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chronic Pain
The Stress-Pain Connection:
Chronic pain can be debilitating and become the focus of our
lives and the activities we choose. As our lives become smaller
and less pleasurable, our stress levels can increase and our
sense of hopelessness and helplessness can also be
impacted. Chronic Pain is typically described as any pain that
endures for more than a 3 month period.
Ongoing pain can feel unbearable. It can make us fretful and vigilant and even in moments of relief,
terrified that the pain will return. The physical pain creates a stress response and stress reactions
actually make pain worse. On top of the stress that derives from the pain itself, unrelated stressors can
also worsen pain.
Stress reactions are biological. When there is a perceived threat your body automatically prepares for
fight or flight. Shortterm stress responses include constriction or dilation of blood vessels which can
directly impact muscular or visceral pain. Moreover, chronic stress responses can create various
endocrine reactions which can compromise general immune functioning. Examining general emotional
coping and typical responses to stress is critical for pain management.
CBT & Chronic Pain:Cognitive Behavioural Therapy is a widely recommended intervention for chronic pain. The primary
function is to reduce stress levels by identifying and challenging appraisals of pain and increasing
coping. CBT for chronic pain will work to identify and alter thoughts and behaviours that increase pain
by exploring these concepts:
1. Pain triggers stress which makes pain worse: Pain is perceived by the brain as pain because the
brain interprets the trigger as threat.
2. Pain is not proportionate to damage: The amount of pain we feel does not correspond with the
amount of tissue damage our body experiences.
3. Acceptance of pain can decrease pain sensations: Hypervigilance and scanning for pain triggers
can amplify pain signals to the brain. Accepting that pain will be present can help us to let go of
scanning behaviours that increase pain signals and increase stress.
*If you are experiencing chronic pain, consult with your family doctor for appropriate medical referrals
and seek out a qualified CBT therapist.
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