Pain psychotherapy

Individual psychotherapeutic sessions look specifically at the individual’s situation: What discomfort is he or she suffering? What helps in dealing with it? What does the patient good and makes them happy? Through conversations and exercises, the subject’s thoughts, feelings and bodily sensations are brought to the fore, to help them address their personal concerns. The focus may be on the pain itself, or on other issues related to the pain. Possible goals include improved pain management and alleviation, the treatment of other mental symptoms (e.g. anxiety, depression, sleep disorders) or promoting a healthy approach to coping with personal stress and resources.

Information about chronic pain and how to deal with it is given in pain psychology group therapies. Group members are shown how to deal with their pain as effectively as possible. They may be taught relaxation techniques or assigned activities or topics such as ‘Pain and stress’, for example. Many group therapies are interdisciplinary, combining pain psychotherapy with elements of physiotherapy, occupational therapy and/or pain medicine.

Biofeedback is an umbrella term for various therapeutic techniques which, for the past few years, have been used with great success in the area of pain psychotherapy, as well as in the treatment of other health problems such as high blood pressure, ADHD, epilepsy, tinnitus, incontinence and insomnia. Biofeedback is provided by body signals, such as muscle tensions in the shoulders or neck, which are measured by sensors and sent via a computer program to the display screen of a patient. The relayed information can then be used to help the patient alleviate their neck or shoulder pain.

In pain medicine, the ability to relax is an important part of therapy, because tension can be the cause as well as the consequence of chronic pain. Various relaxation methods, such as Jacobson’s progressive muscle relaxation (PMR) technique or autogenic training, have proven to be helpful in such cases. In PMR, muscular tension is released in a predetermined sequence, via a transition from slight tension to subsequent relaxation. At the same time, correct breathing techniques promote deeper relaxation. Physical peace and calm have a positive effect on pain and help to reduce stress. The exercise can be learned in both individual and group settings.

These techniques are easy to adopt, but they have to be practised regularly. They help the affected person to improve their perception of their own body, enabling them to break the vicious circle between pain and tension at an earlier stage. Together with PMR, imagination exercises such as ‘a place of calm and relaxation’ are also used. The Centre for Pain Medicine also offers hypnosis, mindfulness and breathing exercises.

Hypnosis is a proven form of therapy that is also used successfully in pain treatment. The procedure is as follows: first, the patient’s level of consciousness is lowered into a sleep-like state, also known as deep relaxation. In this state of deep relaxation, the subject’s perception of pain can be changed, so that pain is subsequently perceived less strongly in the waking state.

Hypnosis goes beyond the bounds of pure pain therapy by activating and strengthening the body’s own resources, thus improving the subject’s quality of life. It can also alter pain-inducing or -sustaining influences, as traumas or fears can be worked through or resolved through hypnosis. During the treatment, even in a state of deep relaxation, the patient maintains control over him- or herself. Hypnosis works particularly well in conjunction with other pain therapies, such as conversational psychotherapy, physiotherapy or acupuncture