If you are like me, you have had at least one infuriating encounter with a doctor who suggested your pain is more or less a figment of your imagination. And perhaps an equally frustrating encounter with a doctor (or a string of them) who claimed to have the cure. To be fair, it must be difficult for a doctor who has never experienced constant pain to sound compassionate rather than condescending while suggesting that if I do X I will be better, and it must be difficult for many doctors to admit that pain is something they don't know what to do with. If I had an insurance copay for every time I've heard a flummoxed doctor say, Have you tried ice? Or physical therapy? Or Advil? Or Effexor?...well, let's just say I'd be having a massage right now. I wish it had taken me less time to understand the complexity of chronic pain, and to come to appreciate the doctors who acknowledge my pain is real without claiming they can fix it.
It turns out that while pain is not exactly a mental problem, it is not entirely mechanical, either. Distress about pain can augment suffering, just as much as frustrating encounters with doctors can. A recent study (summarized here) suggests that treatments designed to minimize psychological distress can also relieve physical suffering. The research targeted people with chronic low-back pain, and focused on treatments such as cognitive behavioral therapy and biofeedback. Though the study did not compare the effects of psychological treatments with those of more conventional approaches, it did show that subjects found some relief from physical pain by controlling their mind's response to it. The study contributes to a growing body of evidence on the complex relationship between the mind and pain . In my view, as long as we don't use such research to suggest that pain is any less real, the advantage of psychological treatments is that they treat patients by empowering them to understand and treat themselves.