Chronic pain can be a debilitating diagnosis. Patients with chronic pain often find themselves trapped in a cycle of anxiety and fear. You want to work out but you know that it will cause you to have pain afterwards so you avoid working out which in the long run makes your overall pain levels worse. Sound familiar?

If this vicious cycle repeats itself, you might start dealing with pain in ways that actually make it worse. A psychological response like this is called “rigidity. “ Reducing this rigid way of thinking about pain can have a lot of positive affects, like decreasing anxiety and low mood. But to do this you need to change the way you automatically think about pain. Instead of clinging onto the negative emotional response that you automatically get when you think about your pain, it may help to be more flexible and open to other options.

Acceptance and commitment therapy for pain, otherwise known as ACT, is one way to tackle this. It encourages people to honestly understand and evaluate how their pain affects how they think and then develop ways to deal with that pain using a different emotional response. Here are the 6 core areas that ACT emphasizes:

1.  Acceptance - the knowledge that thoughts and actions that avoid or try to control pain or not the most effective way of managing it.

2.  Committed action- the commitment to continue to do things that are important in your life while at the same time experiencing pain.

3. Cognitive diffusion – the uncoupling of negative thoughts from pain

4. Flexible present focused attention – the ability to be mindful and aware of your immediate situation.

The main goal of ACT therapy is to acknowledge that while chronic pain is there, the best way to cope with it may be to manage it in a more positive and constructive mentality.

Mauna Radahd, MD

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