Psychological Therapy for Centralized Pain: An Integrative Assessment and Treatment Model

Psychosomatic Medicine

Volumn 81, Issue 2, 2019, Pages 114-124

  Lumley, Mark A ^a   Schubiner, Howard ^b  

^a WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b MICHIGAN STATE UNIVERSITY   (United States)

Author keywords

ACT = acceptance and commitment therapy; CBT = cognitive behavioral therapy; centralized pain; chronic pain; clinical case; EAET = emotional awareness and expression therapy; emotional awareness and expression; FM = fibromyalgia; IBS = irritable bowel syndrome; ISTDP = intensive short term dynamic psychotherapy; MRI = magnetic resonance imaging; psychological treatment; psychotherapy

Indexed keywords

ACCEPTANCE AND COMMITMENT THERAPY; ADAPTIVE BEHAVIOR; ARTICLE; CHRONIC PAIN; COGNITIVE BEHAVIORAL THERAPY; CONFLICT; EMOTION; EXPOSURE THERAPY; HUMAN; INTERPERSONAL COMMUNICATION; MEDICAL HISTORY; MINDFULNESS; NEUROIMAGING; PATIENT EDUCATION; PERSONAL EXPERIENCE; PHYSICAL EXAMINATION; PRIORITY JOURNAL; PSYCHOTHERAPY; SOCIAL PSYCHOLOGY; WRITING; PROCEDURES;

CHRONIC PAIN; HUMANS; PSYCHOTHERAPY;

EID: 85060955991     PISSN: 00333174     EISSN: 15347796     Source Type: Journal    
DOI: 10.1097/PSY.0000000000000654     Document Type: Article

References (105)

1. Merskey H. Pain terms: A list with definitions and notes on usage. Recommended by the IASP subcommittee on taxonomy. Pain 1979; 6: 249-52.
2. APA. Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision). Washigton, DC: American Psychiatric Association Press; 2000.
3. Lumley MA, Cohen JL, Borszcz GS, Cano A, Radcliffe AM, Porter LS, Schubiner H, Keefe FJ. Pain and emotion: A biopsychosocial review of recent research. J Clin Psychol 2011; 67: 942-68.
4. APA. Diagnostic and Statistical Manual of Mental Disorders. 5th ed.Washington, DC: American Psychiatric Association Press; 2013.
5. Johannes CB, Le TK, Zhou X, Johnston JA, Dworkin RH. The prevalence of chronic pain in United States adults: Results of an internet-based survey. J Pain 2010; 11: 1230-9.
6. Council NR. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Tesearch.Washington, DC: The National Academies Press; 2011.
7. Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: A systematic review and data synthesis. Pain 2015; 156: 569-76.
8. Morales-Espinoza EM, Kostov B, Salami DC, Perez ZH, Rosalen AP,Molina JO, Gonzalez-de Paz L, Momblona JM, Àreu JB, Brito-Zerón P, Ramos-Casals M, Sisó-AlmirallA. CPSGPC Study Group. Complexity, comorbidity, and health care costs associated with chronic widespread pain in primary care. Pain 2016; 157: 818-26.
9. Deyo RA, Mirza SK, Turner JA, Martin BI. Overtreating chronic back pain: Time to back off? J Am Board Fam Med 2009; 22: 62-8.
10. HoffmanBM, Papas RK, Chatkoff DK, Kerns RD. Meta-analysis of psychological interventions for chronic low back pain. Health Psychol 2007; 26: 1-9.
11. Williams AC, Eccleston C, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev 2012; 11: CD007407.
12. Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. Am Psychol 2014; 69: 153-66.
13. McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress. Am Psychol 2014; 69: 178-87.
14. Hann KEJ, McCracken LM. A systematic review of randomized controlled trials of acceptance and commitment therapy for adults with chronic pain: Outcome domains, design quality, and efficacy. J Contextual Behav Sci 2014; 3: 217-27.
15. Cherkin DC, Sherman KJ, Balderson BH, Cook AJ, AndersonML, Hawkes RJ, Hansen KE, Turner JA. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: A randomized clinical trial. JAMA 2016; 315: 1240-9.
16. Veehof MM, Trompetter HR, Bohlmeijer ET, Schreurs KM. Acceptance- And mindfulness-based interventions for the treatment of chronic pain: A meta-analytic review. Cogn Behav Ther 2016; 45: 5-31.
17. Lauche R, Cramer H, Dobos G, Langhorst J, Schmidt S. A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. J Psychosom Res 2013; 75: 500-10.
18. Morley S,Williams A, Eccleston C. Examining the evidence about psychological treatments for chronic pain: Time for a paradigm shift? Pain 2013; 154: 1929-31.
19. Clauw DJ. Diagnosing and treating chronic musculoskeletal pain based on the underlying mechanism(s). Best Pract Res Clin Rheumatol 2015; 29: 6-19.
20. Kosek E, CohenM, Baron R, Gebhart GF, Mico J-A, Rice ASC, RiefW, Sluka AK. Do we need a third mechanistic descriptor for chronic pain states? Pain 2016; 157: 1382-6.
21. YunusMB. Central sensitivity syndromes: A new paradigmand group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum 2008; 37: 339-52.
22. Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K,Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol 2015; 36: 811-6.
23. Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992; 268: 760-5.
24. Kroenke K. Patients presenting with somatic complaints: Epidemiology, psychiatric comorbidity and management. Int J Methods Psychiatr Res 2003; 12: 34-43.
25. Lane RD, Waldstein SR, Critchley HD, Derbyshire SWG, Drossman DA, Wager TD, Schneiderman N, Chesney MA, Jennings JR, Lovallo WR, Rose RM, Thayer JF, Cameron OG. The rebirth of neuroscience in psychosomatic medicine, part II: Clinical applications and implications for research. Psychosom Med 2009; 71: 135-51.
26. Hashmi JA, Baliki MN, Huang L, Baria AT, Torbey S, Hermann KM, Schnitzer TJ, Apkarian AV. Shape shifting pain: Chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain 2013; 136: 2751-68.
27. Blasini M, Corsi N, Klinger R, Colloca L. Nocebo and pain: An overview of the psychoneurobiological mechanisms. Pain Rep 2017; 2: E585.
28. Coleshill MJ, George DN, Mazzoni G. Placebo analgesia from a rubber hand. J Pain 2017; 18: 1067-77.
29. Zaki J,Wager TD, Singer T, Keysers C, Gazzola V. The Anatomy of suffering: Understanding the relationship between nociceptive and empathic pain. Trends Cogn Sci 2016; 20: 249-59.
30. Derbyshire SWG, Whalley MG, Stenger VA, Oakley DA. Cerebral activation during hypnotically induced and imagined pain. Neuroimage 2004; 23: 392-401.
31. Van den Bergh O,Witthöft M, Petersen S, Brown RJ. Symptoms and the body: Taking the inferential leap. Neurosci Biobehav Rev 2017; 74: 185-203.
32. Barrett LF, SimmonsWK. Interoceptive predictions in the brain.Nat RevNeurosci 2015; 16: 419-29.
33. Prescott SA, Ma Q, De Koninck Y. Normal and abnormal coding of somatosensory stimuli causing pain. Nat Neurosci 2014; 17: 183-91.
34. Tabor A, Keogh E, Eccleston C. Embodied pain-negotiating the boundaries of possible action. Pain 2017; 158: 1007-11.
35. Gracely RH, Schweinhardt P. Programmed symptoms: Disparate effects united by purpose. Curr Rheumatol Rev 2015; 11: 116-30.
36. VarinenA,KosunenE,MattilaK, KoskelaT,SumanenM. The relationship between childhood adversities and fibromyalgia in the general population. J Psychosom Res 2017; 99: 137-42.
37. Generaal E, Vogelzangs N,Macfarlane GJ, Geenen R, Smit JH, de Geus EJCN, Penninx BWJH, Dekker J. Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain: A 6-year cohort study. Ann Rheum Dis 2016; 75: 847-54.
38. Nicol AL, Sieberg CB, Clauw DJ, Hassett AL, Moser SE, Brummett CM. The association between a history of lifetime traumatic events and pain severity, physical function, and affective distress in patients with chronic pain. J Pain 2016; 17: 1334-48.
39. You DS,MeagherMW. Childhood adversity and pain sensitization. Psychosom Med 2016; 78: 1084-93.
40. Van Houdenhove B, Luyten P, Tiber Egle U. Stress as a key concept in chronic widespread pain and fatigue disorders. J Musculoskel Pain 2009; 17: 390-9.
41. Landa A, Peterson BS, Fallon BA. Somatoform pain: A developmental theory and translational research review. Psychosom Med 2012; 74: 717-27.
42. Sachs-EricssonNJ, Sheffler JL, Stanley IH, Piazza JR, Preacher KJ.When emotional pain becomes physical: Adverse childhood experiences, pain, and the role of mood and anxiety disorders. J Clin Psychol 2017; 73: 1403-28.
43. Luyten P, Van Houdenhove B, Lemma A, TargetM, Fonagy P. Vulnerability for functional somatic disorders: A contemporary psychodynamic approach. J Psychother Integr 2013; 23: 250-62.
44. Kross E, Berman MG, Mischel W, Smith EE,Wager TD. Social rejection shares somatosensory representations with physical pain. ProcNatlAcad Sci 2011; 108: 6270-5.
45. Eisenberger NI, Lieberman MD. Why rejection hurts: A common neural alarm system for physical and social pain. Trends Cogn Sci 2004; 8: 294-300.
46. Lane RD, Waldstein SR, Chesney MA, Jennings JR, Lovallo WR, Kozel PJ, Rose RM, Drossman DA, Schneiderman N, Thayer JF, Cameron OG. The rebirth of neuroscience in psychosomatic medicine, Part I: Historical context, methods, and relevant basic science. Psychosom Med 2009; 71: 117-34.
47. Yunus MB. Fibromyalgia and overlapping disorders: The unifying concept of central sensitivity syndromes. Semin Arthritis Rheum 2007; 36: 339-56.
48. Lane RD, Ryan L, Nadel L, Greenberg L. Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science. Behav Brain Sci 2015; 38: E1.
49. Abbass A, Kisely S, Kroenke K. Short-term psychodynamic psychotherapy for somatic disorders. Psychother Psychosom 2009; 78: 265-74.
50. Foa EB, Kozak MJ. Emotional processing of fear: Exposure to corrective information. Psychol Bull 1986; 99: 20-35.
51. Sarno JE. The Mindbody Prescription: Healing the Body, Healing the Pain. New York, NY: Hachette Book Group USA; 1998.
52. Schubiner H, Betzold M. Unlearn Your Pain: A 28-day Process to Reprogram Your Brain. 3rd ed. Pleasant Ridge, MI: Mind-Body Pubishing; 2016.
53. Schechter D. Think Away Your Pain: Your Brain Is the Solutoin to Your Pain. Culver City, CA: Mindbody Medicine Publications; 2014.
54. Selfridge N, Peterson F. Freedom From Fibromyalgia: The 5 Week Program Proven to Conquer Pain. New York, NY: Three Rivers Press; 2001.
55. Hanscom D. Back in Control: A Surgeon's Roadmap Out of Chronic Pain. 2nd ed. Seattle, WA: Vertus Press; 2017.
56. Shires A, Cayoun B, Simmons A. Immediate and lasting chronic pain reduction following a brief self-implemented mindfulness-based interoceptive exposure task: A pilot study. Mind in press.
57. Yoshino A, Okamoto Y, Okada G, Takamura M, Ichikawa N, Shibasaki C, Yokoyama S, DoiM, Jinnin R, Yamashita H, HorikoshiM, Yamawaki S. Changes in resting-state brain networks after cognitive-behavioral therapy for chronic pain. Psychol Med 2018; 48: 1148-56.
58. Sarno JE. Mind Over Back Pain: The Mind-Body Connection. New York, NY: Warner Books; 1991.
59. Sarno JE. Mind Over Back Pain. A Radically New Approach to the Diagnosis and Treatment of Back Pain. New York: Harper Collins Publishers; 1982.
60. Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil 2011; 92: 2041-56.
61. Moseley GL, Butler DS. Fifteen years of explaining pain: The past, present, and future. J Pain 2015; 16: 807-13.
62. Burger AJ, Lumley MA, Carty JN, Latsch DV, Thakur ER, Hyde-Nolan ME, Hijazi AM, Schubiner H. The effects of a novel psychological attribution and emotional awareness and expression therapy for chronic musculoskeletal pain: A preliminary, uncontrolled trial. J Psychosom Res 2016; 81: 1-8.
63. Hsu MC, Schubiner H, Lumley MA, Stracks JS, Clauw DJ,Williams DA. Sustained pain reduction through affective self-awareness in fibromyalgia: A randomized controlled trial. J Gen Intern Med 2010; 25: 1064-70.
64. Vlaeyen JW, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain 2012; 153: 1144-7.
65. Vlaeyen J, Morley S, Linton SJ, Boersma K, de Jong J. Pain-Related Fear: Exposure Based Treatment for Chronic Pain. Seattle, WA: IASP Press; 2012.
66. Linton SJ, Fruzzetti AE. A hybrid emotion-focused exposure treatment for chronic pain: A feasibility study. Scand J Pain 2014; 5: 151-8.
67. Linton SJ, Flink IK, Schrooten MGS, Wiksell R. Understanding co-occurring emotion and pain: The role of context sensitivity from a transdiagnostic perspective. J Contemp Psychother 2016; 46: 1-9.
68. Lumley MA, Keefe FJ, Mosley-Williams A, Rice JR, McKee D, Waters SJ, Partridge RT, Carty JN, Coltri AM, Kalaj A, Cohen JL, Neely LC, Pahssen JK, Connelly MA, Bouaziz YB, Riordan PA. The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: A randomized clinical trial. J Consult Clin Psychol 2014; 28: 644-58.
69. LumleyMA, Leisen JC, Partridge RT,Meyer TM, Radcliffe AM,Macklem DJ, Naoum LA, Cohen JL, Lasichak LM, Lubetsky MR, Mosley-Williams AD, Granda JL. Does emotional disclosure about stress improve health in rheumatoid arthritis? Randomized, controlled trials of written and spoken disclosure. Pain 2011; 152: 866-77.
70. Keefe FJ, Anderson T, LumleyM, Caldwell D, Stainbrook D,Mckee D,Waters SJ, Connelly M, Affleck G, Pope MS,Weiss M, Riordan PA, Uhlin BD. A randomized, controlled trial of emotional disclosure in rheumatoid arthritis: Can clinician assistance enhance the effects? Pain 2008; 137: 164-72.
71. Kelley JE, Lumley MA, Leisen JCC. Health effects of emotional disclosure in rheumatoid arthritis patients. Health Psychol 1997; 16: 331-40.
72. Smyth JM, Stone AA, Hurewitz A, Kaell A. Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: A randomized trial. JAMA 1999; 281: 1304-9.
73. Broderick JE, Stone AA, Smyth JM, Kaell AT. The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions. Ann Behav Med 2004; 27: 50-9.
74. GillisME, Lumley MA,Mosley-Williams A, Leisen JCC, Roehrs T. The health effects of at-home written emotional disclosure in fibromyalgia: A randomized trial. Ann Behav Med 2006; 32: 135-46.
75. Broderick JE, Junghaenel DU, Schwartz JE. Written emotional expression produces health benefits in fibromyalgia patients. Psychosom Med 2005; 67: 326-34.
76. Norman SA, Lumley MA, Dooley JA, Diamond MP. For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain. Psychosom Med 2004; 66: 174-83.
77. Graham JE, Lobel M, Glass P, Lokshina I. Effects of written anger expression in chronic pain patients: Making meaning from pain. J BehavMed 2008; 31: 201-12.
78. Pepe L, Milani R, Di Trani M, Di Folco G, Lanna V, Solano L. A more global approach to musculoskeletal pain: Expressive writing as an effective adjunct to physiotherapy. Psychol Health Med 2014; 19: 687-97.
79. LumleyMA, Sklar ER, Carty JN. Emotional disclosure interventions for chronic pain: From the laboratory to the clinic. Transl Behav Med 2012; 2: 73-81.
80. Gerhardt A, Leisner S, Hartmann M, Janke S, SeidlerGH, EichW, Tesarz J. Eye movement desensitization and reprocessing vs. treatment-as-usual for non-specific chronic back pain patients with psychological trauma: A randomized controlled pilot study. Front Psychiatry 2016; 7: 201.
81. Tesarz J, Leisner S, Gerhardt A, Janke S, Seidler GH, EichW, HartmannM. Effects of eye movement desensitization and reprocessing (EMDR) treatment in chronic pain patients: A systematic review. Pain Med 2014; 15: 247-63.
82. LumleyMA, Cohen JL, Stout RL, Neely LC, Sander LM, Burger AJ. An emotional exposure-based treatment of traumatic stress for people with chronic pain: Preliminary results for fibromyalgia syndrome. Psychotherapy (Chic) 2008; 45: 165-72.
83. Abbass A. Reaching Through Resistance: Advancing Psychotherapy Techniques. Kansas City, MO: Seven Leaves Press; 2015.
84. Chavooshi B, Saberi M, Tavallaie SA, Sahraei H. Psychotherapy for medically unexplained pain: A randomized clinical trial comparing intensive short-term dynamic psychotherapy and cognitive-behavior therapy. Psychosomatics 2017; 58: 506-18.
85. Chavooshi B, Mohammadkhani P, Dolatshahee B. Efficacy of intensive shortterm dynamic psychotherapy for medically unexplained pain: A pilot threearmed randomized controlled trial comparison with mindfulness-based stress reduction. Psychother Psychosom 2016; 85: 123-5.
86. Baldoni F, Baldaro B, Trombini G. Psychotherapeutic perspectives in urethral syndrome. Stress Med 1995; 11: 79-84.
87. Abbass A, Lovas D, Purdy A. Direct diagnosis and management of emotional factors in chronic headache patients. Cephalalgia 2008; 28: 1305-14.
88. AbbassA. Somatization: Diagnosing it sooner through emotion-focused interviewing. J Fam Pract 2005; 54: 231-9, 243.
89. Pascual-Leone A, Greenberg LS. Emotional processing in experiential therapy: Why "the only way out is through". J Consult Clin Psychol 2007; 75: 875-87.
90. Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behav Ther 2004; 35: 205-30.
91. Hackmann A. Imagery rescripting in posttraumatic stress disorder. Cog Behav Pract 2011; 18: 424-32.
92. Lumley MA, Schubiner H, Lockhart NA, Kidwell KM, Harte SE, Clauw DJ, Williams DA. Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: A cluster-randomized controlled trial. Pain 2017; 158: 2354-63.
93. Thakur ER, Holmes HJ, Lockhart NA, Carty JN, Ziadni MS, Doherty HK, Lackner JM, Schubiner H, Lumley MA. Emotional awareness and expression training improves irritable bowel syndrome: A randomized controlled trial. Neurogastroenterol Motil 2017; 12: E13143.
94. Slavin-Spenny O, LumleyMA, Thakur ER, Nevedal DC, HijaziAM. Effects of anger awareness and expression training versus relaxation training on headaches: A randomized trial. Ann Behav Med 2013; 46: 181-92.
95. Ziadni MS, Carty JN, Doherty HK, Porcerelli JH, Rapport LJ, Schubiner H, Lumley MA. A life-stress, emotional awareness and expression interview for primary care patients withmedically unexplained symptoms: A randomized controlled trial. Health Psychol 2018; 37: 282-90.
96. Carty JN, Ziadni MS, Holmes HJ, Tomakowsky J, Peters K, Schubiner H, Lumley MA. The effects of a life stress emotional awareness and expression interview for women with chronic urogenital pain: A randomized controlled trial. Pain Med 2018; in press.
97. Abbass A, Schubiner H. Hidden From View. Pleasant Ridge, MI: Psychophysiologic Press; 2018.
98. Nijs J, Torres-Cueco R, vanWilgen P, Lluch Girbés E, Struyf F, Roussel N, Van Oosterwijck J, Daenen L, Kuppens K, Vanderweeen L, Hemans L, Beckwee D, Voogt L,Clark J,MononeyN,Meeus M.Applying modern pain neuroscience in clinical practice: Criteria for the classification of central sensitization pain. Pain Physician 2014; 17: 447-57.
99. Williams DA. Phenotypic features of central sensitization. J Appl Biobehav Res 2018; 23: E12135.
100. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RS, Mease P, Russell AS, Russell IJ,Winfield JB. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: A modification of the ACR preliminary diagnostic criteria for fibromyalgia. J Rheumatol 2011; 38: 1113-22.
101. Clauw DJ. Fibromyalgia: A clinical review. JAMA 2014; 311: 1547-55.
102. Mayer TG, Neblett R, Cohen H, Howard KJ, Choi YH, Williams MJ, Perez Y, Gatchel RJ. The development and psychometric validation of the central sensitization inventory. Pain Pract 2012; 12: 276-85.
103. Falk EB, O'Donnell MB, Cascio CN, Tinney F, Kang Y, LiebermanMD, Taylor SE, An L, Resnicow K, Strecher VJ. Self-affirmation alters the brain's response to health messages and subsequent behavior change. Proc Natl Acad Sci U S A 2015; 112: 1977-82.
104. Clarke DD. They Can't Find Anything Wrong! 7 Keys to Understanding, Treating, and Healing Stress Illness. Boulder, CO: Sentient Publications; 2007.
105. Oldfield G. Chronic Pain: Your Key to Recovery. Bloomington, IN: AuthorHouse UK Ltd.; 2014.