Updated: May 11
Chronic Pain. Can we unlearn pain?
Are you a viable candidate for Pain Reprocessing Therapy (PRT)
Having worked with people experiencing chronic pain for several years, I know that the past focus and approach was Cognitive Behaviour Therapy approaches (CBT).
But CBT is a form of talk therapy that focuses on changing the thoughts, feelings and behaviours and in this case how it is related to the experience of pain.
Focus was on improving coping skills and changing their relationship with pain; however, pain levels would often remain much the same.
The goal was to help pain clients function better and for pain to interfere less with a person’s quality of life. CBT often focused on making lifestyle changes such as attending to sleep routines, nutrition and healthy movement.
Pacing strategies were often helpful in reducing pain flare-ups.
Pacing is a strategy where one would alternate between activity and rest and gradually work to increase periods of activity. We would also introduce relaxation approaches to reduce muscle tension and stress. A common theme seen in this population is that people become more fearful and avoidant of activity.
As you can imagine, this had a significant impact on relationships (e.g., more reliance on others to meet our needs, having to cancel plans last minute on bad pain days, being limited to what activities could be engaged in, having to pre-plan to avoid flare-ups and then the down time needed to recover from periods of activity).
Pain is often invisible so it can be hard to explain these limitations to others and for others to fully understand the impact of pain on day to day living. Because chronic pain is invisible, it is unlike visible injuries which others often treat with deference (e.g., people hold doors, send flowers, bring food).
Those suffering with pain often experience symptoms of low mood, motivation, not wanting to socialize and feeling anxious which further complicates their pain experience.
Fortunately advances in neuroscience have informed us how to better support chronic pain clients in more impactful ways resulting in lessening pain levels or eliminating pain altogether.
Yes, you heard right! I have witnessed clients who have been significantly disabled return to work and to activities that they value!
Neuroscience explains how stress and fear can fuel persistent pain as well as how to retrain the brain and nervous system so that we can break this cycle.
Pain Reprocessing Therapy (PRT) is an evidence-based approach for treating chronic pain, which focuses on changing how the brain perceives pain signals.
PRT involves educating clients about the brain’s role in pain and using techniques such as imagery, mindfulness and exposure to reduce the fear and anxiety associated with pain triggers.
It is also an approach that empowers clients to take control of their pain so that they can improve their quality of life. We now know that many types of pain (e.g., lower back pain, fibromyalgia, irritable bowel syndrome, headaches) are not the result of structural causes but rather are the result of learned neural pathways in the brain. We call this type of pain, neuroplastic pain.
Neuroplastic pain results from the brain misinterpreting safe signals from the body as if they were dangerous.
This does not mean pain is imagined.
In fact, brain imaging shows us that pain is quite real! However, when structural causes are not identified, many feel their pain is being discounted by primary care practitioners and specialists.
Symptoms experienced are dismissed as being psychological rather than physical which often results in clients feeling defeated. They often feel something is structurally wrong with them that has not yet been identified, despite having seen several specialists. We also know that even when structural causes are identified they are not always the cause of pain. While CBT approaches remain relevant and helpful, PRT gives us another tool for overcoming the challenges associated with chronic pain.
If you are struggling with chronic pain and would like to learn more about PRT please book a complimentary meet and greet HERE
You can also read more about it HERE
Joanne Simpson MSW, RSW has extensive and admiral experience helping pain patients over her career. She has trained directly with Alan Gordan, LCSW to better understand pain psychology.