The Role of Psychological Therapy in Medical Conditions and Chronic Pain
A committed father broke down in tears in therapy recently, after he learnt that there was little doctors could do about his serious back injury. His tears were from fear that he may never be able to do the things he envisioned himself doing with his son – riding bikes or climbing trees just as his own father had done with him.
Like him, every day, thousands of people around the world get a physical health diagnosis that severely impacts both their quality of life and mental health.
what are the psychological impacts of a serious health condition?
- Will I/they be able to work?
- Will I/they be able to walk?
- Will I/they be able to look after the kids the way we use to?
Individuals living with chronic illness or ongoing health problems often experience feelings of loss, frustration, helplessness, uncertainty, and a loss of independence.Poor health can lead to a variety of psychological struggles, including increased risk of depression, anxiety, and emotional distress.These psychological challenges are frequently compounded by changes in self-identity, and concerns about the future.
Another common outcome is loneliness – for example, when cancer treatment makes it necessary to be isolated, or painful knees make it difficult to visit your adult son in his walk-up apartment.
Research indicates also that the stress of managing symptoms, adhering to treatment regimens, and coping with uncertainty can impact mental well-being and overall quality of life.
how can a psychologist or counsellor help you cope with a health condition?
Psychological therapy can be invaluable to support both the individual facing these challenges, and their family members. The purpose of therapy for people with physical condition is to have a safe space to discuss the extent of their physical and emotional pain, as well as the fears that they often hide from their families. The overall goal with patients with serious health conditions is to improve or maintain quality of life in the face of disease. Psychological therapy can also be beneficial for loved ones or caregivers who feel the stress and strain of caring for their loved ones.
One client, Ahmed, 38 suffered a serious injury at work that left him hobbling on a prosthesis, and living with the pain of a broken shoulder and one glass eye. While he stayed impressively cheerful and upbeat at home with his parents, wife and kids, he came to therapy regularly to discuss his many private struggles. Topics he discussed included the extent of his physical pain, and the emotional pain of not being able to keep up with his fast-growing teens as they explored a new city on holiday. At other times he discussed his feelings of being dependent financially on his successful wife, and not being able to contribute to the family finances. Said Ahmed, “Therapy allowed me to feel my emotions, and strengthened me to so I could be cheerful and present with my family.”
what can psychological support do for those with chronic pain?
Chronic pain arises when an injury heals, but the pain continues. It is often a mysterious condition to many. Clients complain about unresolving back injuries and concussions, or mysterious headaches or stomach troubles for which there appears to be no medical cause.
In patients with chronic pain, their brain’s sensitivity to pain amplifies over time, and occasional pain can slowly become constant or debilitating.
Their injuries appear healed, but the pain continues and they get little relief from visiting doctor after doctor. In fact. doctor visit often leave these patients feeling more invalidated and worthless when they are told that “The pain is all in your head”.
While the pain appears to be coming from nowhere, we understand from neuroscience that physical pain often comes from emotional pain.
Psychological therapy can help individuals understand the intrinsic relationship between pain and misunderstood or ignored emotions. This reduces feelings of helplessness, and address conditions like depression or health anxiety disorder singapore that commonly co-occur with chronic pain.
While psychological therapy for buried emotions may take some time to bear fruit, techniques from pain management therapy are extremely useful to help clients manage their chronic pain symptoms more immediately. Pain management strategies include the use of biofeedback, and understanding the gate theory of pain
how can therapy help if the cause of my medical condition is unclear?
Often when the cause of pain is unclear, it is important to address underlying anxiety or mood symptoms that can be causing the condition. For example, clients often come to therapy after exploring many avenues to treat their irritable bowel syndrome. In my office, it often becomes clear that the stomach troubles are triggered not by specific foods, but unacknowledged feelings, unfaced anxiety and unfamiliar emotions.
Emotional awareness and processing becomes a key part then of managing what otherwise looks like a physical condition. Other conditions that often have a psychological cause are chronic pain, unresolving concussions and headaches.
Even if a condition is not emotionally caused, psychological therapy is helpful because emotional pain tends to aggravate physical conditions, and the stress and anxiety associated with the diagnosis (e.g. worry, sadness) can make symptoms worse.
can psychological therapy reduce physical symptoms?
While psychological therapy does not cure underlying medical conditions, research shows that it can help reduce the severity and frequency of physical symptoms by improving emotion regulation, pain management stress management and even sleep quality. For example, For some individuals, learning new ways to cope with pain can lead to improved daily functioning and a greater sense of control over their health.
how can a psychologist help my seriously ill child?
A psychologist can support parents and children who are struggling with a serious health conditions. Children are often confused by their own illnesses, wondering why they are stuck in hospital or have to endure repeated visits to the clinic.
Parents despair when they find themselves having to force their tantruming children to sit through painful treatments. It is hard to explain to your screaming child the necessity of having a cannula inserted very painfully into their arm, or why the previously nice doctor is now forcing a scope through their throat.
In these situations, therapy becomes invaluable in providing age-appropriate understanding. Play-based interventions are targeted at helping them express emotions, build coping skills, and adjust to medical treatments or hospitalisation.
Therapy is also useful to parents struggling to accept or come to terms with their child’s difficulties, or even their impending loss. Please get in touch if your child is struggling with a serious medical condition.
what is illness anxiety disorder?
Illness Anxiety Disorder (IAD), previously known as hypochondriasis, is a condition characterised by excessive worry about having or acquiring a serious illness. As a psychologist with two decades of clinical experience, I have encountered numerous individuals whose lives have been significantly impacted by this disorder. The distress caused by IAD often persists despite medical reassurance, and it can interfere with daily functioning, relationships, and overall wellbeing.
Patients with illness anxiety disorder treatment typically misinterpret normal bodily sensations as signs of severe illness. For example, a mild headache may be perceived as a symptom of a brain tumour, or a fleeting chest pain as an impending heart attack. These fears are not alleviated even after thorough medical evaluation and negative test results. The anxiety can lead to frequent doctor visits, excessive online research about diseases (sometimes referred to as “cyberchondria”), and avoidance of situations perceived as health risks.
In my practice, I have seen cases such as a middle-aged man who repeatedly sought cardiac assessments for benign palpitations, convinced that he had a hidden heart condition. Another client, a young woman, became preoccupied with the idea of developing counselling for cancer after reading about it online, leading her to avoid certain foods and environments despite lack of evidence.
Empirical research underscores the complexity of IAD. A meta-analysis published in the journal Psychosomatic Medicine found that individuals with IAD show heightened attention to body sensations and often misinterpret ambiguous symptoms as dangerous.
Recent research also highlights the role of the internet in exacerbating health anxiety. A systematic review in Journal of Medical Internet Research demonstrated that excessive health-related searching can intensify anxiety and reinforce maladaptive beliefs. This is especially relevant in today’s digital age, where information—accurate or otherwise—is readily accessible.
In summary, IAD is a persistent and distressing disorder, but with appropriate psychological support. individuals can learn to manage their anxiety and lead fulfilling lives.
can therapy help families cope when a loved one is sick?
Absolutely. Psychological therapy can support the entire family by addressing communication challenges, emotional distress, and caregiving stress. Family therapy helps relatives understand how to support each other, maintain hope, and navigate the complexities of living with chronic health conditions.
Finding the right psychologist involves considering their experience in working with medical conditions and pain management. Dr Amrit has expertise in both paediatric psychology, and health psychology and has worked successfully with many individuals and families over the years.
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