Psychosocial Treatment of Physical Disorders
In rat experiment, it was found out that if a rat is in extreme pain, the associated
stress may further enhance the pain. This finding seems to apply humans.
Pain medication before surgery = less pain after surgery & less pain medication
in patients but many people are reluctant to use pain-killing medication in
chronic diseases
Adequate pain-management procedures, either medical or psychological, are an
essential part of the management of chronic diseases.
Modern pain therapy - based on a biopsychosocial model of pain that involves a
multidimensional & interdisciplinary plan of pain management
A variety of psychological treatments have been developed for physical
disorders & pain:
biofeedback
relaxation procedures
hypnosis
Overriding role of stress in cause & maintenance of many physical disorders ->
comprehensive stress-management programs are increasingly incorporated into
medical centers where such disorders are treated
A. Biofeedback
Biofeedback - process of making patients aware of specific physiological
functions that, ordinarily, they would not notice consciously (such as heart rate,
blood pressure, muscle tension in specific areas of the body,
electroencephalogram rhythms (brain waves) & patterns of blood flow)
Through use of a variation of operant-conditioning procedures in an experiment,
rats were reinforced for the increases or decreases of their physiological
responses, thus, rats could learn to directly control many of these (stated above)
responses.
Clinicians applied the procedures with some success to humans who suffered
from various physical disorders or stress-related conditions using physiological
monitoring equipment to make the response, visible or audible to the patient &
to learn to control the response
It was discovered that humans could discriminate changes in autonomic nervous
system activity with a high degree of accuracy. The question then became this:
Why are people ordinarily so poor at discriminating their internal states?
Our abilities have always been highly developed in this regard but over the
millennia we have simply lost our skills through lack of practice.
But in an evolutionary sense, it might have been adaptive to turn our
attention from precise monitoring of our internal responses because to focus
successfully on the task at hand, we may have found it necessary to ignore
our internal functioning & leave it to the more automatic & less aware parts
of the brain.
Still, internal sensations often take control of our consciousness & make us
fully aware of our needs such as the need to urinate & the feeling of hunger.
In any case, it does seem that through precise physiological feedback we can
learn to control our responses, although the mechanisms by which we do so are
not yet clearly known.
One goal of biofeedback: reduce tension in the muscles of the head & scalp
(headaches)
Biofeedback was successful but no more successful than deep muscle
relaxation procedures
Some thought that biofeedback might achieve its effects with tension
headaches by simply teaching people to relax
The success of biofeedback may depend not on the reduction of tension but to
which the procedures instill a sense of control over the pain (at least for
headaches)
Whatever the mechanism, biofeedback & relaxation are more effective
treatments than, for example, placebo medication interventions
The results of these two treatments (stated above) are not altogether
interchangeable, in that some people benefit more from biofeedback & others
benefit from relaxation procedures, therefore, applying one treatment or the
other is a safe strategy that seem to be long lasting.
