Psychosocial models of chronic pain argue for a causal role for pain beliefs in the development and maintenance of chronic pain. A great deal of evidence supports an association between pain beliefs – in particular beliefs regarding (a) the meaning of pain with respect to bodily damage, (b) the extent to which one is disabled by pain, (c) one's sense of control over pain, and (d) catastrophizing beliefs – and important pain treatment outcomes. Thus, both theory and research support the possibility that pain-related beliefs may be viable treatment targets in individuals with chronic pain. A preliminary study comparing the effects of a cognitive restructuring intervention (targeting only pain-related beliefs, and not behavior or coping), relative to an education control condition, supports the causal impact of beliefs on pain intensity. A follow-up study comparing the effects of (a) a cognitive restructuring intervention targeting pain beliefs, (b) a self-hypnosis training condition targeting pain intensity, and (c) a hypnotic cognitive therapy intervention targeting pain beliefs, relative to an education control condition, provide additional support for the specific effects of cognitive restructuring on pain intensity. As a group, this research supports the viability of pain beliefs as treatment targets, cognitive restructuring as an effective strategy for impacting pain by altering pain beliefs, and the potential of using hypnosis to enhance the efficacy of cognitive therapy.
Disclosure of Interest None declared