Psychological therapy, chronic pain and stress: What we have learned from the neurosciences
It has been found that specialized psychological support for dealing with pain enhance individuals’ mental control over pain, thus reducing the negative effects of chronic pain or stress (Veehof et al. 2016).
On a behavioral level, this means that these sessions train the individual’s brain to reduce perception of chronic pain by increasing the effort to find active solutions for dealing with pain and ultimately diverting the individual’s attention to active coping rather than passive focus on chronic pain (on the problem). For example, the person learns to pay attention to positive elements that exist in life and has neglected due to pain, or learns to focus on accomplishing small goals in daily life despite the fear of pain. At a cogntive level, this means that individuals learn to involve the prefrontal cortex more in their daily lives. The prefrontal cortex is related with the ability to take decisions, the ability to choose, etc. So there is enhanced mental control of the individual in relation to pain or, in other words, the individual can decide and have control over himself despite the pain (Grant et al . 2011).
Reducing stress through mindfulness training and meditation can have positive effects on chronic pain through similar neurophysiological processes. Meditation reduces pain and can help reduce the experience of pain by reducing the maladaptive cognitive processes that people in chronic pain can often feel (outbursts or suicidal tendencies). Meditation causes analgesia and increased activity in the prefrontal cortex area, which as stated above is involved in the “cognitive regulation” of pain (Zeidan et al. 2011).
The research of neuroimaging in these areas continues. In the future, it may help in optimization of psychological (and psychosomatic) therapies for people with chronic pain and stress. It could also provide objective biomarkers of chronic pain in the brain and guide treatment for individualized pain management.
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