Clinical: Chronic Pain: A Contemporary Psychoanalytic Treatment Model

Both physical pain and psychiatric disorders are widely prevalent, and collectively they account for the most frequently presenting complaints in the primary care setting. These conditions are a complex challenge for both the patient and provider, with frequent high use of medical services and increased morbidity. The Integrated Behavioral Pain Medicine (IBPM) treatment model incorporates a multidisciplinary, biopsychosocial, team-based approach for patients who have chronic and largely treatment-refractory pain. IBPM uses an integrated care team of providers and coordinators, who collectively work with the chronic pain patient to individualize a pain management plan, which may include pharmacologic management, cognitive-behavioral therapy, trauma-focused therapy, biofeedback, mindfulness, acupuncture, nutrition, behavioral weight and sleep management, and physical therapy. Ideally, primary care providers will refer patients to an IBPM model of care, but if the treatment model is not available in a specific area, a piecemeal approach with partial use of services is recommended.

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Psychoanalytic Treatment of Chronic Pain: The Body Speaks on Multiple Levels

Journal of the American Academy of Psychoanalysis ◽

10.1521/jaap.1.1996.24.2.257 ◽

1996 ◽

Vol 24 (2) ◽

pp. 257-271 ◽

Cited By ~ 4

Author(s):

Stuart D. Perlman

Keyword(s):

Chronic Pain ◽

The Body ◽

Psychoanalytic Treatment ◽

Multiple Levels

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Conceptualizing and Treating Comorbid Chronic Pain and PTSD

Pain Research and Treatment ◽

10.1155/2013/174728 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 36

Author(s):

Michelle A. Bosco ◽

Jessica L. Gallinati ◽

Michael E. Clark

Keyword(s):

Posttraumatic Stress Disorder ◽

Chronic Pain ◽

Stress Disorder ◽

Integrated Treatment ◽

Evidence Based ◽

Treatment Model ◽

Evidence Based Treatment ◽

Fundamental Factor ◽

Clinical Complexity ◽

The Relationship

The purpose of this paper is to review the rationale for concurrent, evidence-based treatment of chronic pain and posttraumatic stress disorder (PTSD). To meet this end, we review pertinent definitions and extant theories related to the two conditions and their correlations with each other. We then synthesize theoretical components into a proposal of a comprehensive conceptual framework for understanding the relationship and clinical complexity of overlapping chronic pain and PTSD. We conclude with an example of an integrated treatment model designed specifically to address a fundamental factor associated with pain and PTSD: avoidance.

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