Psychological pain: what is it, types and how to treat it

Life brings with it difficult moments such as the loss of a loved one, a disappointment or a betrayal. Psychological pain is, in fact, a condition that sooner or later affects anyone. It is not an official diagnostic term, but is used to describe pain that can be attributed to factors psychological, which can understand certain beliefs, fears, memories or emotions that we detect at the beginning or at the worsening pain With this Psychology-Online article, we are going to try to make a summary on the subject, addressing psychological pain to understand what it is, the different types and how we can treat it.

Index

1. What is psychological pain
2. Pain disorder
3. Types of pain and duration
4. How to recognize psychological pain
5. How to treat psychological pain

To think of pain as psychological means to assume that it has a purely psychic origin. Psychological pain is the experience of mental discomfort, feeling unpleasant and painful emotions.

Let's look at the psychic causes of pain. Psychological pain is caused by a stimulus, also psychic, which could be a dream, a hallucination or a memory. This does not mean that the psychological pain is a dream, or a hallucination or a memory, but it only means that such pain can derive from a mechanism similar to the one that derives an event considered only of psychic origin like a dream.

Psychological pain can also be explained in a process of identification; This can happen, for example, when a subject loses a loved one, who has suffered a lot.

On the other hand, psychological pain can also refer to psychogenic pain or somatic pain. Complex to define, even harder to deal with, psychogenic pain remains a challenge for contemporary medicine from the pathophysiological and therapeutic point of view. The DEM IV definition of "pain disorder" best reflects the clinical characteristics of this phenomenon, among the many nosographic definitions that have occurred in the last 30 years.

Over the years, and with the expansion of knowledge about pain, psychological pain has found and changed different definitions and diagnostic criteria; what best reflects its characteristics seems to be the definition of the MDE of pain disorder, a psychic diagnosis that best fits that of psychological pain.

It is part of the chapter of the somatoform disorders, but it is little used in clinical practice; a diagnosis that can be used when pain represents the main component of the clinical picture and generates clinically significant discomfort, limiting, in the absence of pathological psychic conditions but in the presence of some factor psychological that plays a determining role in the initiation, implementation or maintenance of the pain itself.

In the following article, you will find more information about What is somatization in psychology.

Pain, being a personal experience, is subjective and not easily quantifiable, but we can distinguish different types according to their duration:

• Acute. The sensory component seems more important; it generally disappears with repair of the damage.
• Chronic. The affective and evaluation factors acquire greater importance, associated with profound changes in personality and lifestyle.
• Transient. It disappears with the end of the stimulus.
• Recidivist. Recurring psychological pain.
• Persistent. Permanence of the nociceptive stimulus.

Psychological pain is difficult to manage and must be approached from several perspectives. In the next section, we will see how to treat psychosomatic pain.

Let us now look at some elements that frequently coincide, often in combination, in patients with pain with a psychological component:

1. History of illness in a relative or acquaintance with symptoms similar to those of the patient.
2. History of child or adult abuse. In this article, we talk in depth about the child abuse.
3. History of "multiple allergies" and drug intolerance.
4. History of somatoform symptoms or medical conditions of a questionable nature.
5. History of useless, invasive therapeutic attempts with iatrogenic damage.
6. History of forensic litigation with absence in the history of psychiatric pathology.

Clinical features

1. Pain that starts suddenly and grows over time.
2. High intensity pain, qualitatively variable, which is not modified by posture, movement, circadian variability.
3. Lack of response or only transient response to analgesics.
4. Choice of location and type of symptom with a symbolic background.
5. Existence of a serious disability, disproportionate to clinical objectivity.
6. Negative of diagnostic tests or clear disproportion / inconsistency between the evidence of pathology and the clinical picture.
7. Presence of sensory and motor disorders associated with the "non-anatomical" distribution.

Behaviors and convictions

1. Conviction of having an organic pathology and rejection of possible psychological or psychiatric interpretations.
2. Presence of defensive attitude, anger and great criticism of the antecedents.
3. Omission of documents and medical information that support psychogenicity.
4. Description of symptoms and disability with intense emotional participation.
5. Exaggerated pain behavior in the presence of "sensitive" people (health workers, spouses and relatives, colleagues and employers).
6. Incongruence between high estimate of pain and very poor or absent pain behavior.
7. Manipulative behavior towards the environment to ensure primary and secondary advantages.
8. Doctors shopping phenomenon (jerky search for a new specialist who can finally understand pain to solve it, with great expense of time / money and risk of iatrogenic damage), with a collection of huge documentation medical.
9. Unemployment and lack of motivation to return to work.

How to remove psychological pain? Psychological pain is not an invention, it is not madness, but it must be the starting point to recognize a real situation of suffering. The person must, first of all, feel understood in a way that accepts and legitimizes the discomfort as such and then be able to embark on a path of treatment.

How to cure psychosomatic pain? In recent years, studies on chronic pain have shown that multidimensional treatment is extremely effective as a strategy in treating the patient. On the one hand, a psycho-rehabilitative treatment, on the other, pharmacological treatment. Let's look at the treatment options for psychosomatic pain:

• The psychological interventions as the cognitive behavioral therapy, the relaxation techniques or with hypnosis or simply a supportive intervention, they are remarkably effective in nociceción.
• The physical therapies (acupuncture, magnetotherapy, electroanalgesia, etc.) and the drug therapies performed with analgesics, neuromodulators or psychotropic drugs, they also achieve significant efficacy on psychosocial aspects of pain.
• The pain management psychological can be similar to chronic pain. However, in this type of multidimensional approach to patients with psychological pain, it is necessary to carefully evaluate the use of medications and therefore avoid those with a high potential for abuse, such as opiates and benzodiazepines, which can cause addiction.

The simultaneous use of several techniques is essential for effective multidimensional management.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Psychological pain: what is it, types and how to treat it, we recommend that you enter our category of Clinical psychology.

• Gianfrancesco, F. (2020). Psychogenic pain. Recovered from: https://www.nurse24.it/dossier/dolore/dolore-psicogeno.html
• Vendramini, M. T. (2007). Oltre l’evento. La morte nella relazione educativa. Milan: Franco Angeli.