Dr Kate Jochimsen - how we think and feel influences our pain.
Nov 25, 2024
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Join Dr. Kate Jochimsen, a researcher at CHOIR and Harvard Medical School, as she unravels the fascinating connection between psychological factors and physical pain. Discover how fear and anxiety can amplify pain sensitivity and the concept of a 'pain dial' that influences recovery. Learn about cognitive restructuring techniques to transform thoughts and improve health behaviors. Dr. Jochimsen emphasizes patient-centered care and tailored interventions to foster resilience, bridging sports medicine and psychology for better pain management.
Psychosocial factors play a critical role in pain sensitivity, prompting a need for tailored, collaborative treatment approaches in healthcare.
Cognitive restructuring techniques empower patients by modifying negative thought patterns, promoting resilience and adaptive coping strategies in managing pain.
Deep dives
Understanding Pain Sensitivity
Pain sensitivity can be influenced by various psychosocial factors rather than solely by tissue damage. The concept of a 'pain dial' is introduced, which represents different patient-specific factors that can amplify or reduce symptoms. When clinicians engage in discussions with patients about these levers, it promotes a collaborative approach to identifying what aspects can be modified to alleviate pain. By understanding this sensitivity, healthcare providers can offer more tailored treatment options that address the complex interplay between physical sensations and emotional responses.
Mechanisms of Pain Experience
The relationship between psychological factors and pain is bi-directional, meaning that anxiety can amplify pain sensations while pain can increase anxiety levels. Mechanisms such as behavioral changes and heightened neural awareness contribute to this cycle, where maladaptive responses to discomfort can lead to increased pain perception over time. For example, certain models explain how fear avoidance can exacerbate chronic pain by causing people to limit their activities, leading to social isolation and a decrease in overall physical health. Understanding these mechanisms is essential for professionals as they develop interventions that target both physical and psychological aspects of patient care.
Promotion of Patient Self-Management
Setting specific, measurable, achievable, relevant, and time-bound (SMART) goals can significantly enhance patient self-management strategies. Quota-based pacing is highlighted as a technique to allow patients to gradually increase their activity levels, helping them to avoid the boom-bust cycle often associated with chronic pain. Encouraging self-efficacy through personalized activity quotas fosters a sense of agency, allowing patients to actively engage in their recovery process. By grounding these goals in the patient’s personal values, healthcare providers can increase motivation and facilitate sustained engagement with their treatment plans.
Cognitive Restructuring for Pain Management
Cognitive restructuring techniques can help patients recognize and modify unhelpful thought patterns related to pain. The 'catch, check, change' methodology teaches patients to identify negative thoughts, assess their validity, and reframe them into more constructive perspectives. For instance, a patient who sees themselves as a burden due to their injury might learn to challenge this belief and explore alternative ways to engage socially. Implementing these cognitive skills fosters resilience and adaptability, allowing patients to navigate their pain while maintaining a healthier emotional state.
Kate Jochimsen, PhD, ATC is a Researcher at the Center for Health Outcomes and Interdisciplinary Research (CHOIR) at Massachusetts General Hospital and a Member of the Faculty in the Department of Psychiatry at Harvard Medical School. Her work “bridges the gap” between sports medicine and psychology by developing interventions to improve patient's pain-related cognitions (‘how they think’) and emotions (‘how they feel’) to improve their health behaviors and increase physical activity. She is passionate about advancing psychologically informed practice and teaching clinicians how to communicate about mental health and intervene when appropriate. Her work has been funded by agencies such as the National Institutes of Health and the American College of Sports Medicine.
The big questions we try to answer: 1. When you have hip pain why does it hurt? 2. What is the mechanism behind psychological factors influencing pain? 3. How do we address these psychological factors? 4. What is cognitive restructuring and how can you do it to help pain?
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