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The Thief in the Night

January 30, 2020

Chronic pain is the thief in the night; it robs from one’s relationships and it steals one’s strength. Few things are as strongly correlated with the decline in quality of life as chronic pain. It is associated with an increased risk of diabetes and cardiovascular disease. It’s positively correlated with an increased risk of divorce, unemployment, depression, addiction, and anxiety. Long-term chronic pain affects families and creates added challenges for couples. The struggle of constant pain makes it difficult for people to bond with their families or partners on a physiological level.

There are a billion people living with chronic pain worldwide; this includes one in five Americans (NCCIH, 2016). Many find relief with medications, surgical implants, and regular injections, but there are far too many who find relief elusive, or who find the side effects of their medical treatment unbearable. Chronic pain is difficult to treat because it includes mental, emotional, and social aspects as well as biological ones. Chronic pain causes changes in the brain associated with decreased functioning and increased pain. Therapists and their precursors have utilized techniques that anecdotally have been observed to reduce the symptoms of pain, by encouraging functional changes in the brain. These techniques work because they encourage changes that are associated with a higher quality of life and increased function. It’s possible for therapists to combine different techniques to promote changes that result in a reduction in symptoms. Therapists can help clients improve their physical symptoms by utilizing brain-based interventions and holistic techniques.

Brain-based interventions are exercises and practices that change the way the brain functions. The connection between the brain and body is bi-directional; changes in thought and emotion can affect the physical functioning of the body. By integrating brain-based interventions into therapy, therapists can tackle chronic pain-related symptoms that were once considered to be outside the scope of therapy. Modern insights into the brain have revealed that psychotherapy is a crucial tool that is correlated with changes in the neurophysiology of the brain connected with lower levels of pain. The relationship between the mind and body is so fundamental that each can affect the other.

An area of the brain that is known to change when a person experiences chronic pain long-term is the somatosensory cortex. The somatosensory cortex contains a map of the body. The more sensitive areas of the body like the lips, hands, and feet have a larger portion of the somatosensory devoted to them. For a person dealing with chronic pain, their somatosensory cortex areas devoted to the painful parts of their body grows, while areas devoted to pleasure areas shrink. Therapists help clients by utilizing a holistic technique known as a body scan. Body scans help to modulate the process of negative changes in the somatosensory cortex and are helpful when they are integrated into a daily mindfulness routine.

The conscious mind can only keep focused attention on a limited number of things simultaneously. It is possible for people living with pain to fill their attention with enough other things such that the pain gets pushed to the background. There are different therapeutic techniques that work by distracting the brain. Guided imagery is an effective method people living with pain can utilize at home. It involves focusing on all the aspects of a safe place. By incorporating the smells, sights, sounds, tastes, temperatures and textures of an imaginary place, pain does not need to remain at top of mind. It’s also important to utilize a narrative approach. Narrative therapy techniques are correlated with positive or more functional changes in the default mode network, an area of the brain affected by chronic pain. It’s important for therapists to utilize different techniques that either encourage an overall change in the brain or focus on change in a specific area of the brain.

The human brain has at least 100 trillion connections. While complicated, incorporating this knowledge into therapy can be immensely empowering for clients. Therapists can introduce clients to holistic techniques for dealing with chronic pain that they can then implement at home. Brain-based interventions deal with the psychological components of chronic pain and have the potential to help clients heal and reclaim their lives no matter the original source of that pain.


Matthew currently sees clients at our University City office, or online, anywhere in Pennsylvania. He is especially passionate about working with adults and children who are dealing with pain and/or disability. To set up an appointment, you can reach him at mpurinton@councilforrelationships.org or 215-382-6680 ext. 3135.