocol reinforcer role
In this role, a pain psychologist is making sure you maintain your improvements from your pain treatments and don’t relapse when you don’t follow the protocol. Sometimes, you just need to be able to recognize and cope with difficult aspects of the treatment. A psychologist can help you practice new coping techniques and pain management strategies, particularly when faced with hard or high-risk situations.
Analysis of outcome role
Finally, a pain psychologist can be an assessor for how a treatment protocol is really working. Without meaningful and critical analysis of pain therapies, physicians may end up continuing to prescribe patients ineffective or even needless therapies. By providing measurements of more “generic” outcomes – including quality of life, patient satisfaction and overall health – a psychologist can augment the outcome being measured by the pain specialist and present a more complete picture of how well a treatment is working.
What should you expect from the experience?
When you first start working with a pain psychologist, you will likely be asked to complete a questionnaire to record your thoughts and feelings about your pain…but be prepared to also spend some time discussing your emotional as well as physical health. It’s important for your psychologist to have a very comprehensive understanding of your stresses and concerns about your pain and the treatment being proposed. From there, your psychologist can determine what coping skills, relaxation techniques or other behavioral approaches to work on with you.
The process will bring to light any anxiety or depression that may be accompanying your pain or the proposed treatment protocol. So if lifestyle changes are needed, a psychologist can help you make the ones that will allow you to keep participating in life’s activities or learn to sleep better…just to name two.
Depending on your situation, you may only need a few treatments or benefit from a longer-term approach to seeing a pain psychologist.You and your psychologist, together, will decide on the best length of treatment. While how long you have treatment varies, the goal is always the same: to help you develop skills to cope with your pain and live a full life.
How to find a pain psychologist
Pain psychologists may work in private practice or as a part of a clinical setting. Sometimes, you will be referred to them by another health care provider or your pain physician. The bottom line is that psychologists often collaborate with other providers – it is not unusual, given the connections between physical and emotional aspects of pain.
If you don’t get a referral, you can start your search at Psychology Today, where they have a listing by zip code and city for licensed psychologists who specialize in chronic pain.
PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.