Compassion and chronic pain

Purdie, Fiona; Morley, Stephen

doi:10.1097/j.pain.0000000000000638

Cited by 42 publications

(34 citation statements)

References 28 publications

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“…Interventions in CP may benefit from introducing deliteralization techniques as a way of interrupting the fusion with language-focused processes (Blackledge, 2007), as well as mindfulness meditation practices in order to promote distancing from and acceptance of internal experiences (McCracken & Vowels, 2014). Whilst selfcompassion is often an important aspect of acceptance and mindfulness based interventions, little empirical work exists exploring more explicit compassion-based interventions in CP (Purdie & Morley, 2016). The current study suggests that interventions targeting self-compassion could be helpfully applied in CP settings.…”

Section: Discussionmentioning

confidence: 87%

Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

Carvalho

Pinto‐Gouveia

Gillanders

et al. 2018

The Journal of Psychology

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The association between chronic pain (CP) and depression is complex, and influenced by several psychological processes. Cognitive fusion (i.e. being entangled with one´s internal experiences) and self-compassion (i.e. being touched by one´s suffering, with a motivation to alleviate it) have been hypothesized as relevant psychological processes in physical and mental health, but few studies have addressed them in CP, and none in a comprehensive model relating pain intensity and depressive symptoms. This study tests, in a moderated mediation model, the mediator role of cognitive fusion between pain intensity and depressive symptoms, and the moderator effect of self-compassion in this mediation. In a cross-sectional study, 231 female CP patients (Age: M = 48.51, SD = 10.89) responded online self-report measures. PROCESS, an SPSS macro for conducting path analysis modeling, was used to test the hypothesized model. The model explained 63% of depressive symptoms, and cognitive fusion mediates the association between pain intensity and depressive symptoms. Also, self-compassion moderates this mediation (regardless of self-compassion being low, moderate or high). Although pain intensity is a predictor of depressive symptoms, fusion with thinking in general mediates this association, this relationship is buffered when patients are able to respond to setbacks and perceived shortcomings with self-kindness and warmth. Clinical and theoretical implications are discussed.

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Section: Discussionmentioning

confidence: 87%

Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

Carvalho

Pinto‐Gouveia

Gillanders

et al. 2018

The Journal of Psychology

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“…Validation can be described as communication of empathy, acceptance, and understanding; it has a positive impact on adherence to treatment and is known to help in regulating negative emotions [52]. When patients experience validation and compassion, they often feel more satisfied; furthermore, clinicians who manage to validate their patients and show compassion for their predicaments are often able to give the patients what they have long soughta feeling of being cared for [53,54] and decrease the discrepancy between the wanted and the pain-afflicted self at an inter-personal level [54].…”

Section: Meaning Of the Studymentioning

confidence: 99%

“My life is under control with these medications”: an interpretative phenomenological analysis of managing chronic pain with opioids

Ljungvall

Rhodin

Wagner

et al. 2020

BMC Musculoskelet Disord

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Background: The use of opioids to relieve chronic pain has increased during the last decades, but experiences of chronic opioid therapy (COT) (> 90 days) point at risks and loss of beneficial effects. Still, some patients report benefits from opioid medication, such as being able to stay at work. Guidelines for opioid use in chronic pain do not consider the individual experience of COT, including benefits and risks, making the first person perspective an important scientific component to explore. The aim of this study was to investigate the lived experience of managing chronic pain with opioids in a sample who have severe chronic pain but are able to manage their pain sufficiently to remain at work. Methods: We used a qualitative research design: interpretative phenomenological analysis. Ten individuals with chronic pain and opioid therapy were purposively sampled in Swedish tertiary care. Results: Three super-ordinate themes emerged from the analyses: Without opioids, the pain becomes the boss; Opioids as a salvation and a curse, and Acknowledgement of the pain and acceptance of opioid therapy enables transition to a novel self. The participants used opioids to regain control over their pain, thus reclaiming their wanted life and self, and sense of control over one's life-world. Using opioids to manage pain was not unproblematic and some of the participants had experienced a downward spiral of escalating pain and uncontrollable opioid use, and stigmatisation. Conclusions: All participants emphasised the importance of control, regarding both pain and opioid use. To accomplish this, trust between participants and health care providers was essential for satisfactory treatment. Regardless of the potential sociocultural benefits of staying at work, participants had experiences of balancing positive and negative effects of opioid therapy, similar to what previous qualitative research has found. Measurable improvement of function and quality of life, may justify the long-term use of opioids in some cases. However, monitoring of adverse events should be mandatory. This requires close cooperation and a trusting relationship between the patients and their health care provider.

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“…Relaxation strategies, mindfulness, self-awareness and non-judgemental acceptance can help to self-regulate distress in the presence of pain. 42 As well as directly supporting pain self-management, calming the nervous system and mind assists in alleviating insomnia and anxiety.…”

Section: Psychological Treatmentsmentioning

confidence: 99%

“…Clinicians can help patients to recognise and modify unhelpful cognitions such as catastrophising, 'black and white' thinking and beliefs that drive fear-avoidance behaviours. 15,42,43 It is critical to identify and treat depression or anxiety. 42 Treatments include encouraging the scheduling of pleasurable activities, relaxation and exercise based on pacing principles.…”

Section: Psychological Treatmentsmentioning

confidence: 99%