Psychologists play an integral role in pain management, especially as it pertains to associated feelings of anxiety, depression, cognitive rumination of pain sensations and systemic family secondary gains. Drs. Simon and Folen review statistics that show depression is co-morbid with chronic pain 30-50% of the time and anxiety 20-40% of the time. It’s important that the psychologist work alongside the physician to break the cycle of pain—depression—immobility—more pain---more depression and so on. Treatment adherence is another issue where psychologists can be of great help, as statistics show only 50% of chronic pain patients take their medications as directed. Some of the non-invasive adjunctive psychotherapeutic interventions which can help a patient suffering chronic pain include hypnosis, biofeedback, muscle relaxation exercise, and contingency management.
Simon, Eric and Folen, Raymond. Professional Psychology: Research and Practice, 2001, 32, 125-134.
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Results of back and neck pain survey
In the February 2003 issue of the journal Spine (2003; 28: 292-297), Dr. Peter Wolsko and his colleagues report that 75% of the adult population at some time during their lives suffer back pain. Among the complementary treatments sought for back or neck pain, were Chiropractic (20%), massage (14%). Among those who sought these treatments, over 60% reported that these complementary healing modalities were “very helpful.” The authors conclude by saying, “Chiropractic, massage, relaxation techniques, and other complementary methods all play an important role in patients with back or neck pain.”
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Breast cancer and life stress
Dr. Kirsi Lillberg, of the University of Helsinki, Finland, and colleagues report that divorce, job loss, relocation or death in the family are associated with an increased risk of breast cancer. Dr. Lillberg conducted a prospective study of the association of life events and risk of breast cancer in 10,808 women and found that divorce/separation was independently associated with an increased breast cancer risk (hazard ratio = 2.26). An independent association was also observed for death of a husband (hazard ratio = 2.00)
Lillberg, Kirsi et al. Journal of Epidemiology 2003, 157, 415-423
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How cancer patients make medical decisions
Dr. Suni Petersen and colleagues studied the decisional processes used by cancer patients and found that patients use four strategies to make medical decisions: Information Seeking, Information Processing, Advice Following and Ruminating. Patients who used Information-Seeking and Information Processing (active/vigilant coping) relied on strategies that previous research had shown were more effective for coping with life-threatening illness than those who utilized Advice-Following (passive coping). Dr. Petersen and colleagues conclude: “…advice followers used fewer healthy coping strategies, so avoidant-type strategies dominated their repertoire… Patients engaged in thoughtful decisional styles also use more social support strategies to cope. Their network is likely to introduce alternative opinions that may enhance the reappraisal process, making their decisions more self-relevant and less dependent on a preconceived and potentially outmoded schema.”
Petersen, Suni et al. Journal of Counseling Psychology 2001, 48, 239-244
Dr. Lachman, a licensed clinical psychologist in private practice in Monterey and Salinas, California, specializes in psychooncology and pain management, and leads a weekly cancer patient and grief therapy groups. Dr. Lachman has just completed a new book on coping with cancer entitled, Parallel Journeys—A Spirited Approach to Coping and Living With Cancer.” Carmel, California: SunInk Presentations, 2003, ISBN #0-931104-50-5, (March/April 2003)
Psychooncology Associates, P. O. Box 22151, Carmel, Ca. 93922 Ph: (831) 643-2635/Fx: (734) 448-4724 Co-Author of the new book: "Parallel Journeys--A Spirited Approach to Coping and Living with Cancer,"
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Psychologists as part of the pain management team 
