Using the Internet to deliver Acceptance and Commitment Therapy for chronic pain

Cognitive-behavioural therapy (CBT) can improve quality of life and functioning in people with chronic pain. However, many people cannot access CBT in a timely manner, or at all. Simply put, there are too few psychologists with adequate training in pain management. There are also practical barriers to engaging in CBT, such as distance, work, and … [Read more...]

Editors picks: Pain as a threat to the social self

Over this holiday season we are publishing our Editor’s picks of 2018 for you to read and enjoy again. The second one is by Kai Karos. -- Times are changing. Our understanding of pain from a purely biomedical perspective has evolved to a biopsychosocial perspective of pain. Intuitively, pain has long been recognized as an experience that can … [Read more...]

Can we learn to feel tired?

At BiM, we have often discussed the idea that learning processes might contribute to chronic pain (e.g., 1, 2, 3, 4). Researchers are also investigating whether other unpleasant states, such as fatigue, can be learned. For this reason we have invited researcher and psychologist Bert to tell us about his work. It is normal to feel tired after a … [Read more...]

Physiotherapists struggle to identify and deal with psychological factors in chronic low back pain

Psychological factors including catastrophizing, fear of movement and psychological distress are predictors of negative outcomes in patients with chronic low back pain (CLBP).[1] Furthermore, patients with CLBP often have comorbid depressive and anxiety disorders.[2] Healthcare professionals involved in managing CLBP are therefore challenged to … [Read more...]

Who responds well to psychologically-based treatments for chronic pain?

How do we know whether a patient is likely to do well in the psychologically-based treatment we offer them? The truth is, at least for the moment, we don’t. At least not in any way that is evidence-based or precise. If you work clinically and are anything like me, this might sit rather uncomfortably. I work with patients with chronic pain and … [Read more...]

To express or not to express pain? That’s the question

A child falling on the street might seem perfectly fine yet burst into tears upon being noticed by its parents. If your (male) partner has the flu, you will no doubt detect his overt expressions of suffering. As humans, we likely express our pain when we seek understanding or help from others. In extreme cases this might save our lives, so it is … [Read more...]

Designing next-generation psychotherapy in pain

People are often surprised at how badly our treatments for chronic pain perform. Pharmacological, surgical, rehabilitative, and psychological treatments all underperform against our expectations, wishes and ideals (Eccleston and Crombez, 2017). The good news, however, is that there is fervent research activity in the pharmacological and surgical … [Read more...]

Changing pain thresholds with classical conditioning

Our previous post about a classical conditioning model for pain generated some lively discussion.  Some argued vehemently that pain cannot be a classically conditioned response, and others argued vehemently that of course it can and we have known this for decades.  We haven’t yet pinned our colours to any particular mast – we’d like to see the … [Read more...]

Expressing pain: which patients do we trust?

Trustworthiness is one of those instant judgements we automatically make about other people, affecting our behaviour towards them [1]. We wanted to know whether clinicians’ judgements of patients’ trustworthiness affected their estimation of patients’ pain [2]. There seem to be so many grounds on which the complaint and expression of pain is met … [Read more...]

Pain Management – it’s a sham

If we posit that pain is an output of the brain that is based on the perception of threat, it would follow that decreasing threat, whatever it may be, would positively influence a person’s pain experience. This has led to some exciting therapeutic advances aimed at altering threat, which include encouraging patients to rewrite their pain experience … [Read more...]