Sunday, 24 December 2017

Acceptance And Commitment Therapy For Nerve Damage Pain

Today's post from (see link below) may cause the more cynical reader to raise an eyebrow or two before bursting into laughter at the very thought of yet another cognitive behavioural therapy for neuropathy pain. Should we be so cynical, as the burning and tingling starts with the dawn and never stops and the only thing that helps are strong analgesics? Probably not - if there's one thing neuropathy patients have learned, it's to keep an open mind. We all know that what works for one doesn't necessarily work for another, so why shouldn't ACT (Acceptance And Commitment Therapy) be a viable option? The problem is, it sounds so 'new age' and that has become a dirty word among chronic pain patients who are reluctant to spend their income on a therapy that few insurance companies will cover. That open mind eh!! Read on and see what you think.

A Therapy That May Help With Neuropathy Pain Management
By Jacqueline Marshall, Aug 9, 2017 

People usually see a psychotherapist to relieve mental distress, but one type of psychotherapy may help with physical pain as well, such as the pain caused by peripheral neuropathy.

Many individuals with diabetes develop peripheral neuropathy (PN), a chronic condition that causes prickling, tingling, or numbness typically in the feet, hands, arms, and legs.

Those with PN can also experience throbbing, freezing, sharp, or burning pain in their extremities, be highly sensitive to touch, and have problems with coordination and balance.

Looking For Relief

The antidepressant and anti-seizure medications usually prescribed for PN (e.g., Neurontin, Lyrica, Cymbalta) provide relief, but the drugs' side effects can be disturbing, especially when higher dosages are needed. Common side effects include, drowsiness, weight gain, nausea, fatigue, and confusion, plus other effects specific to each drug.

Some people find PN symptom relief, or help with pain management using complementary treatments such as creams containing capsaicin, doing water aerobics, acupuncture, using magnetic compression wraps, getting plenty of vitamin B12, and magnesium.

Individuals with PN have also benefitted by engaging in a type of counseling called Acceptance and Commitment Therapy.

ACT and Chronic Pain

Acceptance and Commitment Therapy (ACT) is an offshoot of cognitive behavioral therapy, a treatment method that helps people realize the consequences of how they think about things. It promotes adaptability, and facilitates effective behavior change.

The central premise of ACT is to be present with whatever life brings, and to choose behaviors in line with one’s values. It emphasizes acceptance of what is, mindfulness techniques, personal commitment, and behavior modification strategies.

New research out of King’s College London (KCL) shows that the psychological flexibility focus of ACT helps people with chronic pain by emphasizing: 

Awareness of, and engagement with thoughts and feelings.
Appreciating what every situation affords.
Living up to one’s most cherished goals and values.

“…psychological flexibility is the ability to be more aware, more focused on goals, and more engaged," says researcher Lance M. McCracken, a KCL professor. “Another aspect of psychological flexibility pertinent to chronic called committed action, which involves goal-directed, flexible persistence.”

Accepting and Observing

In the KCL study, two components of ACT - pain acceptance, and self-observation - were of particular value to chronic pain sufferers: 

Accepting pain means embracing our situation as it is, since we cannot change what's already occurred. A state of acceptance diminishes the tension, frustration, sadness, or anger that resistance to "what is" generates. 

By objectively observing our thoughts and feelings, as if we are a disinterested bystander watching them, we soon realize that we’re not defined, nor harmed by our thoughts and feelings. This perspective is calming, and actually gives people a greater sense of control over their lives.

The researchers found acceptance and self-observation were associated with less pain-related anxiety, and less physical, psychological, and social distress.

Finding ACT Counselors

For some individuals, ACT could be a helpful adjunct to current PN treatments. While medications and complementary care more directly address the physical pain of PN, ACT helps by teaching people to manage their thoughts about, and reactions to the symptoms.

If interested, and an Internet search doesn’t turn up an ACT therapist in your locale, try contacting the psychology, social work, or psychiatry department of the nearest college or university; someone on the staff may provide a referral. Also, any cognitive behavioral therapist may know of a colleague who specializes in ACT.

Sources: Medical News Today, Med Shadow, Science Daily

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