Psychological Treatment for Chronic Pain

Everyone has experienced pain from an injury, or a surgery, or just because of normal wear and tear on the body. But what happens when pain is either chronic or it keeps coming back? For millions of people, pain, or the anticipation of pain, is a daily event. And it is natural and normal for those with pain to try and find the root cause of the pain and get someone to fix what’s broken. At the very least, we hope for medicines that will get rid of or reduce the agony. But persons suffering from chronic pain are often left feeling that the medical system has abandoned them. Feelings of anxiety, anger, depression and helplessness are all too common, and the mental world in which they live becomes a nightmare: as great a problem as the original source of pain.

Psychological treatment for chronic pain is now considered a mainstream part of an interdisciplinary treatment approach. Although it is still common for people to think that a psychologist only treats mental illness, the role for a psychologist in pain management goes well beyond working with someone’s emotional reactions to pain. Typically, pain psychologists will offer some type of cognitive-behavioral therapy (CBT), which is consider the “the gold standard” of psychological pain treatment. CBT works by helping you learn to recognize the importance of your thoughts, your emotions, and your behaviors in response to pain – and gives you the skills to do something about each of these reactions.

Can psychologists reverse the physical pathology that may have caused the pain in the first place? No. But we can teach those suffering from pain a way to better manage it. Think of chronic pain as a chronic illness, like diabetes is a chronic illness. You don’t expect it to go away, you expect to manage it. Doing so improves mood, gets you out of bed, and lowers the ‘stress thermostat’, all of which reduce pain levels and help people regain lost function. The end result is that people are freed up to live their lives despite having a chronic pain condition.

Many people ask, “So, does this mean the pain is all in my head?” No! And yes. Your brain tells your body that you are in pain, and of course, your brain is in your head. More important, though, the most recent scientific understanding of pain is that there are emotions and thought centers in our brain that have the ability to control the amount of pain experienced. So if you have a handle on the emotional and thought centers you can actually reduce the incoming pain signals to your brain, decreasing the amount of pain you experience. In a very real sense, you will learn skills to use the mind to your advantage. What can you expect? To quote one recent patient, “I still have pain, but it doesn’t have me.” Is that worth exploring for yourself?


Beverly E. Thorn, PhD

Chair, Department of Psychology, University of Alabama
Fellow, Society of Behavioral Medicine
Former Member, AL Board of Examiners in Psychology