Health Psychology Chapter 10 (part 2) Management of Pain

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PSYC 412
David Perrin

Chapter 10 (Part 2) 10/22/13 1:43 PM Management of Pain and Discomfort —Different behavioral techniques for the treatment of pain Biofeedback • Method of achieving control over bodily processes o Electrodes/sensors with readout of autonomic responses; train patient to reduce those responses § EX: reduce heart rate, blood pressure o Used to treat chronic disorders, headaches, hypertension and many types of pain (especially lower back pain) § Youtube video—“Intro to Biofeedback” ú 10-15 sessions • Moderately effective in reducing pain o May be no more successful than relaxation training, and is more expensive (sensors, computers, programs, etc) Relaxation techniques • Shift the body into a state of low arousal o Enables patients to cope with stress, anxiety, depression, and reducing pain • Examples o Controlled/Deep breathing § incredibly helpful for falling asleep! § reestablishes normalized oxygen/carbon dioxide balance § correct way: breath in as deeply as possible, hold it, breath out as deeply as possible, hold it, repeatà6-7 breaths/minute o Meditation § mindful of own thoughts o Progressive muscle relaxation • Modestly successful with some acute pains and when combined with other methods (physical therapy, meds) for chronic pain • Tied to release of endogenous opioids Hypnosis • One of the oldest (but most misunderstood) techniques for pain o Youtube video—“Hypnosis Basics: How to Hypnotize Someone” • Works through relaxation and suggestion o Told will reduce pain (placebo & expectations) o Distractibility—“induced trance”     o Instructed to think differently about pain and meaning attached § Change perspective of pain as client experiences it • Has shown to work with many different conditions, including IBS, acute pain due to surgery, childbirth, dental procedures, burns, headaches • Hypnosis and Dialysis Pain o Dialysis is a painful process and tends to get more painful over each 90 minute session (performed 3-4 times per week) § average pain score as a function of procedure-time interval for each group ú standard: most pain over time ú attention (distracted by movie): ranges of pain, but still reduced ú hypnosis: reduced pain scores over the entire session § average anxiety score as a function of procedure-time interval for each group ú standard: high anxiety ú attention: moderately reduced ú hypnosis: very reduced anxiety Acupuncture • Long, thin needles (sterile) are inserted into areas of the body (“pressure points”) that theoretically influence a disorder o Developed in China over 2,000 years ago o REALLY WORKS!! • Effects may be due to: o Counterirritation o Induction of a state of relaxation o Reduces fear o Increases tolerance of pain o Release of endorphins • Lacks formal studies (more coming out now) o Youtube video—“Acupuncture Reduces Pain, Need for Opioids after Surgery” § Acupuncture during surgery aids in surgery recovery, reduces nausea due to anesthesia, significantly reduces symptoms due to opioid medications § How or why does it work? Who cares, it works     Distraction • Focusing attention on an irrelevant and attention-getting stimulus instead of focusing on the pain o Focus on another activity o Focus on an object in the environment (external from the self) o PTSD—“grounding” • Most effective with acute or low-levels of pain o Limited for chronic pain because you cannot distract indefinitely • Especially helpful for kids Guided Imagery • Patient instructed to conjure up a picture that brings them happiness during the painful experience o Youtube video—“Happy Gilmore happy place” • Can imagine a combative, action filled scenes • Can also be more directive (
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