In detail

Psychological therapy for chronic pain

Psychological therapy for chronic pain

One of the most disabling sensations that exist is pain. When our head hurts intensely for a few hours, on many occasions, we have to leave our homework, take a medication and rest. Dental pains are also severe, as is post-surgery, for example, of an appendicitis operation. If this type of pain can temporarily incapacitate us, What will it be like to live with chronic pain? Luckily, psychology is also prepared to offer psychological therapy for chronic pain.

Throughout the article will deepen the type of psychological therapy for chronic pain most used, as well as different techniques that range from relaxation to midfulness. It is important to note that this article is informative and briefly reviews how psychology works in chronic pain. It is therefore recommended that those who suffer from chronic pain go to a professional in both medicine and psychology.


  • 1 Psychological therapy for chronic pain
  • 2 Cognitive-Behavioral Therapy
  • 3 Breathing and Relaxation
  • 4 Mindfulness

Psychological therapy for chronic pain

The most commonly used therapy for chronic pain is Cognitive-Behavioral (CBT). Through her, emotions, thoughts and behavior are worked. At the same time, special emphasis is placed on cognitive restructuring. Another relevant aspect and part of the therapy is the information offered to the patient. It is important to know that pain is not only composed of a physical factor, but several other aspects are involved. Among the different factors we find:

  • Physical At this point, not only the pain itself counts, but the tension that such pain can cause. When, for example, our cervical pain hurts, the tension to which we are subjected can increase the sensation of pain.
  • Emotional. When we are angry, the pain increases. When something hurts and we get angry, what happens? It hurts more. How many times have we told someone to leave us alone because our head hurts? Thus, emotion also influences feeling more or less pain.
  • Cognitive The cognitive aspect is very important. In this section cognitive distortions become relevant. For example, phrases like: "I will never get over it", they only cause negativity and prevent us from seeing the positive aspects that we do have.
  • Social. When we are alone, we are more likely to feel pain than if we have a healthy family and friendship circle. The support benefits the health and, therefore, diminishes the sensation of pain.

The information is essential so that you know that pain is not something physical, but that it is a multiple work between the physical part, the emotional, cognitive and social aspects.

Cognitive-Behavioral Therapy

But what is the psychological therapy for chronic pain based on CBT? First, note that CBT therapy is based on the fact that any experience and / or event is experienced and lived differently depending on how each person interprets it. In the face of a specific situation, certain thoughts and beliefs are set in motion that will condition our feelings and emotions that will guide us towards a type of behavior.

The chains of thoughts, emotions and behaviors of each of us determine the way in which we will face different situations from day to day, including the experience of pain. As we can see below, CBT acts on the aforementioned areas as pain facilitators:

  • Physical elements. When muscles are tense, they hurt more than when they are relaxed.
  • Emotions. When we are sad or angry, the pain is more intense.
  • Cognitions There are wrong thoughts that directly influence our mood. Use of cognitive restructuring to detect these thoughts and exchange them for more healthy and positive ones.
  • Social relationships. The support of others is important and there are techniques capable of increasing personal interactions.

Breathing and Relaxation

There are two types of breaths: pectoral and abdominal or diaphragmatic. The first tends to predominate in situations of stress, anxiety and fatigue. The second is deep, so it calms and provides relaxation to the central nervous system and the peripheral. Abdominal breathing is composed of three important steps: inspiration through the nose, air retention for a few seconds and exhalation, again, through the nose. The purpose of breathing is relaxation, so what does diaphragmatic breathing and relaxation give us?

What does diaphragmatic breathing give us?

  • Increase lung capacity.
  • Perfect the respiratory process.
  • Purify the airways.
  • Positive effects on circulation.
  • Positive effects on the nervous system: relaxing effect.
  • Effects on the mind leaving it more serene and calm.

What gives us relaxation?

  • It affects the psychophysiological basis of pain through response learning by deactivating muscle hyperactivity.
  • Breaking of the tension-pain-tension circle.
  • Somatic deactivation.
  • Decreased anxiety associated with pain experience.
  • Increased perception of self-control and self-efficacy.
  • Sleep regulation.


Finally, midfulness, in which relaxation is also practiced, represents an ideal combination with CBT to treat chronic pain. The fundamental aspect of mindfulness in pain is both the not judge thoughts and emotions like learning to control attention. But what is attention really?

Attention it is the ability that allows us to attend specific stimuli without being distracted by other stimuli, internal or external. Focus mental activity. You cannot attend to two stimuli at the same time. Main characteristics of care:

  • We usually choose those stimuli that are newer, more intense, those that excite us, those that terrify us…
  • You cannot attend to two stimuli at the same time optimally.
  • We usually live with the "autopilot" but we can learn to control it.

Through the practice of mindfulness, we will learn not to focus attention only on pain. Pain also has a very high attention component. If we pay attention only to pain instead of other more positive stimuli, the painful sensation increases. That is why it is so important to learn to focus attention on a more positive stimulus and not judge pain negatively. In this link you can find a practical session of mindfulness.


  • Caudill, M. (2011). Control the pain before the pain controls you. Madrid: Espasa Libros.
  • Miró, J. (2006). Chronic pain. Assessment procedures and psychological intervention. Bilbao: Editorial Desclée de Brouwer.
  • Moix, J. and Kovacs, F. (2015). Manual of pain Cognitive behavioral treatment of chronic pain. Barcelona: Espasa Libros.
  • Robles, H. and Peralta, I. (2015). Stress Control Program. Madrid: Pyramid Editions.