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Engaging with a psychotherapist to help treat chronic pain does not mean that one’s pain is all in their head. Therapy for chronic-pain patients has been shown to benefit both the mind and the body, targeting physical symptoms and increasing daily functioning. In other words, for many, addressing their emotional health through therapy affects their physical health. A therapist can help a client challenge unhelpful thoughts about pain and develop new ways to respond to it, such as distraction or calming breathing techniques. Studies have found that therapy can be as effective as surgery for certain cases of chronic pain and many doctors recommend trying psychotherapy in advance of considering invasive surgery.

Stress, anxiety, depression, catastrophizing, ruminating, lack of activity, and social withdrawal all make chronic pain worse. Addressing these issues, research shows, can help people gain control over their pain symptoms. Therapeutic approaches such as cognitive behavioral therapy, biofeedback, and mindfulness-based stress reduction, along with greater pain-management education, have been found to help people reduce fear and disability.

Many cases of chronic pain, particularly those involving back pain, remain medically unexplained. But there is evidence that changes in the brain or nervous system are caused by previous physical ailments such as tissue damage; in such cases, the brain may continue to send out pain signals despite the physical cause having healed. To aid patients under these circumstances, a recently developed treatment known as pain reprocessing therapy (PRT) is designed to help the brain “unlearn” this response. A PRT practitioner helps individuals to reduce the “threat value” of their ongoing pain signals until they can reappraise them as less threatening and fear-inducing. They also help an individual to develop new emotional regulation skills.

There is no set timeline for recovery from chronic pain, especially as there may be a range of physical and psychological causes for any individual’s discomfort, but most patients should expect to see a therapist for a number of weeks or months, typically spanning at least 12 sessions. Studies of pain reprocessing therapy found that many individuals’ experience of pain lessened in eight sessions over four weeks.