Skip to main content
Log in

Learning from Physical Pain to Help with the Management of Emotional Pain

  • Original Paper
  • Published:
Journal of Contemporary Psychotherapy Aims and scope Submit manuscript

Abstract

There may be important similarities between chronic emotional pain and chronic physical pain. Both forms of chronic pain may promote negative beliefs about the self and the future. Chronic emotional pain and chronic physical pain both serve to disrupt patients’ focus from their actions and goals. Techniques used for the treatment of physical pain may be translated into the treatment of emotional pain. Four core strategies are reviewed including: (1) reducing catastrophic interpretations, (2) increasing tolerance by promoting acceptance, (3) cultivating positive expectations, and (4) remaining flexible in movements and attitudes. Patients can learn to tolerate limitations while pursuing their goals. Clinicians can help patients to reduce emotional pain by making a series of small changes in their thoughts and behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ablin, J. N., & Buskila, D. (2014). Predicting fibromyalgia, a narrative review: Are we better than fools and children? European Journal of Pain, 18(8), 1060–1066.

    Article  CAS  PubMed  Google Scholar 

  • Atlas, L. Y., & Wager, T. D. (2012). How expectations shape pain. Neuroscience Letters, 520(2), 140–148.

    Article  CAS  PubMed  Google Scholar 

  • Beck, A. T. (2008). The evolution of the cognitive model of depression and its neurobiological correlates. American Journal of Psychiatry, 165(8), 969–977.

    Article  PubMed  Google Scholar 

  • Benedetti, F., Lanotte, M., Lopiano, L., & Colloca, L. (2007). When words are painful: Unraveling the mechanisms of the nocebo effect. Neuroscience, 147(2), 260–271.

    Article  CAS  PubMed  Google Scholar 

  • Benedetti, F., Maggi, G., Lopiano, L., Lanotte, M., Rainero, I., Vighetti, S., & Pollo, A. (2003). Open versus hidden medical treatments: The patient’s knowledge about a therapy affects the therapy outcome. Prevention & Treatment, 6(1), 1a.

    Google Scholar 

  • Boselie, J. J. L. M., Vancleef, L. M. G., Smeets, T., & Peters, M. L. (2014). Increasing optimism abolishes pain-induced impairments in executive task performance. Pain, 155(2), 334–340.

    Article  PubMed  Google Scholar 

  • Carstens, J. K. P., Shaw, W. S., Boersma, K., Reme, S. E., Pransky, G., & Linton, S. J. (2014). When the wind goes out of the sail—declining recovery expectations in the first weeks of back pain. European Journal of Pain, 18(2), 269–278.

    Article  CAS  PubMed  Google Scholar 

  • Colloca, L., & Finniss, D. (2012). Nocebo effects, patient-clinician communication, and therapeutic outcomes. JAMA, 307(6), 567–568.

    Article  PubMed  Google Scholar 

  • Costa, L. D. C. M., Maher, C. G., McAuley, J. H., Hancock, M. J., & Smeets, R. J. E. M. (2011). Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain. European Journal of Pain, 15(2), 213–219.

    Article  Google Scholar 

  • Crombez, G., Viane, I., Eccleston, C., Devulder, J., & Goubert, L. (2013). Attention to pain and fear of pain in patients with chronic pain. Journal of Behavioral Medicine, 36(4), 371–378.

    Article  PubMed  Google Scholar 

  • Daenen, L., Varkey, E., Kellmann, M., & Nijs, J. (2015). Exercise, Not to exercise, or how to exercise in patients with chronic pain? Applying science to practice. The Clinical Journal of Pain, 31(2), 108–114.

    Article  PubMed  Google Scholar 

  • Darnall, B. D., Sturgeon, J. A., Kao, M.-C., Hah, J. M., & Mackey, S. C. (2014). From catastrophizing to recovery: A pilot study of a single-session treatment for pain catastrophizing. Journal of Pain Research, 7, 219–226.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dehghani, M., Sharpe, L., & Khatibi, A. (2014). Catastrophizing mediates the relationship between fear of pain and preference for elective caesarean section. European Journal of Pain, 18(4), 582–589.

    Article  CAS  PubMed  Google Scholar 

  • Dominick, C. H., Blyth, F. M., & Nicholas, M. K. (2012). Unpacking the burden: Understanding the relationships between chronic pain and comorbidity in the general population. Pain, 153(2), 293–304.

    Article  PubMed  Google Scholar 

  • Dysvik, E., Natvig, G. K., Eikeland, O.-J., & Lindstrøm, T. C. (2005). Coping with chronic pain. International Journal of Nursing Studies, 42(3), 297–305.

    Article  PubMed  Google Scholar 

  • Eccleston, C., & Crombez, G. (1999). Pain demands attention: A cognitive-affective model of the interruptive function of pain. Psychological Bulletin, 125(3), 356–366.

    Article  CAS  PubMed  Google Scholar 

  • Ehde, D. M., & Jensen, M. P. (2004). Feasibility of a cognitive restructuring intervention for treatment of chronic pain in persons with disabilities. Rehabilitation Psychology, 49(3), 254–258.

    Article  Google Scholar 

  • Eisenberger, N. I., & Lieberman, M. D. (2004). Why rejection hurts: A common neural alarm system for physical and social pain. Trends in Cognitive Sciences, 8(7), 294–300.

    Article  PubMed  Google Scholar 

  • Eisenlohr-Moul, T. A., Burris, J. L., & Evans, D. R. (2013). Pain acceptance, psychological functioning, and self-regulatory fatigue in temporomandibular disorder. Health Psychology, 32(12), 1236–1239.

    Article  PubMed  Google Scholar 

  • Enck, P., Benedetti, F., & Schedlowski, M. (2008). New insights into the placebo and nocebo responses. Neuron, 59(2), 195–206.

    Article  CAS  PubMed  Google Scholar 

  • Gatzounis, R., Schrooten, M., Crombez, G., & Vlaeyen, J. (2012). Operant learning theory in pain and chronic pain rehabilitation. Current Pain and Headache Reports, 16(2), 117–126.

    Article  PubMed  Google Scholar 

  • Gerrits, M. M. J. G., van Oppen, P., van Marwijk, H. W. J., Penninx, B. W. J. H., & van der Horst, H. E. (2014). Pain and the onset of depressive and anxiety disorders. Pain, 155(1), 53–59.

    Article  PubMed  Google Scholar 

  • Gosden, T., Morris, P. G., Ferreira, N. B., Grady, C., & Gillanders, D. T. (2014). Mental imagery in chronic pain: Prevalence and characteristics. European Journal of Pain, 18(5), 721–728.

    Article  CAS  PubMed  Google Scholar 

  • Hasenbring, M. I., Hallner, D., Klasen, B., Streitlein-Böhme, I., Willburger, R., & Rusche, H. (2012). Pain-related avoidance versus endurance in primary care patients with subacute back pain: Psychological characteristics and outcome at a 6-month follow-up. Pain, 153(1), 211–217.

    Article  PubMed  Google Scholar 

  • Hayes, B. K., Newell, B. R., & Hawkins, G. E. (2013). Causal model and sampling approaches to reducing base rate neglect. In Proceedings of the 35th Annual Conference of the Cognitive Science Society. http://csjarchive.cogsci.rpi.edu/Proceedings/2013/papers/0125/paper0125.pdf. Austin, TX: Cognitive Science Society.

  • Hodges, P. W., & Smeets, R. J. (2015). Interaction between pain, movement, and physical activity: Short-term benefits, long-term consequences, and targets for treatment. The Clinical Journal of Pain, 31(2), 97–107.

    Article  PubMed  Google Scholar 

  • Huijnen, I. P. J., Verbunt, J. A., Peters, M. L., Smeets, R. J. E. M., Kindermans, H. P. J., Roelofs, J., … Seelen, H. A. M. (2011). Differences in activity-related behaviour among patients with chronic low back pain. European Journal of Pain, 15(7), 748–755.

  • Hurter, S., Paloyelis, Y., de Williams, A. C. C., & Fotopoulou, A. (2014). Partners’ empathy increases pain ratings: Effects of perceived empathy and attachment style on pain report and display. Journal of Pain, 15(9), 934–944.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jackson, T., Wang, Y., Wang, Y., & Fan, H. (2014). Self-efficacy and chronic pain outcomes: A meta-analytic review. Journal of Pain, 15(8), 800–814.

    Article  PubMed  Google Scholar 

  • Klinger, R., Colloca, L., Bingel, U., & Flor, H. (2014). Placebo analgesia: Clinical applications. Pain, 155(6), 1055–1058.

    Article  PubMed  Google Scholar 

  • Koyama, T., McHaffie, J. G., Laurienti, P. J., & Coghill, R. C. (2005). The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences of the United States of America, 102(36), 12950–12955.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lepine, J.-P., & Briley, M. (2011). The increasing burden of depression. Neuropsychiatric Disease and Treatment, 7(Suppl 1), 3–7.

    PubMed  PubMed Central  Google Scholar 

  • Lindquist, K. A., Wager, T. D., Kober, H., Bliss-Moreau, E., & Barrett, L. F. (2012). The brain basis of emotion: A meta-analytic review. Behavioral and Brain Sciences, 35(03), 121–143.

    Article  PubMed  PubMed Central  Google Scholar 

  • Linton, S. J., Nicholas, M. K., MacDonald, S., Boersma, K., Bergbom, S., Maher, C., & Refshauge, K. (2011). The role of depression and catastrophizing in musculoskeletal pain. European Journal of Pain, 15(4), 416–422.

    Article  PubMed  Google Scholar 

  • Linton, S. J., & Shaw, W. S. (2011). Impact of psychological factors in the experience of pain. (Psychologically informed practice)(Report). Physical Therapy, 91(5), 700.

    Article  PubMed  Google Scholar 

  • Mason, V. L., Mathias, B., & Skevington, S. M. (2008). Accepting low back pain: Is it related to a good quality of life? The Clinical Journal of Pain, 24(1), 22–29.

    Article  PubMed  Google Scholar 

  • McCracken, L. M. (2013). Committed action: An application of the psychological flexibility model to activity patterns in chronic pain. Journal of Pain, 14(8), 828–835.

    Article  PubMed  Google Scholar 

  • Mccracken, L. M., & Morley, S. (2014). The psychological flexibility model: A basis for integration and progress in psychological approaches to chronic pain management. Journal of Pain, 15(3), 221–234.

    Article  PubMed  Google Scholar 

  • McCracken, L. M., Sato, A., & Taylor, G. J. (2013). A trial of a brief group-based form of acceptance and commitment therapy (ACT) for chronic pain in general practice: Pilot outcome and process results. Journal of Pain, 14(11), 1398–1406.

    Article  PubMed  PubMed Central  Google Scholar 

  • McCracken, L. M., & Zhao-O’Brien, J. (2010). General psychological acceptance and chronic pain: There is more to accept than the pain itself. European Journal of Pain, 14(2), 170–175.

    Article  PubMed  Google Scholar 

  • Mee, S., Bunney, B. G., Bunney, W. E., Hetrick, W., Potkin, S. G., & Reist, C. (2011). Assessment of psychological pain in major depressive episodes. Journal of Psychiatric Research, 45(11), 1504–1510.

    Article  PubMed  Google Scholar 

  • Meerwijk, E., & Weiss, S. (2011). Toward a unifying definition of psychological pain. Journal of Loss and Trauma, 16(5), 402–412.

    Article  Google Scholar 

  • Merskey, H., & Bogduk, N. (1994). Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms. Pain. Seattle: IASP Press.

    Google Scholar 

  • Nahaliel, S., Sommerfeld, E., Orbach, I., Weller, A., Apter, A., & Zalsman, G. (2014). Mental pain as a mediator of suicidal tendency: A path analysis. Comprehensive Psychiatry, 55(4), 944–951.

    Article  PubMed  Google Scholar 

  • Newton-John, T. (2014). Negotiating the maze: Risk factors for suicidal behavior in chronic pain patients. Current Pain and Headache Reports, 18(9), 1–7.

    Article  Google Scholar 

  • Nicholas, M. K., Asghari, A., Sharpe, L., Brnabic, A., Wood, B. M., Overton, S., et al. (2014). Cognitive exposure versus avoidance in patients with chronic pain: Adherence matters. European Journal of Pain, 18(3), 424–437.

    Article  CAS  PubMed  Google Scholar 

  • Nielsen, C. S., Staud, R., & Price, D. D. (2009). Individual differences in pain sensitivity: Measurement, causation, and consequences. Journal of Pain, 10(3), 231–237.

    Article  PubMed  Google Scholar 

  • Pacheco-López, G., Engler, H., Niemi, M.-B., & Schedlowski, M. (2006). Expectations and associations that heal: Immunomodulatory placebo effects and its neurobiology. Brain, Behavior, and Immunity, 20(5), 430–446.

    Article  PubMed  Google Scholar 

  • Peuter, S. D., Lemaigre, V., Diest, I. V., & Bergh, O. V. D. (2008). Illness-specific catastrophic thinking and overperception in asthma. Health Psychology, 27(1), 93–99.

    Article  PubMed  Google Scholar 

  • Prins, B., Decuypere, A., & Van Damme, S. (2014). Effects of mindfulness and distraction on pain depend upon individual differences in pain catastrophizing: An experimental study. European Journal of Pain, 18(9), 1307–1315.

    Article  CAS  PubMed  Google Scholar 

  • Rasmussen, H. N., Scheier, M. F., & Greenhouse, J. B. (2009). Optimism and physical health: A meta-analytic review. Annals of Behavioral Medicine, 37(3), 239–256.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sharpe, L. (2014). Attentional biases in pain: More complex than originally thought? Pain, 155(3), 439–440.

    Article  PubMed  Google Scholar 

  • Somers, T. J., Keefe, F. J., Pells, J. J., Dixon, K. E., Waters, S. J., Riordan, P. A., … Rice, J. R. (2009). Pain catastrophizing and pain-related fear in osteoarthritis patients: Relationships to pain and disability. Journal of Pain and Symptom Management, 37(5), 863–872.

  • Sturgeon, J. A. (2014). Psychological therapies for the management of chronic pain. Psychology Research and Behavior Management, 7, 115–124.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tang, N. K. Y., Salkovskis, P. M., Hodges, A., Wright, K. J., Hanna, M., & Hester, J. (2008). Effects of mood on pain responses and pain tolerance: An experimental study in chronic back pain patients. Pain, 138(2), 392–401.

    Article  PubMed  Google Scholar 

  • Tobon, J. I., Ouimet, A. J., & Dozois, D. J. A. (2011). Attentional bias in anxiety disorders following cognitive behavioral treatment. Journal of Cognitive Psychotherapy, 25(2), 114–129.

    Article  Google Scholar 

  • Van Den Broeke, E. N., Geene, N. C. M., van Rijn, C. M., Wilder-Smith, O. H. G., & Oosterman, J. M. (2014). Negative expectations facilitate mechanical hyperalgesia after high-frequency electrical stimulation of human skin. European Journal of Pain, 18(1), 86–91.

    Article  PubMed  Google Scholar 

  • Vowles, E., Mccracken, M., Sowden, M., & Ashworth, M. (2014). Psychological flexibility in coping with chronic pain: Further examination of the brief pain coping inventory-2. The Clinical Journal of Pain, 30(4), 324–330.

    Article  PubMed  Google Scholar 

  • Vowles, K., & Thompson, M. (2012). The patient-provider relationship in chronic pain. Current Pain and Headache Reports, 16(2), 133–138.

    Article  PubMed  Google Scholar 

Download references

Funding

There are no funding sources to report.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alison Athey.

Ethics declarations

Conflicts of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Athey, A., Overholser, J. Learning from Physical Pain to Help with the Management of Emotional Pain. J Contemp Psychother 46, 119–127 (2016). https://doi.org/10.1007/s10879-016-9330-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10879-016-9330-y

Keywords

Navigation