Essay about The Problem of Chronic Pain

📌Category: Health, United States, World
📌Words: 1013
📌Pages: 4
📌Published: 22 June 2021

An estimated 20.4 percent of Americans struggle with chronic pain, defined as persistent pain lasting longer than six months. While an estimated 8.0 percent of U.S. adults have high-impact chronic pain. High-impact chronic pain is defined by a period of three months or more where an individual suffers chronic pain that is debilitating and restricts their ability to take part in key life aspects such as school, work, or complete daily tasks/chores (CITE). Predominantly chronic pain and high impact chronic pain increases with age and is higher among adults aged 65 and over. Non-Hispanic white adults are by far the most likely to experience chronic pain (23.6%) compared to non-Hispanic black adults (19.3%), Hispanic adults (13.0%), and non-Hispanic Asian (6.8%) adults (CITE). Individuals with chronic pain are three times more likely to develop mood disorders than those without chronic pain, and patients experiencing depression are three times as likely to develop chronic pain (CITE). Chronic pain can also lead to an increased likelihood of opioid or other medication dependencies. Overall, chronic pain is a debilitating and widespread issue within the United States. While it is sometimes possible to treat chronic pain through medications or other approaches, it is unfortunately an issue that goes unresolved for many. It deeply affects quality of life and mental health and can lead to shorter life expectancies. Cognitive approaches are important to treat the widespread distress and hopelessness that arises from a chronic pain diagnosis.

The treatment selected uses Cognitive Behavioral therapy (CBT), a form of therapy pioneered by Dr. Aaron T. Beck in the 1960s. Dr. Beck, a psychiatrist at the University of Pennsylvania, had long studied Psychoanalysis and its relation to understanding mental illness— especially depression. Dr. Beck discovered that psychoanalysis did not explain depression well, nor did it offer an effective treatment plan. Because of this, Beck began to research “automatic thoughts” and their effect on depression. Beck found that many depressed patients struggle to take the world in factually, and instead can tend to have negative thoughts about themselves, and the world around them. Through creating a framework for how to challenge and replace negative cognitions Beck was able to create a successful model that has been effectively used for the treatment of a vast degree of mental illnesses.

CBT for the treatment of chronic pain is really a multistep approach. While it is helpful to attempt to change one’s perspective about chronic pain and how it inhibits your ability to participate in one’s life fully, it does not entirely solve the issue. Managing Chronic Pain by John T. Otis uses a variety of techniques often used in CBT as well as other modalities of therapy. He focuses on the use of mindfulness to inform the individual about where they sit on their pain threshold and to inform goals for the future. Otis’ modality seeks to educate the individual about what is causing their chronic pain, how the ways they think (and therefor feel) impact their overall mood and experience of that pain and learn to restructure their life to better navigate pain in such a way so as not to debilitate themselves further.

The approach of CBT for pain management focuses on 4 main goals: To reduce the impact pain has on your daily life, learn skills for coping better with pain, improve your physical and emotional functioning, and reduce your pain and reliance on pain medication. These goals are reached through replacing and challenging thoughts surrounding the severity of your pain, increased focus on what you can change about the situation through diet, exercise, and coping skills, and finding alternatives through cooperation with healthcare professionals. Many of the mechanisms used to treat chronic pain in this modality focus on using the understanding of how our body experience pain to combat the pain itself. For example, the book starts one of the first sessions by teaching the individual about the Gat Control Theory, a process that allows the individual to “open” or “close” the flow of pain to the brain to decrease the overall level of pain experienced. This is done through the paying deliberate attention to what thoughts one has about your pain (negative thoughts open the gate and positive thoughts close the gate) as well as relying on your social supports, engaging in moderate and well-paced activities, or finding distraction through alternative areas of focus.

In addition to emphasizing the importance of understanding where pain come from, the modality focuses heavily on learning to relax muscles that are naturally tense in reaction to the experience of pain. This is quite often done through progressive muscle relaxation, a process that helps the individual to focus on every key muscle group in the body and begin to relax those muscles one at a time. In addition to relaxing the body, Otis teaches about the mind body relationship, and how thoughts or feelings impact the pain one experiences. Changing cognitions about the world around them the individual learns to reduce negative thoughts that “prime the body to feel pain.” One such cognition is catastrophizing. Catastrophizing and all or nothing thinking are a big focus of Otis’ CBT approach. Beyond leading to an increase in depression and anxiety, catastrophizing and all or nothing thinking are very common primers for increased pain. 

Here you review two articles on the empirical evidence of the treatment.  Be sure to include statements on culture and diversity in the sample of clients and therapists in your review. Who was being treated and who was treated?  Avoid making general statements that the treatment is effective or strong.  Those are decisions made by the reader who can do so if you effectively present the data clearly and comprehensively. 

While the efficacy of Cognitive Behavioral Therapy for the treatment of chronic pain is common, the evaluation of its use with a range of cultures and ethnicities is not (Taloyan et al., 2013). In order to continue to effectively use CBT for the treatment of a wide variety of kinds of pain from a wide variety of cultures it is important to further study outcomes of its use with these populations. Recently, one such study attempted to measure CBT’s impact on those from multicultural backgrounds

Treatment Procedures.2-3 pag Here you outline what happens during the treatment (i.e., session 1, session 2, etc. and the activities associated with each step)

Future directions and considerations 1-2 pages

Concluding Statement  

Here you summarize your thoughts on the overall picture of the treatment you reviewed.

Taloyan, M., Alinaghizadeh, H., & Löfvander, M. (2013). Short‐term cognitive‐behavioral treatment in multicultural primary care of patients with longstanding backache. Scandinavian Journal of Psychology, 54(5), 371–375. https://doi-org.ezproxy.callutheran.edu/10.1111/sjop.12061.

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