Types of psychological therapy

When pain persists for a long time and does not go away, it is understandable that you might feel angry, frustrated, worried or hopeless. These feelings are triggered by many things, including automatic and conscious thoughts that pass through the mind, such as “My pain will never go away”, “I will never be able to do the things I want” or “Nothing helps my pain.” However, these negative thoughts are often not accurate. In fact, in many cases they make your pain worse, and make you feel less capable of coping with your pain.

Cognitive behavioural therapy (CBT) is a type of treatment that helps you to recognize negative thoughts about your pain and change these thoughts. Research shows that CBT is one of the most effective treatments for chronic pain.

The theory behind CBT is that our thoughts influence our feelings and, in turn, our feelings influence our behaviours. So by helping you review and change your thoughts, CBT can also help you to positively change your emotions related to pain and improve your coping strategies. All of these things help you to better manage your pain.

Cognitive behavioural therapy is often done with the help of a therapist, who can offer support with identifying and adapting negative thoughts and setting goals for practising certain behaviours, for example doing physical activity to relieve pain. A therapist may also teach various techniques that you can use on your own, such as different types of relaxation and distraction.

Many people with chronic pain have lost their ability to relax their bodies because they have spent so much time in pain. Their muscles often become chronically tense. This tension can lead to several problems, including increased headaches. As a result, these people sometimes need to re-learn how to fully relax.

Your health team might recommend specific exercises to help you become more relaxed and may teach specific relaxation techniques to reduce tense muscles throughout your body. Practising these relaxation techniques during your “wind down” time in the hour before bed might also help you fall asleep faster.

Distraction is when you focus your attention so intently on one task that you are no longer focusing on your pain. Distraction is a technique you can use to change the way your body interprets pain signals.

When to use distraction

Distraction is a good technique to use when you are experiencing pain but want to be able to do an activity. Here are some examples of situations when it would be good to use distraction.

• You need to study for an exam when your pain starts to get worse.

• You are sitting on a bus with your friends coming back from a trip. You want to be sociable, but your joints feel painful from sitting still for so long.

There are different methods of distraction. Some are very simple and others need more practice. You can use each of these distraction techniques to help you carry on with activities and other things that are important to you.

Mindfulness treatments can teach you to become more aware of your thoughts, emotions and physical sensations at the moment they occur without reacting out of habit or on “autopilot”. Once you master this skill, you can choose how to respond to the experience so you can enjoy life, even in difficult times.

Mindfulness approaches are based on learning to accept our experiences and become less reactive to them. By accepting how you feel, you can learn to cope with your pain in new and unexpected ways.

Hypnosis consists partly of deep relaxation techniques and partly of guided imagery. It can be an effective way to manage pain, reduce tension and improve your confidence in your ability to achieve your goals. It can also help you achieve more focused attention.

In the hands of a skilled therapist, hypnosis can help someone change how they experience pain either through suggestions from the therapist or from their unconscious mind, provided that the suggestions are in line with your beliefs and expectations. Hypnosis does not involve controlling your mind or forcing you to do things you would not normally be prepared to do.

Hypnosis is a technique that should only be learned from a professional who has been properly trained to use this technique.

Ask your doctor for advice on where to find a qualified professional who can provide hypnosis techniques.

Biofeedback is a technique that teaches a person to focus on processes in their body that they are not usually aware of, such as their skin temperature or heart rate, and then control them.

During a biofeedback session, a person is connected to a machine that gathers and presents information (feedback) about your body (bio). This feedback can help you focus on making subtle changes in your body to reduce pain and help you have more control over your body. For example, it’s possible to learn to slow down your heart if it is beating fast or to cool down or warm up your skin.

Biofeedback is a concrete way of seeing how much control you have over your body. This can help increase your confidence in other pain-reduction techniques that you might try.

It should first be learned from a trained professional and often uses complicated equipment, but, with time, you can begin to apply the techniques in real-life situations on your own. For example, some forms of biofeedback use very simple equipment such as temperature-sensitive “sticky dots” that change colour with temperature. You can easily search for and buy these online and use them at home.​