Behavioural management of migraine

Abstract

It is important to recognise that migraine is a ‘biological’ and not a ‘psychological’ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1) Migraines can be triggered by psychological stressors; 2) Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3) Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope with their pain more effectively; 4) Longitudinal data demonstrate a complex bidirectional association between mood disorders and migraine. Treatment of a co-existing mood disorder, for example with cognitive behavioural techniques, may therefore reduce the impact of migraine. It would thus appear logical to view medical and psychological approaches as potentially synergistic rather than mutually exclusive. Functional imaging indicates that cognition, emotions, and pain experiences change the way the brain processes pain inputs. This may provide a physiological rationale for psychological interventions in pain management. As most studies of psychological management of migraine have been relatively small and the approach often varies between clinicians, the magnitude of benefit, optimum method of delivery, and the length of intervention are uncertain.

The Value of the Rorschach Method in Clinical Assessment of Migraine Patients

“…Concerning care for migraine patients, behavioral approach techniques are reported to be the most useful therapy to recognize and deal with feelings (Holroyd & Drew, 2006; Pizza et al, 2001; Weatherby, Brown, Newman, & Noad, 2012). However, our results highlight that migraine patients have a specific functioning that cannot be treated solely by a behavioral approach.…”

Somatoform dissociation, fatigue severity and pain behavior compared in patients with migraine headache and in healthy individuals

“…Consistent with the results of this research, during the investigations it appears that although migraine is a physiological disease, psychological factors have significant roles in pain management. 10 In a survey conducted in patients with chronic pain it became clear that seeking for help and accepting the pain had impacts on reduction of factors associated with the severity of the pain. Also, in a study the regression equation regarding the prediction of physical disability showed that, accepting the pain and asking for help factors predicted less physical disability 18 And again, an investigation showed that asking for help and pain acceptation, was effective in reduction of pain-related anxiety and the severity of pain.…”

“…Pain is the most common mental stress encountered with individuals and none of other physical symptoms, is not the same extent as pain. 10 …”

The Effectiveness of Compassion-focused Therapy for Improving Emotional Control and Reducing the Severity of Pain in Migraine Patients

“…Besides, emotional control methods are the main source of understanding the emotional and behavioral dependencies of stresses and negative emotional events (Gross, 2002). Previous studies confirm the effectiveness of non-pharmaceutical and cognitive-behavioral approaches in treating headaches (Brown, Newman, Noad, & Weatherby, 2012;Nicholson, Buse, Andrasik, & Lipton, 2011). According to Neff and Germer's study (2013), there is a significant relationship between self-compassion and reduced anxiety, depression, perfectionism, neuroticism, preoccupations, and thought inhibitions.…”