By Diane LaChapelle Ph.D., LPsyc

What are psychological therapies?
If you live with pain, you already know how it can take over and seep into every corner of your life.

Dealing with the pain itself on a daily basis is exhausting. Dealing with all of the consequences of having pain can create even more problems. For example, if your pain affects your ability to work, you might have trouble making a living. You might lose your social network of co-workers. You might feel like you are no longer making a difference to society or helping your family. All of this can lead to depression, anger, and anxiety. As shown in the figure below, these emotions and thoughts then feed back into your pain experience and can make the pain worse. This is called The Pain Cycle.

The Pain Cycle
Some people get caught in this negative downward spiral and find it difficult to see a way out. This is where a psychologist can help. A psychologist can help you break out of this cycle by teaching you new skills to better manage the pain itself and how to cope with the consequences of pain.

Types of psychological therapies
There are two types of psychological therapies that have been shown to be effective in helping people with chronic pain significantly improve their quality of life. These are cognitive-behavioural therapy (CBT) and acceptance and commitment-based therapy (ACT). Mindfulness meditation and family/couples counselling can also be used along side of these therapies.

CBT focuses on how your physical pain experience, emotional reactions, thoughts, and behaviours are connected. The goal is to help you learn new skills to change your thoughts and behaviours and improve your mood.

ACT can help you identify your core values and beliefs so that you can learn to make choices about how to live your life on the basis of these values rather than on the basis of pain.

Mindfulness meditation
Mindfulness meditation involves learning how to be in the moment. It can help you let go of the past and reduce your worry about the future.

Family or couples counselling
Pain can impact the whole family. Because of this, family or couples therapy can be a helpful addition to individual therapy.

Overall, the goal of the psychologist is to help you break free of the Pain Cycle by teaching you how to become an effective self-manager of your chronic pain condition and its consequences.

To help yourself break free of the Pain Cycle, please explore the links in this site and the resources listed in the “Self-Help Resources” page of this section.

Some words of caution
Self-help resources may be all you need to help manage your pain or to deal with milder cases of emotional distress. In this case, you could consult with a psychologist to help you work through a self-help manual in order to make the most of your new skills and stay motivated.
If you are experiencing serious sadness, fear, anxiety, or anger, you should see a psychologist. If you are experiencing thoughts of suicide, talk to your family physician immediately – professional assistance is a must.

Tips for finding a therapist
Let’s begin by setting the record straight. The pain you feel is REAL. Working with a psychologist does not in anyway indicate that the pain is not real or that it is “all in your head.”

Those who do not live with pain may require help understanding how chronic pain can lead to so many problems. Having your friends and family explore this website with you will help them get on board with the changes you will be making.

Many of the skills recommended in the “Resources” Section can be self-taught. However, if you have a lot of fear, anger, or sadness, you should consult with a psychologist. He or she can help guide you through the changes that are necessary to feel better. A psychologist can effectively treat the psychological problems that sometimes accompany chronic pain including anxiety, depression, PTSD, and panic.

To find a licensed psychologist in your area, consult with your provincial or territorial licensing board. You can find a listing of all the licensing boards across Canada on the Canadian Psychological Association website.

Find a psychologist who is experienced in working with people who have pain and who practices cognitive-behavioural or acceptance and commitment-based therapy. Both these approaches have been shown to help people with pain regain a better quality of life.

Remember, breaking the pain cycle takes hard work. Don’t expect things to change overnight. Persistence with implementing these recommendations will help you regain a better quality of life.