Skip to main content
Top
Published in: Journal of Contemporary Psychotherapy 3/2016

01-09-2016 | Original Paper

Chronic Pain, Chronic Demoralization, and the Role of Psychotherapy

Authors: John M. de Figueiredo, James L. Griffith

Published in: Journal of Contemporary Psychotherapy | Issue 3/2016

Login to get access

Abstract

This article discusses demoralization in patients with chronic pain and the role of psychotherapy at combating chronic demoralization associated with chronic pain. The advantages of the biopsychosocial conceptual framework for the understanding of chronic pain are highlighted. Demoralization may be viewed as a combination of distress and subjective incompetence. While the distress experienced by the patient may be understandable and commensurate to the predicament, the co-occurrence of subjective incompetence (the polar opposite of resilience) and its escalation to helplessness, and hopelessness may result in suicidal attempts, demands for euthanasia, or death by suicide. The complexity of chronic pain and its relationship to demoralization may be examined from multiple perspectives. Biological, psychological, social and cultural variables play varying roles depending on the observer’s perspective and the context of the observation. The role of psychotherapy in chronic pain may be viewed in terms of multiple pathways through which language, cognitive style, behavior, relationships, attitude towards pain, and awareness of the body modify the relative influences of top-down and bottom-up processing of information within the pain neuromatrix. Various psychotherapeutic interventions developed for patients with chronic pain are reviewed and recommendations are made for future research.
Literature
go back to reference Arsten, A. F. T. (2009). Stress signaling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience, 10, 410–422.CrossRef Arsten, A. F. T. (2009). Stress signaling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience, 10, 410–422.CrossRef
go back to reference Astin, J. A. (2004). Mind-body therapies for the management of pain. Clinical Journal of Pain, 20(1), 27–32.CrossRefPubMed Astin, J. A. (2004). Mind-body therapies for the management of pain. Clinical Journal of Pain, 20(1), 27–32.CrossRefPubMed
go back to reference Astin, J. A., Shapiro, S. L., Eisenberg, D. M., & Forys, K. L. (2003). Mind-body medicine: State of the science, implications for practice. Journal of the American Board of Family Practice, 16, 131–147.CrossRefPubMed Astin, J. A., Shapiro, S. L., Eisenberg, D. M., & Forys, K. L. (2003). Mind-body medicine: State of the science, implications for practice. Journal of the American Board of Family Practice, 16, 131–147.CrossRefPubMed
go back to reference Beneditti, F., Mayberg, H. S., Wager, T. D., Stohler, C. S., & Zubieta, J.-K. (2005). Neurobiological mechanisms of the placebo effect. Journal of Neuroscience, 25, 10390–10402.CrossRef Beneditti, F., Mayberg, H. S., Wager, T. D., Stohler, C. S., & Zubieta, J.-K. (2005). Neurobiological mechanisms of the placebo effect. Journal of Neuroscience, 25, 10390–10402.CrossRef
go back to reference Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.
go back to reference Borsook, D., Becerra, L., & Hargreaves, R. (2011a). Biomarkers for chronic pain and analgesia, part 1: The need, reality, challenges, and solutions. Discovery Medicine, 11(58), 197–207.PubMed Borsook, D., Becerra, L., & Hargreaves, R. (2011a). Biomarkers for chronic pain and analgesia, part 1: The need, reality, challenges, and solutions. Discovery Medicine, 11(58), 197–207.PubMed
go back to reference Borsook, D., Becerra, L., & Hargreaves, R. (2011b). Biomarkers for chronic pain and analgesia, part 2: How, where, and what to look for using functional imaging. Discovery Medicine, 11(58), 209–219.PubMed Borsook, D., Becerra, L., & Hargreaves, R. (2011b). Biomarkers for chronic pain and analgesia, part 2: How, where, and what to look for using functional imaging. Discovery Medicine, 11(58), 209–219.PubMed
go back to reference Borsook, D., Moulton, E. A., Schmidt, K. F., & Becerra, L. R. (2007). Neuroimaging revolutionizes therapeutic approaches to chronic pain. Molecular Pain, 3, 3–25.CrossRef Borsook, D., Moulton, E. A., Schmidt, K. F., & Becerra, L. R. (2007). Neuroimaging revolutionizes therapeutic approaches to chronic pain. Molecular Pain, 3, 3–25.CrossRef
go back to reference Carlson, L. (2012). Review Article: Mindfulness-Based Interventions for Physical Conditions: A Narrative Review Evaluating Levels of Evidence. International Scholarly Research Notices (ISRN), 2012. Carlson, L. (2012). Review Article: Mindfulness-Based Interventions for Physical Conditions: A Narrative Review Evaluating Levels of Evidence. International Scholarly Research Notices (ISRN), 2012.
go back to reference Chiesa, A., & Serreti, A. (2011). Mindfulness-based interventions for chronic pain: a systematic review of the evidence. Journal of Alternative and Complementary Medicine, 17(1), 83–93.CrossRefPubMed Chiesa, A., & Serreti, A. (2011). Mindfulness-based interventions for chronic pain: a systematic review of the evidence. Journal of Alternative and Complementary Medicine, 17(1), 83–93.CrossRefPubMed
go back to reference Clarke, D. M., Kissane, D. W., Trauer, T., & Smith, G. C. (2005). Demoralization, anhedonia and grief in patients with severe physical illness. World Psychiatry, 4(2), 95–105. Clarke, D. M., Kissane, D. W., Trauer, T., & Smith, G. C. (2005). Demoralization, anhedonia and grief in patients with severe physical illness. World Psychiatry, 4(2), 95–105.
go back to reference Clauw, D. J. (2014). Fibromyalgia: A clinical review. Journal of the American Medical Association, 311(15), 1547–1555.CrossRefPubMed Clauw, D. J. (2014). Fibromyalgia: A clinical review. Journal of the American Medical Association, 311(15), 1547–1555.CrossRefPubMed
go back to reference Crow, E. M., Jeannot, E., & Trewhela, A. (2015). Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: A systematic review. International Journal of Yoga, 8(1), 3–14.CrossRefPubMedPubMedCentral Crow, E. M., Jeannot, E., & Trewhela, A. (2015). Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: A systematic review. International Journal of Yoga, 8(1), 3–14.CrossRefPubMedPubMedCentral
go back to reference Damasio, A. (1999). The feeling of what happens. Body and emotion in the making of consciousness. New York: Harcourt Brace & Company. Damasio, A. (1999). The feeling of what happens. Body and emotion in the making of consciousness. New York: Harcourt Brace & Company.
go back to reference Damasio, A. (2010). Self comes to mind. Constructing the conscious brain. New York: Pantheon Books. Damasio, A. (2010). Self comes to mind. Constructing the conscious brain. New York: Pantheon Books.
go back to reference Davis, M. C., Thummala, K., & Zautra, A. J. (2014). Stress-related clinical pain and mood in women with chronic pain: moderating effects of depression and positive mood induction. Annals of Behavioral Medicine, 48(1), 61–70.CrossRefPubMedPubMedCentral Davis, M. C., Thummala, K., & Zautra, A. J. (2014). Stress-related clinical pain and mood in women with chronic pain: moderating effects of depression and positive mood induction. Annals of Behavioral Medicine, 48(1), 61–70.CrossRefPubMedPubMedCentral
go back to reference de Figueiredo, J. M. (1993). Depression and demoralization: Phenomenologic differences and research perspectives. Comprehensive Psychiatry, 34(5), 308–311.CrossRefPubMed de Figueiredo, J. M. (1993). Depression and demoralization: Phenomenologic differences and research perspectives. Comprehensive Psychiatry, 34(5), 308–311.CrossRefPubMed
go back to reference de Figueiredo, J. M. (2011). Deconstructing demoralization: Distress and subjective incompetence in the face of adversity. In R. D. Alarcon & J. B. Frank (Eds.), The psychotherapy of hope: The legacy of persuasion and healing (pp. 107–124). Baltimore, MD: The Johns Hopkins University Press. de Figueiredo, J. M. (2011). Deconstructing demoralization: Distress and subjective incompetence in the face of adversity. In R. D. Alarcon & J. B. Frank (Eds.), The psychotherapy of hope: The legacy of persuasion and healing (pp. 107–124). Baltimore, MD: The Johns Hopkins University Press.
go back to reference de Figueiredo, J. M. (2013). Distress, demoralization, and psychopathology. Diagnostic boundaries. The European Journal of Psychiatry, 27(1), 61–73.CrossRef de Figueiredo, J. M. (2013). Distress, demoralization, and psychopathology. Diagnostic boundaries. The European Journal of Psychiatry, 27(1), 61–73.CrossRef
go back to reference Desai, G., & Chaturvedi, S. K. (2016). Do Diagnostic Criteria for Psychosomatic Research explain diagnosis of medically unexplained somatic symptoms? Psychotherapy and Psychosomatics, 85, 121–122.CrossRefPubMed Desai, G., & Chaturvedi, S. K. (2016). Do Diagnostic Criteria for Psychosomatic Research explain diagnosis of medically unexplained somatic symptoms? Psychotherapy and Psychosomatics, 85, 121–122.CrossRefPubMed
go back to reference Dohrenwend, B. P., Raphael, K. G., Marbach, J. J., & Gallagher, R. M. (1999). Why is depression comorbid with chronic myofascial face pain? A family study test of alternative hypotheses. Pain, 83, 183–192.CrossRefPubMed Dohrenwend, B. P., Raphael, K. G., Marbach, J. J., & Gallagher, R. M. (1999). Why is depression comorbid with chronic myofascial face pain? A family study test of alternative hypotheses. Pain, 83, 183–192.CrossRefPubMed
go back to reference Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (2010). The heart and soul of change: Delivering what works in therapy. Washington, DC: American Psychological Association.CrossRef Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (2010). The heart and soul of change: Delivering what works in therapy. Washington, DC: American Psychological Association.CrossRef
go back to reference Dunford, E., & Thompson, M. (2010). Relaxation and mindfulness in pain: a review. Reviews in Pain British Journal of Pain, 4(1), 18–22.CrossRef Dunford, E., & Thompson, M. (2010). Relaxation and mindfulness in pain: a review. Reviews in Pain British Journal of Pain, 4(1), 18–22.CrossRef
go back to reference Eccleston, C., Williams, A.C. & Morley, S. (2009) Psychological therapies for the management of chronic pain (excluding headache) in chronic pain. Cochrane Database of Systematic Reviews 2009 (2) Article No. CD0047072. Eccleston, C., Williams, A.C. & Morley, S. (2009) Psychological therapies for the management of chronic pain (excluding headache) in chronic pain. Cochrane Database of Systematic Reviews 2009 (2) Article No. CD0047072.
go back to reference Eisenberger, N. I. (2013). An empirical review of the neural underpinnings of receiving and giving social support: implications for health. Psychosomatic Medicine, 75, 545–556.CrossRefPubMedPubMedCentral Eisenberger, N. I. (2013). An empirical review of the neural underpinnings of receiving and giving social support: implications for health. Psychosomatic Medicine, 75, 545–556.CrossRefPubMedPubMedCentral
go back to reference Fersum, K. V., O’Sullivan, P., Skouen, J. S., Smith, A., & Kvale, A. (2013). Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: A randomized controlled trial. European Journal of Pain, 17(6), 916–928.CrossRef Fersum, K. V., O’Sullivan, P., Skouen, J. S., Smith, A., & Kvale, A. (2013). Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: A randomized controlled trial. European Journal of Pain, 17(6), 916–928.CrossRef
go back to reference Frank, J. D., & Frank, J. B. (1991). Persuasion and healing. A comparative study of psychotherapy. Baltimore: The Johns Hopkins University Press. Frank, J. D., & Frank, J. B. (1991). Persuasion and healing. A comparative study of psychotherapy. Baltimore: The Johns Hopkins University Press.
go back to reference Gallagher, R. M., Marbach, J. J., Raphael, K. G., Handte, J., & Dohrenwend, B. P. (1995). Myofascial face pain: seasonal variability in pain intensity and demoralization. Pain, 61, 113–120.CrossRefPubMed Gallagher, R. M., Marbach, J. J., Raphael, K. G., Handte, J., & Dohrenwend, B. P. (1995). Myofascial face pain: seasonal variability in pain intensity and demoralization. Pain, 61, 113–120.CrossRefPubMed
go back to reference Grassi, L., Mangelli, L., Fava, G. A., Grandi, S., Ottolini, F., Porcelli, P., et al. (2007). Psychosomatic characterization of adjustment disorders in the medical setting: some suggestions for DSM-V. Journal of Affective Disorders, 101, 251–254.CrossRefPubMed Grassi, L., Mangelli, L., Fava, G. A., Grandi, S., Ottolini, F., Porcelli, P., et al. (2007). Psychosomatic characterization of adjustment disorders in the medical setting: some suggestions for DSM-V. Journal of Affective Disorders, 101, 251–254.CrossRefPubMed
go back to reference Griffith, J. L. (2010). Religion that heals, religion that harms. New York: Guilford Press. Griffith, J. L. (2010). Religion that heals, religion that harms. New York: Guilford Press.
go back to reference Griffith, J. L., & Gaby, L. (2005). Brief psychotherapy at the bedside: countering demoralization from medical illness. Psychosomatics, 46(2), 109–116.CrossRefPubMed Griffith, J. L., & Gaby, L. (2005). Brief psychotherapy at the bedside: countering demoralization from medical illness. Psychosomatics, 46(2), 109–116.CrossRefPubMed
go back to reference Gruenberg, E. M. (1974). The social breakdown syndrome and its prevention. In G. Caplan (Ed.), American handbook of psychiatry (pp. 697–711). New York, NY: Basic Books. Gruenberg, E. M. (1974). The social breakdown syndrome and its prevention. In G. Caplan (Ed.), American handbook of psychiatry (pp. 697–711). New York, NY: Basic Books.
go back to reference Guidi, J., Fava, G. A., Picardi, A., Porcelli, P., Bellomo, A., Grandi, S., et al. (2011). Subtyping depression in the medically ill by cluster analysis. Journal of Affective Disorders, 132, 383–388.CrossRefPubMed Guidi, J., Fava, G. A., Picardi, A., Porcelli, P., Bellomo, A., Grandi, S., et al. (2011). Subtyping depression in the medically ill by cluster analysis. Journal of Affective Disorders, 132, 383–388.CrossRefPubMed
go back to reference Hardt, J., Jacobsen, C., Goldberg, J., Nickel, R., & Buchwald, D. (2008). Prevalence of chronic pain in a representative sample in the United States. Pain Medicine, 9(7), 803–812.CrossRefPubMed Hardt, J., Jacobsen, C., Goldberg, J., Nickel, R., & Buchwald, D. (2008). Prevalence of chronic pain in a representative sample in the United States. Pain Medicine, 9(7), 803–812.CrossRefPubMed
go back to reference Ingvar, D. H. (1985). “Memory of the future”: an essay on the temporal organization of conscious awareness. Human Neurobiology, 4(3), 127–133.PubMed Ingvar, D. H. (1985). “Memory of the future”: an essay on the temporal organization of conscious awareness. Human Neurobiology, 4(3), 127–133.PubMed
go back to reference Jensen, K. B., Petrovic, P., Kerr, C. E., Kirsch, I., Raicek, J., Cheetham, A., et al. (2014). Sharing pain and relief neural correlates of physicians during treatment of patients. Molecular Psychiatry, 19(3), 392–398.CrossRefPubMed Jensen, K. B., Petrovic, P., Kerr, C. E., Kirsch, I., Raicek, J., Cheetham, A., et al. (2014). Sharing pain and relief neural correlates of physicians during treatment of patients. Molecular Psychiatry, 19(3), 392–398.CrossRefPubMed
go back to reference Klein, D. F., Gittelman, R., Quitkin, F., & Rifkin, A. (1980). Diagnosis and drug treatment of psychiatric disorders: adults and children. Baltimore: Williams & Wilkins. Klein, D. F., Gittelman, R., Quitkin, F., & Rifkin, A. (1980). Diagnosis and drug treatment of psychiatric disorders: adults and children. Baltimore: Williams & Wilkins.
go back to reference Landa, A., Peterson, B. S., & Fallon, B. A. (2012). Somatoform pain: A developmental theory and translational research review. Psychosomatic Medicine, 74(7), 717–727.CrossRefPubMedPubMedCentral Landa, A., Peterson, B. S., & Fallon, B. A. (2012). Somatoform pain: A developmental theory and translational research review. Psychosomatic Medicine, 74(7), 717–727.CrossRefPubMedPubMedCentral
go back to reference Latremoliere, A., & Woolf, C. J. (2009). Central sensitization: A generator of pain hypersensitivity by central neural plasticity. Journal of Pain, 10, 895–926.CrossRefPubMedPubMedCentral Latremoliere, A., & Woolf, C. J. (2009). Central sensitization: A generator of pain hypersensitivity by central neural plasticity. Journal of Pain, 10, 895–926.CrossRefPubMedPubMedCentral
go back to reference Lee, C., Crawford, C., Swann, S., & Active Self-Care Therapies for Pain (PACT) Working Group (2014) Multimodal, integrative therapoies for the self-management of chronic pain symptoms. Pain Medicine 15: S76–S85. Lee, C., Crawford, C., Swann, S., & Active Self-Care Therapies for Pain (PACT) Working Group (2014) Multimodal, integrative therapoies for the self-management of chronic pain symptoms. Pain Medicine 15: S76–S85.
go back to reference Lennon, M. C., Dohrenwend, B. P., Zautra, A. J., & Marbach, J. J. (1990). Coping and adaptation to facial pain in contrast to other stressful life events. Journal of Personality and Social Psychology, 59, 1040–1050.CrossRefPubMed Lennon, M. C., Dohrenwend, B. P., Zautra, A. J., & Marbach, J. J. (1990). Coping and adaptation to facial pain in contrast to other stressful life events. Journal of Personality and Social Psychology, 59, 1040–1050.CrossRefPubMed
go back to reference Levine, P., & Phillips, M. (2012). Freedom from Pain. Boulder, CO: Sounds True. Levine, P., & Phillips, M. (2012). Freedom from Pain. Boulder, CO: Sounds True.
go back to reference Machikanti, L., Singh, V., Datta, S., Cohen, S. P., & Hirsch, J. A. (2009). American Society of Interventional Pain Physicians. Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician, 12(4), E35–E70. Machikanti, L., Singh, V., Datta, S., Cohen, S. P., & Hirsch, J. A. (2009). American Society of Interventional Pain Physicians. Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician, 12(4), E35–E70.
go back to reference Mangelli, L., Fava, G. A., Grandi, S., Grassi, L., Ottolini, F., Porcelli, P., et al. (2005). Assessing demoralization and depression in the setting of medical disease. Journal of Clinical Psychiatry, 66(3), 391–394.CrossRefPubMed Mangelli, L., Fava, G. A., Grandi, S., Grassi, L., Ottolini, F., Porcelli, P., et al. (2005). Assessing demoralization and depression in the setting of medical disease. Journal of Clinical Psychiatry, 66(3), 391–394.CrossRefPubMed
go back to reference Mantyh, P. W. (2002). Neurobiology of substance P and the NK1 receptor. Journal of Clinical Psychiatry, 63(Suppl. 11), 6–10.PubMed Mantyh, P. W. (2002). Neurobiology of substance P and the NK1 receptor. Journal of Clinical Psychiatry, 63(Suppl. 11), 6–10.PubMed
go back to reference Marbach, J. J., Schleifer, S. J., & Keller, S. E. (1990). Facial pain, distress, and immune function. Brain, Behavior, and Immunity, 4, 243–254.CrossRefPubMed Marbach, J. J., Schleifer, S. J., & Keller, S. E. (1990). Facial pain, distress, and immune function. Brain, Behavior, and Immunity, 4, 243–254.CrossRefPubMed
go back to reference McCracken, L. M., & Thompson, M. (2011). Psychological advances in chronic pain: a concise selective review of research from 2010. Current Opinion in Supportive and Palloiative Care, 5(2), 122–126.CrossRef McCracken, L. M., & Thompson, M. (2011). Psychological advances in chronic pain: a concise selective review of research from 2010. Current Opinion in Supportive and Palloiative Care, 5(2), 122–126.CrossRef
go back to reference McHugh, P. R., & Slavney, P. R. (1998). The perspectives of psychiatry. Baltimore, MD: Johns Hopkins University Press. McHugh, P. R., & Slavney, P. R. (1998). The perspectives of psychiatry. Baltimore, MD: Johns Hopkins University Press.
go back to reference McRae, K., Misra, S., Prasad, A. K., Pereira, S. C., & Gross, J. J. (2012). Bottom-up and top-down emotion generation: implications for emotion regulation. SCAN, 7, 253–262.PubMed McRae, K., Misra, S., Prasad, A. K., Pereira, S. C., & Gross, J. J. (2012). Bottom-up and top-down emotion generation: implications for emotion regulation. SCAN, 7, 253–262.PubMed
go back to reference Mechanic, D. (1995). Sociological dimensions of illness behavior. Social Science & Medicine, 41(9), 1207–1216.CrossRef Mechanic, D. (1995). Sociological dimensions of illness behavior. Social Science & Medicine, 41(9), 1207–1216.CrossRef
go back to reference Melzack, R. (1999). From the gate to the neuromatrix. Pain Supplement, 6, 121–126.CrossRef Melzack, R. (1999). From the gate to the neuromatrix. Pain Supplement, 6, 121–126.CrossRef
go back to reference Melzack, R. (2001). Pain and the neuromatrix in the brain. Journal of Dental Education, 65(12), 1378–1382.PubMed Melzack, R. (2001). Pain and the neuromatrix in the brain. Journal of Dental Education, 65(12), 1378–1382.PubMed
go back to reference Merikangas, K. R., Angst, J., & Isler, H. (1990). Migraine and psychopathology. Archives of General Psychiatry, 47, 849–853.CrossRefPubMed Merikangas, K. R., Angst, J., & Isler, H. (1990). Migraine and psychopathology. Archives of General Psychiatry, 47, 849–853.CrossRefPubMed
go back to reference National Comprehensive Cancer Network. (2003). Distress management clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 1, 344–374. National Comprehensive Cancer Network. (2003). Distress management clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network, 1, 344–374.
go back to reference Nitch, S. R., & Boone, K. B. (2004). Normal personality correlates of chronic pain subgroups. Journal of Clinical Psychology in Medical Settings, 11(3), 203–209.CrossRef Nitch, S. R., & Boone, K. B. (2004). Normal personality correlates of chronic pain subgroups. Journal of Clinical Psychology in Medical Settings, 11(3), 203–209.CrossRef
go back to reference Ochsner, K. N., & Gross, J. J. (2005). The cognitive control of emotion. Trends in Cognitive Sciences, 9, 242–249.CrossRefPubMed Ochsner, K. N., & Gross, J. J. (2005). The cognitive control of emotion. Trends in Cognitive Sciences, 9, 242–249.CrossRefPubMed
go back to reference Otti, A., Guendel, H., Laer, L., Wohlschlaeger, A. M., Lane, R. D., Decety, J., et al. (2010). I know the pain you feel: How the human brain’s default mode predicts our resonance to another’s suffering. Neuroscience, 169(1), 143–148.CrossRefPubMed Otti, A., Guendel, H., Laer, L., Wohlschlaeger, A. M., Lane, R. D., Decety, J., et al. (2010). I know the pain you feel: How the human brain’s default mode predicts our resonance to another’s suffering. Neuroscience, 169(1), 143–148.CrossRefPubMed
go back to reference Poleshuck, E. L., Gamble, S. A., Corta, N., Hoffman-King, D., Cerrito, B., Rosario-McCabe, L. A., et al. (2010). Interpersonal psychotherapy for co-occurring depression and chronic pain. Professional Practice: Research and Practice, 41(4), 312–318.CrossRef Poleshuck, E. L., Gamble, S. A., Corta, N., Hoffman-King, D., Cerrito, B., Rosario-McCabe, L. A., et al. (2010). Interpersonal psychotherapy for co-occurring depression and chronic pain. Professional Practice: Research and Practice, 41(4), 312–318.CrossRef
go back to reference Porcelli, P., Bellomo, A., Quartesan, R., Altamura, M., Iuso, S., Ciannameo, S., et al. (2009). Psychosocial functioning in consultation-liaison psychiatry patients: influence of psychosomatic syndromes, psychopathology, and somatization. Psychotherapy and Psychosomatics, 78(6), 352–358.CrossRefPubMed Porcelli, P., Bellomo, A., Quartesan, R., Altamura, M., Iuso, S., Ciannameo, S., et al. (2009). Psychosocial functioning in consultation-liaison psychiatry patients: influence of psychosomatic syndromes, psychopathology, and somatization. Psychotherapy and Psychosomatics, 78(6), 352–358.CrossRefPubMed
go back to reference Radebaugh, T. S., Hooper, F. J., & Gruenberg, E. M. (1987). The Social Breakdown Syndrome in the elderly population living in the community: The Helping Study. British Journal of Psychiatry, 151, 341–346.CrossRefPubMed Radebaugh, T. S., Hooper, F. J., & Gruenberg, E. M. (1987). The Social Breakdown Syndrome in the elderly population living in the community: The Helping Study. British Journal of Psychiatry, 151, 341–346.CrossRefPubMed
go back to reference Rainville, P., Hofbauer, R. K., Bushnell, M. C., Duncan, G. H., & Price, D. D. (2002). Hypnosis modulates the activity in cerebral structures involved in the regulation of consciousness. Journal of Cognitive Neuroscience, 14(Supplement), 887–901.CrossRefPubMed Rainville, P., Hofbauer, R. K., Bushnell, M. C., Duncan, G. H., & Price, D. D. (2002). Hypnosis modulates the activity in cerebral structures involved in the regulation of consciousness. Journal of Cognitive Neuroscience, 14(Supplement), 887–901.CrossRefPubMed
go back to reference Ramachandran, V. S., & Blakeslee, S. (1999). Phantoms in the Brain. New York: William Morrow. Ramachandran, V. S., & Blakeslee, S. (1999). Phantoms in the Brain. New York: William Morrow.
go back to reference Raz, A. (2005). Attention and hypnosis neural substrates and genetic associations of two converging processes. International Journal of Clinical and Experimental Hypnosis, 52, 237–258.CrossRef Raz, A. (2005). Attention and hypnosis neural substrates and genetic associations of two converging processes. International Journal of Clinical and Experimental Hypnosis, 52, 237–258.CrossRef
go back to reference Robinson, S., Kissane, D. W., Brooker, J., & Burney, S. (2016). A review of the construct of demoralization: history, definitions, and future directions for palliative care. American Journal of Hospice and Palliative Care, 33(1), 93–101.CrossRefPubMed Robinson, S., Kissane, D. W., Brooker, J., & Burney, S. (2016). A review of the construct of demoralization: history, definitions, and future directions for palliative care. American Journal of Hospice and Palliative Care, 33(1), 93–101.CrossRefPubMed
go back to reference Roditi, D., & Robinson, M. E. (2011). The role of psychological interventions in the management of patients with chronic pain. Psychology Research and Behavior Management, 4, 41–49.CrossRefPubMedPubMedCentral Roditi, D., & Robinson, M. E. (2011). The role of psychological interventions in the management of patients with chronic pain. Psychology Research and Behavior Management, 4, 41–49.CrossRefPubMedPubMedCentral
go back to reference Sattel, H., Lahmann, C., Gundel, H., Guthrie, E., Kruse, J., Noll-Hussong, M., et al. (2012). Brief psychodynamic interpersonal psychotherapy for patients with multi-somatoform disorder: randomized controlled trial. The British Journal of Psychiatry, 200(1), 60–67.CrossRefPubMed Sattel, H., Lahmann, C., Gundel, H., Guthrie, E., Kruse, J., Noll-Hussong, M., et al. (2012). Brief psychodynamic interpersonal psychotherapy for patients with multi-somatoform disorder: randomized controlled trial. The British Journal of Psychiatry, 200(1), 60–67.CrossRefPubMed
go back to reference Semprini, F., Fava, G. A., & Sonino, N. (2010). The spectrum of adjustment of disorders: Too broad to be clinically helpful. CNS Spectrum, 15(6), 382–388. Semprini, F., Fava, G. A., & Sonino, N. (2010). The spectrum of adjustment of disorders: Too broad to be clinically helpful. CNS Spectrum, 15(6), 382–388.
go back to reference Shapiro, S. L., & Carlson, S. E. (2009). The art and science of mindfulness: Integrating mindfulness into psychology and the helping professions. Washington, DC: American Psychological Association Publications.CrossRef Shapiro, S. L., & Carlson, S. E. (2009). The art and science of mindfulness: Integrating mindfulness into psychology and the helping professions. Washington, DC: American Psychological Association Publications.CrossRef
go back to reference Sprenkle, D. H., Davis, S. D., & Lebow, J. (2009). Common factors in couple and family therapy: The overlooked foundation for effective practice. New York: Guilford Press. Sprenkle, D. H., Davis, S. D., & Lebow, J. (2009). Common factors in couple and family therapy: The overlooked foundation for effective practice. New York: Guilford Press.
go back to reference Tacey, I. (2010). Getting the pain you expect: mechanisms of placebo, nocebo and reappraisal effects in humans. Nature Medicine, 16, 1277–1283.CrossRef Tacey, I. (2010). Getting the pain you expect: mechanisms of placebo, nocebo and reappraisal effects in humans. Nature Medicine, 16, 1277–1283.CrossRef
go back to reference Tecuta, L., Tomba, E., Grandi, S., & Fava, G. A. (2015). Demoralization: a systematic review on its clinical characterization. Psychological Medicine, 45, 673–691.CrossRefPubMed Tecuta, L., Tomba, E., Grandi, S., & Fava, G. A. (2015). Demoralization: a systematic review on its clinical characterization. Psychological Medicine, 45, 673–691.CrossRefPubMed
go back to reference Turk, D. C., & Monarch, E. S. (2002). Biopsychosocial perspective on chronic pain. In D. C. Turk & R. J. Gatchel (Eds.), Psychological approaches to pain management: A practitioner’s handbook (pp. 3–29). New York: Guilford. Turk, D. C., & Monarch, E. S. (2002). Biopsychosocial perspective on chronic pain. In D. C. Turk & R. J. Gatchel (Eds.), Psychological approaches to pain management: A practitioner’s handbook (pp. 3–29). New York: Guilford.
go back to reference Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: Integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56(2), 233–238.CrossRefPubMed Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: Integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56(2), 233–238.CrossRefPubMed
go back to reference Turk, D. C., & Rudy, T. E. (1990). The robustness of an empirically derived taxonomy of chronic pain patients. Pain, 44, 5–28.CrossRef Turk, D. C., & Rudy, T. E. (1990). The robustness of an empirically derived taxonomy of chronic pain patients. Pain, 44, 5–28.CrossRef
go back to reference Van Tulder, M. W., Ostelo, R., Vlaeyen, J. W., Linton, S. J., Morley, S. J., & Assendelft, W. J. (2000). Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine, 25, 2688–2699.CrossRefPubMed Van Tulder, M. W., Ostelo, R., Vlaeyen, J. W., Linton, S. J., Morley, S. J., & Assendelft, W. J. (2000). Behavioral treatment for chronic low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine, 25, 2688–2699.CrossRefPubMed
go back to reference Veehof, M. M., Oskam, M. J., Schreurs, K. M., & Bohlmeijer, E. T. (2011). Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain, 152(3), 533–542.CrossRefPubMed Veehof, M. M., Oskam, M. J., Schreurs, K. M., & Bohlmeijer, E. T. (2011). Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain, 152(3), 533–542.CrossRefPubMed
go back to reference Woo, C.-W., Koban, L., Krose, E., Llindquist, M. A., Banich, M. T., Ruzic, L., et al. (2014). Separate neural representations for physical pain and social rejection. Nature Communications, 5, 5380.CrossRefPubMedPubMedCentral Woo, C.-W., Koban, L., Krose, E., Llindquist, M. A., Banich, M. T., Ruzic, L., et al. (2014). Separate neural representations for physical pain and social rejection. Nature Communications, 5, 5380.CrossRefPubMedPubMedCentral
go back to reference Woolf, C. J. (2011). Central sensitization: Implications for the diagnosis and treatment of pain. Pain, 152((Suppl.)), S2–S15.CrossRefPubMed Woolf, C. J. (2011). Central sensitization: Implications for the diagnosis and treatment of pain. Pain, 152((Suppl.)), S2–S15.CrossRefPubMed
Metadata
Title
Chronic Pain, Chronic Demoralization, and the Role of Psychotherapy
Authors
John M. de Figueiredo
James L. Griffith
Publication date
01-09-2016
Publisher
Springer US
Published in
Journal of Contemporary Psychotherapy / Issue 3/2016
Print ISSN: 0022-0116
Electronic ISSN: 1573-3564
DOI
https://doi.org/10.1007/s10879-016-9331-x

Other articles of this Issue 3/2016

Journal of Contemporary Psychotherapy 3/2016 Go to the issue