How Therapy Can Help With Chronic Pain
It's estimated that approximately 50 million adults in the U.S. experience chronic pain. Chronic pain can exist on a large spectrum with symptoms ranging from feeling mildly distressing to downright intolerable. Furthermore, it can be hard to predict if and when you might have "good days" versus the kinds of dark days that leave you writhing in pain.
Chronic pain is much more than just the physical experience of discomfort– it can deeply impact your emotional health and affect your overall quality of life. As a therapist who specializes in chronic pain using both cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), I support my clients as they navigate these complex symptoms. My goal is to offer a transformative, compassionate space where we can unpack your emotional stressors, reconcile identity shifts, and address the mental health challenges associated with your condition.
Understanding the Emotional Impact of Chronic Pain
Pain is not just a physiological response; it deeply connects to our emotions, thoughts, and behaviors. The brain processes specific pain signals based on multiple variables, including emotions, stress levels, and past pain experiences. With that, research consistently shows that chronic pain may exacerbate anxiety and depression and vice versa, with one large study finding that chronic pain exists in up to 70% of people with mood and anxiety disorders.
This can create a challenging cycle that makes it difficult to engage in effective pain management. Therapy helps with this specific dynamic, as addressing the emotional aspects of pain can help you reclaim a sense of empowerment and improve your quality of life.
Does Therapy Reduce Chronic Pain?
Therapy can help decrease chronic pain symptoms by targeting the emotional and behavioral aspects of your pain. Here are some of the broad strokes of how it works:
Changing pain perception: Learning how to reframe your thoughts and behaviors around pain can reduce the sense of suffering you feel regularly.
Reducing stress and anxiety: The brain releases stress hormones in response to real or perceived threats, and this enhances body constriction and muscle tension. Therapy, on the other hand, focuses on relaxing the central nervous system, and it also addresses the many psychological factors contributing to anxiety.
Behavioral accommodations: Therapy encourages people to engage in meaningful activities that honor their body's comfort. As you learn how to better listen to your body and its changing needs, you can feel more connected to yourself and the world around you.
Strengthening coping skills: Therapy offers both short-term and long-term strategies for managing pain, increasing resilience, and building a fulfilling life that works with physical limitations instead of against them.
While therapy may not reduce all pain, it can significantly change the pain-related distress you experience. When coupled with other treatment methods, including prescribed pain medicine or holistic wellness approaches (i.e., acupuncture, yoga, massage therapy), it can offer you profound relief.
Cognitive-Behavioral Therapy (CBT) for Chronic Pain Management
CBT is a well-known, evidence-based modality that can help you manage chronic pain more effectively. CBT helps people recognize and challenge negative thought patterns that may magnify certain pain symptoms. Some of the key components of this method include:
Mindfulness and Relaxation Techniques
Because stress often worsens pain conditions, treating chronic pain often entails learning how to relax the body. Doing so can reduce the perception of how much pain you experience.
Mindfulness-based therapies for chronic pain focus specifically on breathing exercises, guided imagery, and progressive muscle relaxation. That said, integrating more mindfulness can help you feel more in touch with the mind-body connection, helping you better support yourself during pain flares or other stressful situations.
Challenging Cognitive Distortions
Chronic pain often coincides with intense negative thoughts and fears about the state of your condition. You may feel overwhelmed about how you will manage pain- both in the present moment and in the future. These worries are valid, and CBT can help you gently recognize how patterns of catastrophic thinking may be reinforcing more anxiety. In therapy, we work on reframing negative thoughts into more realistic, empowering ones.
Cognitive Reframing
Cognitive reframing can help you shift your focus away from pain sensations and onto sensations of hope, resilience, strength, and clarity. This isn't about invalidating your experience of pain- it's about learning how to lean into more positive sensations and feelings. Pain becomes less of an all-consuming force, as you learn how to make deeper space for focusing on what you can control.
Behavioral Activation
Chronic pain may result in cycles of avoidance. For example, you may withdraw from loved ones because you feel ashamed about your condition or worry about being a burden. Or, you might avoid certain activities that you worry will make your pain worse. This is reasonable, but it can also exacerbate unwanted feelings of helplessness or despair. CBT encourages gradual exposure to meaningful activities that boost your mood and sense of resilience.
Dialectical Behavior Therapy (DBT) for Managing Pain Intensity
Chronic pain often impacts emotional regulation. It may feel very challenging to accept your current condition, especially if it feels like things are getting worse- or your symptoms are significantly affecting your physical and emotional health.
DBT is another evidence-based practice that helps people improve their capacity to tolerate distress and practice more acceptance. Here are some of the principles that often help people with chronic pain:
Emotional Regulation
Pain can quickly trigger intense emotions of anger, despair, fear, and loneliness. DBT skills help you identify and regulate your emotions- while this may not inherently improve your symptoms, it can reduce the emotional suffering you feel. In addition, identifying your triggers and learning adaptive coping skills can improve your well-being.
Distress Tolerance
Learning how to tolerate distress is a lifelong skill that requires tremendous practice and patience. However, it's certainly worth the effort! Avoidance or harmful coping skills like lashing out at others or numbing your emotions may feel good in the moment, but they can actually worsen your pain condition or mental health. DBT offers practical strategies for handling distress without escalating your emotional suffering.
Radical Acceptance
One of the key tenets of DBT is about acknowledging your pain without resisting it. This certainly doesn't mean you must surrender to suffering- it simply means recognizing that pain is something you're dealing with. You can still pursue connection, meaning, and joy. Many people find that, instead of constantly battling their pain, it can feel far more compassionate to simply listen and work with your body's needs.
Addressing Chronic Pain and Its Impact On Your Identity
Chronic pain often coincides with profound identity shifts. Many of my clients express tremendous grief over the loss of their former selves- it can be so painful to lose the ability to engage in favorite activities or experience unwanted career changes. Identity disruptions often also affect relational satisfaction, especially if you lack a strong support system.
Therapy provides a supportive environment to honor these losses while cultivating a new sense of self that accommodates your chronic pain without letting it completely define you.
Reconstructing Your Self-Identity
Who are you beyond your pain and what values and strengths remain unchanged regardless of your symptoms? These questions can be challenging to ask and even more difficult to answer.
In our therapy together, we'll spend meaningful time reconnecting with your inner sense of self, aiming to find more meaning outside of what's happening within your physical body. Sometimes this starts by identifying your core beliefs and values. While chronic pain may shift how you perceive yourself and the world around you, it's still possible to redefine your identity in a way that highlights strength and clarity.
It may be true that you can no longer engage in your former passions, and this grief deserves to be explored and witnessed. My goal is to offer you permission to mourn those changes, as mourning is often an essential step toward healing. With that, healing can be fluid, and therapy offers exploration for rediscovering who you are despite your pain.
Processing Medical Trauma or Medical Frustrations
Many people with chronic pain or chronic illnesses have experienced medical invalidation or trauma within the healthcare setting. This can happen due to experiences associated with misdiagnosis, dismissive attitudes from healthcare providers, or challenging procedures. Repeated medical invalidation often diminishes trust in healthcare professionals- it can also heighten your anxiety about seeking care in the future.
Therapy provides space to process these challenging experiences and validate the emotional impact they had on you. Acknowledging your emotions is often an important part of the recovery process, particularly if you have a history of feeling unheard or disrespected.
Additionally, therapy may help you strengthen advocacy skills. This can empower you to establish boundaries, ask more informed questions, and assert your needs as you deal with the healthcare system. My goal is to help you recover from these past traumas and reclaim your right to effective treatment in the future.
Navigating Relational Difficulties
Chronic pain doesn't exist in isolation- it moves through all aspects of family life, shaping dynamics, and potentially straining relationships. This emotional toll can be profound and tender- at any given moment, you may be struggling with guilt, fear, anger, or shame over your symptoms and how they impact those around you.
Sometimes loved ones are very supportive and open, but this isn't always the case. You may be dealing with family members who struggle to empathize or respond to your pain in ways that feel validating. If you're a parent, you might be balancing the need to care for yourself while also caring for your children (who may or may not fully understand your pain). At times, it may feel impossible to balance these needs without hurting someone's feelings- including your own.
In our therapy, you will have space to express your vulnerabilities and learn how to maintain intimacy and have honest communication with others.
Practicing More Self-Compassion
Guilt and shame often accompany chronic pain in ways that can feel difficult to even define. For example, you may ruminate over past choices that you believe caused certain health conditions, or you may feel ashamed for not being able to function at the level you once did. Chronic pain, of course, can make even simple daily tasks feel overwhelming, leading to more frustration and self-judgment.
Self-compassion can help you learn to respond to your self-criticism with more understanding and kindness. In CBT, for example, we focus on identifying and restructuring negative self-talk, while DBT offers self-validation techniques that allow you to acknowledge your pain without berating yourself.
Cultivating self-compassion typically entails shifting internal expectations. But when you treat yourself with gentle kindness, you're also more apt to engage in self-care, seek support, and avoid harmful coping strategies.
Therapy for Adults Experiencing Chronic Pain in New York and Connecticut
Therapy offers both a structured and compassionate place for navigating chronic pain. Addressing your emotional responses and cognitive patterns can help you experience more relief and lean into a more renewed sense of self. Although your symptoms may be a part of life, therapy can lessen how defined you feel by them.
I offer online therapy to clients living in New York and Connecticut. Virtual services provide the convenience of accessing care from the comfort of your own home- this tends to be especially valuable for people with fluctuating chronic pain symptoms. You don't need to worry about tackling a long commute, and you can do your session right from your bed if you desire!
In my practice, I pull from evidence-based therapies, including CBT, DBT, and solution-focused therapies to help you embrace living in the present moment. In addition to helping people manage pain, I also specialize in providing support for individuals and loved ones navigating cancer or other chronic illnesses.
My goal is to help you develop a more empowered and adaptive relationship with your body. This, in turn, can support you in cultivating a sense of resilience and joy- this is what you deserve regardless of any health problems or painful sensations you may be experiencing.
Please contact me today to learn more and to schedule a complimentary consultation.