A Couple-Based Psychological Treatment for Chronic Pain and Relationship Distress

Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, “Mindful Living and Relating,” aimed at alleviating pain and suffering by promoting couples’ psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are each in need of developing greater psychological and relational flexibility to improve their own and their partners’ health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one’s partner, fully attending to the present moment, and responding empathically in a way that serves one’s own and one’s partner’s values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.     

Anxiety sensitivity moderates the painful effects of feeling burdensome to others

Perceived burdensomeness (PB), the perception of being a burden to others, is associated with pain and physical symptoms. Anxiety sensitivity (AS), the fear of arousal-related sensations, arising from beliefs that the sensations may have adverse personal consequences (physical, cognitive, and social), may increase risk for pain responding, particularly in anxiety-provoking (e.g. socially threatening) contexts. Accordingly, individuals high in AS may have a stronger pain response when experiencing PB than those low in AS. Undergraduate participants (n = 262) completed the Anxiety Sensitivity Index (ASI-3), and then were randomly assigned to re-live an experience when they were either burdensome to others (burdensome condition) or contributed equally to a group (control condition). Both social and physical self-reported pain were assessed post-manipulation. Those high in AS reported significantly higher pain ratings in the burdensome condition than the control condition; for those low in AS, pain did not change across conditions. In particular, being fearful of the physical repercussions of anxiety (AS physical concerns) while also feeling burdensome to others was associated with greater physical pain. AS may exacerbate the already painful effects of feeling burdensome to others, and may have important implications for the development of future suicide- and pain-related interventions.     

Loving-kindness language exposure leads to changes in sensitivity to imagined pain

To better understand the cultivation of positive intra- and interpersonal emotions, we examined an argument that some effects of contemplative training result from language processing. We presented participants with loving-kindness language used in kindness-meditation training studies and asked them to rate imagined pain. If loving-kindness language processing is responsible for some effects recently reported we expected this language could affect intra- and interpersonal sensitivity. Loving-kindness-language participants rated imagined other-pain significantly higher and imagined self-pain significantly lower than closely matched control participants. As a result of this interaction, the loving-kindness-language group showed no significant difference between self-pain and other-pain, whereas controls rated self-pain significantly higher than other-pain. These results suggest that exposure to loving-kindness-language in Loving-Kindness Meditation leads to changes in sensitivity to own and vicarious distress without explicit training. These findings underscore that meditation-like effects may be easily induced. Further research is needed to determine duration and degree of effect.     

Chronic Pain and Neuropsychological Functioning

This review article examines the effect of chronic pain on neuropsychological functioning. Primary attention is given to studies that include patient groups without a history of traumatic brain injury (TBI) or neurologic disorders. Numerous studies were identified that demonstrate neuropsychological impairment in patients with chronic pain, particularly on measures assessing attentional capacity, processing speed, and psychomotor speed. Despite suggestive findings, further studies are needed to clarify the variables that mediate the impact of pain on neuropsychological functioning and the unique role of various symptoms often associated with chronic pain.     

Shadowed reality or the 'Prometheus-complex': analytical psychotherapy after political imprisonment and persecution

Traumatic experiences of violence like those that were brought about by the communist regime of the former German Democratic Republic (GDR) are still present as if they happened yesterday, causing severe disadvantages in everyday life even after all those years. Consequently, in cases of extreme traumatization induced by political imprisonment, persecution and applied psychological methods of disintegration, regressive processes take place which corrode the ego. The breakdown of cathexis, i.e., the failure of empathic connection at the time of the trauma, is the strongest characteristic of severe traumatization. As a result of this destruction for the traumatized there is an inability to keep upright an inner empathic, emotional connection. As we try to grasp, from a Jungian point of view, the psychodynamics of severe traumatization, we can speak of a powerful pathogenous complex, which I call the 'Prometheus-complex'. Gustav Bovensiepen speaks of this complex as a sub-network, a limited fragment of the matrix of all internalized experiences, consisting of internal working models, feelings and patterns of anticipation which interact mutually. The human being, captured in such isolation and paralysis of the mind, can find himself 'in the therapist' on a mental level.     

Reviews

Books Reviewed: Is God a Virus? Genes, Culture and Religion byJohn Bowker Religion and Science: Historical and Contemporary Issues byIan Barbour The Origins of Virtue by Matt Ridley Nature's Grace: Essays on H. N. Wieman's Finite Theism by Marvin C. Shaw The Divine Constitution by Jeh-Tween Gong     

A passion of the soul: an introduction to pain for consciousness researchers

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self.     

The Face of Truth

I attempt to explain Plato's choice of dialogue through an analysis of what he regarded as the conditions of knowledge acquisition. I see the main contribution of the paper in exposing the way in which time and pain are, for Plato, conditions of knowledge acquisition. Plato endorsed the "learning through suffering," or pathei mathos , convention, central to Greek drama, and did so not through theory but through the praxis some of the dialogues employ. This addition of experiential components to the more cognitively oriented definitions of knowledge that Socrates uses complicates what these works may say about human knowledge. I analyze these tensions and the bearing they may have on the question of Plato's choice of dialogue, that is, on his rhetoric in practice. The requirements for actual persuasion, as Plato specifies them in the Seventh Letter, , are only partially met by the fictional scenes of argumentation and knowledge conveying that Plato presents. However, such scenes permit transcending some of the limitations of written, systematic, nonpersonal discourse. The presentation of such interactions to a real reader through dialogue turns into a mode of writing that is closer to meeting the demands of actual communication of knowledge – at least knowledge regarding what Plato envisaged as being the highest sort of epistemic communication