Do the emotions play a role in chronic pain?

SIRPA Q&A

Chronic pain can be extremely debilitating, causing significant emotional distress, but could emotions play a far bigger role in how and why we experience pain?

The FHT recently attended the SIRPA (Stress Illness Recovery Practitioners Association) Conference 2017, entitled Chronic Pain: the role of emotions, to find out more about this fascinating topic. The conference was excellent, with engaging talks from a range of expert speakers, from various backgrounds, including medicine, clinical psychology and academia.

SIRPA founder, Georgie Oldfield, began the conference by highlighting the pioneering work of Dr John E Sarno, who believed chronic pain was predominantly caused by unresolved emotional turmoil. Sarno’s legacy informs much of the work on chronic pain and the emotions today.

Science writer Donna Jackson-Nakazawa was the first guest speaker, outlining links between adverse childhood experiences (ACEs) and chronic pain. People who had experienced four or more ACEs were said to be more at risk of chronic pain and other negative health outcomes. Jackson-Nakazawa also identified a number of strategies that could help with the management of chronic pain, such as ‘writing to heal’, mindfulness, yoga and meditation.

Matt Kinal, a specialist in pain science, followed this by talking about how the body responds to stress. Using a number of studies as examples, he explained how childhood trauma could alter levels of cortisol in the body and how pain could be caused by a vicious cycle between the body and brain.

In a very well-presented and humorous talk Howard Schubiner MD was next up, stating that ‘the reign of pain lies mainly in the brain’. Giving examples, he told delegates that people could be pain free with serious injuries and experience significant physical pain without any sign of injury.

Sally I’Anson, a secondary school teacher who suffered from severe and debilitating chronic pain then shared her own moving story of recovery.

David Clarke MD followed this by exploring links between ACEs and medically unexplained symptoms. He went on to say that childhood stress knocks down self-esteem on a long-term basis and can lead to personality traits that are valued externally, particularly in the workplace, which will in turn help raise self-esteem over time.

After a break, Dr Christos Christophy started the afternoon talks with a dramatic story of a man whose chronic pain was so severe, he amputated his own hand. Christophy looked at what subjectivity tells us about chronic pain and recovery, with quotes from a number of people who had suffered with chronic pain.

Spine surgeon, David A Hanscom MD was the penultimate guest speaker. Taking a whole person approach to treating chronic pain, Hanscom stressed the importance of getting enough sleep and shared a powerful testimony from a client with severe pain, who had benefited significantly from ‘expressive writing’.

The final speaker of the day, Dr Angela Cooper, talked about diagnosing and treating emotional factors in mind-body symptoms through a system called ISTDP (Intensive Short Term Dynamic Psychotherapy). Cooper talked about how unconscious feelings and anxiety and avoidant behaviours could lead to mind-body symptoms and shared the story of a client who she was able to help with this approach.

A major strength of the conference was the way each speaker complemented the subject matter in the previous talks, by simultaneously reinforcing concepts that were already presented and furthering the discussion through their own approaches and research.

 

Look out for an article by Dr Carol Samuel on how stress is linked to pain in the Autumn issue of International Therapist, out tomorrow. In the article Carol references a study on pain and emotion coauthored by Howard Schubiner MD.

 

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