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Psychotherapy for Chronic Pain FAQ's

Why did my doctor recommend psychological services for my chronic pain?

Many patients worry that they are being referred for psychological services because their doctor believes that they are “imagining” their pain, exaggerating their symptoms, or addicted to their pain medications. The reality, however, is that the doctors and physician's assistants on your treatment team recognize the profound impact that chronic pain has on all aspects of your life. The actual physical pain you feel is only one aspect of what you are experiencing.

“With chronic pain, the body part that hurts is often just the tip of the iceberg. Underneath lay various impacts that often accompany, and may worsen, chronic pain, including: emotional distress, fatigue, sleep disturbance, physical deconditioning, thinking and memory problems, and poor nutrition.”

--Mayo Clinic Pain Rehabilitation Center

How is pain related to my mind and emotions?

The experience of pain is complex. Pain messages from the site(s) of your source of pain travel to three different parts of the brain: the somatosensory cortex (the part of your brain that registers physical sensations), the limbic system (the part that regulates emotions), and the frontal cortex (or “thinking region” of the brain). Put simply, this means that chronic pain not only affects how you feel physically, but how you feel emotionally, as well. It can impair thinking and memory, and can exacerbate negative emotions such as sadness, hopelessness, fear, and stress. In turn, these emotions can actually intensify your perception of chronic pain.

How can psychotherapy help?

Dr. Steven D. Abney uses a combination of psychoeducation and cognitive behavioral therapy to enable you to learn more about the role of thoughts and emotions in your experience of chronic pain. Patients learn relaxation skills and pain coping strategies, and are encouraged to discuss any psychosocial factors that may be inhibiting their ability to cope. Such factors may include dysfunctional relationships, trauma, grief, addiction, psychological or personality disorders.

What should I expect?

The first session typically consists of a clinical interview. The interview lasts approximately 30 to 45 minutes and is intended to gather as much information as possible regarding your pain history and current physical and psychological functioning. The interview is an informal process, and you will have ample opportunity to discuss your goals and concerns and ask questions. Following the interview, Dr. Abney will provide feedback and recommendations. 

Length of treatment is dependent upon many factors. Sessions are typically 50 minutes in length, and most patients find that they are coping better within a relatively short period of time (6-8 sessions). Other patients continue to use psychotherapy on an ongoing basis. The important thing to remember is that psychotherapy is a collaborative process. Dr. Abney will work with you to identify your goals and develop a treatment plan best suited to your needs.