NPR: Can You Reshape Your Brain’s Response To Pain?

Jeannine sorts through a binder of writing assignments from her therapy. In keeping a journal about her past experiences with pain, she noticed that the pain symptoms began when she was around 8 — a time of escalating family trauma at home. Jessica Pons for NPR

June 10, 2019 5:00 AM ET
PATTI NEIGHMOND

Jeannine, who is 37 and lives in Burbank, Calif., has endured widespread pain since she was 8. She has been examined by dozens of doctors, but none of their X-rays, MRIs or other tests have turned up any evidence of physical injury or damage.

Over the years, desperate for relief, she tried changing her diet, wore belts to correct her posture and exercised to strengthen muscles. Taking lots of ibuprofen helped, she says, but doctors warned her that taking too much could cause gastric bleeding. Nothing else eased her discomfort. On a pain scale of 0 to 10, her pain ranged from “7 to 9, regularly,” she says.

Around 50 million Americans suffer from chronic pain. Most of us think of pain as something that arises after a physical injury, accident or damage from an illness or its treatment. But researchers are learning that, in some people, there can be another source of chronic pain.

Repeated exposure to psychological trauma, or deep anxiety or depression — especially in childhood — can leave a physical imprint on the brain that can make some people, like Jeannine, more vulnerable to chronic pain, scientists say. (We are not using her last name for reasons of privacy.)

Jeannine was eventually diagnosed with fibromyalgia — a condition characterized by widespread pain throughout the body, among other symptoms. The cause is unknown and likely varies from person to person.

The pain Jeannine experienced was physical. She’d feel “lightning bolts, kind of going up through my shoulders to my neck to my head,” she says. Other times, she’d suddenly experience the shooting pain of sciatica in her legs, and she often suffered from a “grinding pain” in her hips. “I would feel like I can’t walk anymore — it was just so very painful to walk.”

Then, about eight months ago, a friend suggested something else — emotional awareness and expression therapy.

Jeannine was skeptical. She’d periodically seen a counselor in “intensive therapy” over the years, and still, her terrible pain persisted.

But EAET, she learned from her clinical psychologist, Laura Payne, is a different sort of psychotherapy. It’s one of several behavioral therapies (among other interventions) included in a report from the U.S. Department of Health and Human Services titled “Pain Management Best Practices.” According to the report, published May 9, “Research indicates that EAET has a positive impact on pain intensity, pain interference, and depressive symptoms.”

EAET was developed in 2011 by psychologist Mark Lumley at Wayne State University and his colleague Dr. Howard Schubiner. It combines some techniques from traditional talk therapies (such as probing a patient’s life experience for insight and context) with those of cognitive behavioral therapy, which focuses more on skills training and changing harmful patterns of behavior.

It’s an emotion-focused treatment, Lumley says, aimed at helping people who are in widespread, medically unexplained pain.

In a 2017 study of patients with fibromyalgia, Lumley and his colleagues found that EAET decreased widespread pain and other related symptoms for some patients. “In summary,” the researchers concluded, “an intervention targeting emotional awareness and expression related to psychosocial adversity and conflict was well-received, more effective than a basic educational intervention, and had some advantages over CBT on pain.”

Lumley believes the treatment might also help patients who have other sorts of pain, though that’s yet to be proved.

So, how does it work?

For starters, as part of the therapy, Jeannine was asked to begin writing in a daily journal, looking into her past to identify when her problems with pain began.

“I wrote down all the different health symptoms I’ve had throughout my life,” she says, “pain-wise, but also other things” — anything that had caused her distress.

For Jeannine, who grew up in an abusive household, there was a lot of distress, and a lot to write about. (We are not using her last name for reasons of privacy.)

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Can You Reshape Your Brain's Response To Pain?
Article Name
Can You Reshape Your Brain's Response To Pain?
Description
Jeannine, who is 37 and lives in Burbank, Calif., has endured widespread pain since she was 8. She has been examined by dozens of doctors, but none of their X-rays, MRIs or other tests have turned up any evidence of physical injury or damage.