AcasăTerapiiPsihologieDurerea cronică în psihologie|Aesthesis Psihologi Madrid: descoperă cum să o învingi.

Durerea cronică în psihologie|Aesthesis Psihologi Madrid: descoperă cum să o învingi.

Durerea cronică în psihologie|Aesthesis Psihologi Madrid: descoperă cum să o învingi.

In Spain, chronic pain currently affects 18% of the population, posing a serious health problem due to the consequences it has for those who suffer from it day after day. For the past 14 years, World Day Against Pain has been celebrated on October 17th to raise awareness of the urgent need to find relief for those living with pain. At Aesthesis, we believe that psychology has a lot to contribute to this disease.

Definition of Pain
Defining pain correctly is so important that it has led the International Association for the Study of Pain (IASP) to update the definition of pain in 2020, after more than 40 years without any changes. This necessary revision includes contributions from all parties involved, taking into account the criteria of both specialists and patients with pain and their caregivers. In 1979, the IASP defined pain as „an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (with „tissue” referring to damage to the body’s tissues). This definition has been widely accepted by healthcare professionals and researchers in the field of pain and adopted by professional organizations such as the World Health Organization. In 2020, the IASP redefined pain as „an unpleasant sensory and emotional experience associated with, or similar to that associated with, actual or potential tissue damage.” This means that pain doesn’t have to be solely a physical reaction to a present injury or illness, but it can also refer to the pain that people may continue to experience long after the injury or pain associated with an emotional state. The recent update of the definition of pain has become necessary due to the limited understanding historically of pain, its expression, and the associated psychological variables.

What is Chronic Pain?
It is important to differentiate between acute pain and chronic pain. Acute pain is adaptive as it helps people protect themselves from danger. It appears suddenly, there are clear signs of injury, and its duration is short. Chronic pain, on the other hand, is diagnosed when it lasts at least six months, or longer than expected for recovery, and it doesn’t serve a protective function for our body. Chronic pain is characterized by the disruption of basic functions of the person, generates high emotional stress, and can be due to biological, psychological, or social causes, although it often can’t be explained by a specific cause. Pain is a complex and personal reality, extremely variable for each individual, and can’t be directly measured. The experience of pain is greatly influenced by each person’s life experience and significantly affects independence and quality of life, largely due to the emotional consequences it entails. The experience of pain can also vary according to gender, age, or personality traits. Regarding gender, women are the ones who suffer the most from this problem, as they experience more clinical pain, suffer greater emotional stress associated with pain, and show a lower pain threshold response. As for age, older people, compared to the young, often identify pain as something natural within the aging process, experiencing it less distressingly. In industrialized countries, pain is a serious health problem that results in a large number of lost work hours, absenteeism, disability pensions, and sometimes excessive medication consumption. Depression and frustration are, in many cases, the person’s reaction to a problem that medical advances have not been able to address, but only alleviate. In this sense, it is important to note that the psychological consequences of experiencing pain, such as avoidance or feelings of anxiety, anger, or sadness, are independent of the location of the chronic pain being experienced. That’s why all chronic pain is amenable to psychological treatment, and at Aesthesis, we offer specialized treatments for it. The consequences of pain itself can perpetuate it!

Usually, pain entails a series of consequences, among which the following stand out:
– Physical avoidance, meaning to stop doing activities that may cause pain, remaining lying down or sitting.
– Social avoidance, meaning to reduce social interactions because they don’t want to justify the pain they feel, the feeling of not being understood, or the feeling of burdening their close circle.
– Very often it leads to dependence on medication, which progressively loses its initial effect. Today we know that these common consequences of pain contribute to its chronicity. We also know that the different psychological dimensions involved in pain interact with each other, feeding back in different directions, and forming a chain that contributes to the maintenance and chronicity of pain: Fatigue, exhaustion, sleep problems / Pain / Muscle tension, joint stiffness, weakness / Frustration, anger / Stress, anxiety, fear / Depression… Look at the schema, does it sound familiar?

Chronic Pain: How does it affect social and interpersonal relationships?
Chronic Pain and Communication
In the field of social relationships, feelings of misunderstanding among patients with chronic pain are frequent, even among their closest circles. Despite good intentions, family and friends may respond inappropriately to the person expressing their pain, falling into overprotection, excessive criticism, or fear. In response to such reactions, patients experience even more pain, feel more stressed, and exhibit high levels of physical disability. On the other hand, the lack of emotional expression, the fact that the patient does not communicate their pain to those closest to them, has been clearly related to a greater experience of pain and a continuous feeling of loneliness and social isolation. Emotional communication, as well as interpersonal empathy between the patient, their family, and all those who provide assistance and care, are crucial in tolerating chronic pain better and improving the patient’s emotional experience.

Chronic Pain and Attachment
Attachment is also an influential factor in the predisposition to experience pain. Attachment is the type of emotional bond that we establish with our caregivers from the earliest moments of life, and it is responsible for providing us with security in threatening situations. Studies indicate that insecure attachment with parents or caregivers in childhood is a risk factor for responses that include pain. In other words, the child’s distrust and insecurity in the parents’ caregiving abilities influence the perception and expression of pain in adult life. Attachment studies in adults suggest that people with insecure attachment, echoing their initial pain reactions to their caregivers’ separation, anticipate a greater response to pain. This predisposes them to chronic pain and catastrophizing, meaning an excessively negative emotional and cognitive orientation towards pain (real or anticipated) on the part of the individual.

Chronic Pain and Traumatic Experiences
Unprocessed traumatic experiences in childhood, such as physical or sexual abuse, are considered important factors in the development and maintenance of chronic pain in adults. Negative thoughts about pain, inadequate coping strategies, as well as weak support from the family and social environment, increase the activation of our body’s responses to threatening situations or events and increase vulnerability to stress, resulting in experiencing more pain at the onset of an illness or injury.

Consequences of Chronic Pain
There are numerous consequences that chronic pain has in different areas:
– Emotional consequences: Anxiety, depression, insomnia, low self-esteem
– Social consequences: Problems with family, partners, friends, voluntary isolation
– Consequences on quality of life: Decreased physical activity, lack of independence, reduced leisure activities
– Economic consequences: Sick leave, economic resources scarcity, poverty, healthcare costs

How to Cope with Chronic Pain?
It is a common belief that the appropriate treatment for chronic pain is pharmacological. However, pharmacotherapy has serious limitations for relieving chronic pain.

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