Tag Archives: psychotherapy

Learning and Unlearning of Pain

Learning and Unlearning of Pain – free full-text article /PMC6027134/ – Biomedicines. 2018 Jun

This review provides an overview of learning mechanisms and memory aspects for the development of chronic pain.

Pain can be influenced in important ways by an individual’s personality, by family, and by the sociocultural environment in which they live. Therefore, learning mechanisms can explain why pain experience and pain behavior can increase or decrease.

Linking pain with positive consequences or removing negative consequences can contribute significantly to the chronification of pain.

If pain were linked with positive consequences, we wouldn’t mind having it, but I find it impossible to imagine how to link even moderate pain with anything positive. Continue reading

Nora Volkow on Rx opioids, chronic pain and ‘hype’

Nora Volkow on prescription opioids, chronic pain and ‘hype’ – Opioid Watch – Nonprofit News from The Opioid Research Institute – July 2018

Research psychiatrist Nora Volkow, MD—the director of the National Institute on Drug Abuse for the past 15 years—is one of the world’s foremost authorities on addiction. Her pioneering work with brain imaging has changed society’s understanding of the phenomenon.

By showing how addictive drugs alter the brain’s chemistry, she helped prove that addiction was a chronic disease rather than a moral failing.

What follows is part 1 of a two-part interview, which was conducted by email. All links in her answers are to supporting references Volkow provided.   Continue reading

CBT for Chronic Pain + Insomnia Needs More Research

CBT for Chronic Pain and Insomnia Needs More Research – by Angie Drakulich – April 2018

The Sleep/No Sleep Pain Cycle

Most are familiar with the vicious cycle of insomnia, depression, and increased pain.

Finding the right mix of CBT—including patient education, self-regulation, behavioral activation, and cognitive reframing—may help to break this circle.   Continue reading

Why Psychotherapy Helps the Patient in Chronic Pain

Why Psychotherapy Helps the Patient in Chronic Pain – Psychiatry (Edgmont). 2008 Dec – Linda J. Griffith, MD – free full-text /PMC2729621/ 

Psychiatrists frequently see patients in their practices who struggle with issues of chronic physical pain. This can present diagnostic and therapeutic dilemmas.

These patients require an approach that allows them to talk about their pain and feel supported while simultaneously being nudged to develop a meaningful life alongside their pain.

This article addresses an approach to accomplish this difficult balancing act over the course of time and includes case examples.  Continue reading

Patient action: as means and end for chronic pain care

Patient action: as means and end for chronic pain care: PAIN –  August 2017

Historically, pain has been understood as a sensory problem. Even the IASP defines pain as “an unpleasant sensory and emotional experience….”

This aversive sensory experience can prompt a protective motor response, which can include reflexive withdrawal, splinting and resting of the painful body part, and avoidance of activities that can increase pain.

This sensory understanding of pain implies that the pain experience must be reduced to reduce motor reactions.   Continue reading

Forced Exercise with CBT Fails for CSF

Forced Exercise With CBT Fails for CFS  – Journal of Health Psychology –  August 29, 2017 – free full-text Research Article

The results of this study showed what patients have known all along:

For sufferers of CFS/ME,
exercise is the problem, not the solution,
it’s in the body, not the mind.

Cognitive behavioural therapy and graded exercise theapy are promoted as evidence-based treatments for myalgic encephalomyelitis/chronic fatigue syndrome.

This article explores patients’ symptom responses following these treatments versus pacing therapy, an approach favoured by many sufferers.  Continue reading

Metacognitive Therapy for Depression

Frontiers | Metacognitive Therapy for Depression in Adults: A Waiting List Randomized Controlled Trial with Six Months Follow-Up | Psychology for Clinical Settings – January 2017

This small study (39 patients) shows this type of therapy is effective for depression.

This randomized controlled trial examines the efficacy of metacognitive therapy (MCT) for depression.

Participants receiving MCT improved significantly more than the WL group.   Continue reading

Dialectical Behavioral Therapy for Chronic Pain Mgmt

Dialectical Behavioral Therapy for Chronic Pain Management Florence Chaverneff, Ph.D. – September 24, 2016

Still a recent form of cognitive behavioral therapy, dialectical behavioral therapy (DBT) combines dialectics and mindfulness meditation for therapeutic purposes.

The goal with this method is to help patients “gain insight and skills to manage their thoughts, emotions, and behaviors.”

A study presented at the American Academy of Pain Management’s Annual Meeting in San Antonio, Texas, proposed the use of this technique in pain management.

DBT was initially developed in the United States as a treatment complement for patients with the most severe cases of borderline personality disorder (ie, cases of suicidal attempts and ideation).   Continue reading

No need for additional psychosocial therapy treatment

When Added to Opioid Agonist Treatment, Psychosocial Interventions do not Further Reduce the Use of Illicit Opioids: A Comment on Dugosh et al. – PubMed – NCBI – J Addict Med. 2016 Jul-Aug;

This commentary reviews the limitations of the recent literature review by that examined the role of psychosocial interventions with medication for opioid addiction treatment.

The commonly held belief that opioid agonist treatment alone is inferior treatment to such treatment combined with ‘psychosocial’ treatment (which many will understand to mean counseling) is not supported by the research evidence and it results in limitations on the use of these effective medications.   

Below is the review addressed by this commentary:   Continue reading

Values in Modern Clinical Behavior Analysis

In Search of Meaning: Values in Modern Clinical Behavior Analysis | Free full-text PMC article

One of the distinguishing features of human behavior, compared to that of other species, is the extent to which our lives are influenced by values and purpose.

This uniqueness is based on the fact that, unlike other species, we engage in verbal behavior.

Acceptance and commitment therapy (ACT) provides a theory for values and values-based action, based on basic behavioral principles and grounded in a functional analytic theory of language and cognition that we believe provides a strong foundation for creating flexible assessment and intervention strategies related to personal values.   Continue reading