Psych Twister: Using Metaphors, Mindfulness, and Values

Chronic pain is much more than a physical sensation. It can be all-encompassing and often impacts an individual in a multitude of ways, spawning discouraging, painful, or unwanted psychological experiences such as thoughts, feelings, and memories as well as functional limitations.

The natural approach might be to dedicate time and expend energy and resources (emotional, psychological, financial, etc) to controlling or avoiding these uncomfortable experiences. However, increasing evidence suggests that, not only are attempts to control the frequency and form of these types of private experiences often unsuccessful, doing so may result in an increase in their occurrence and an increased sensitivity to their impact, thus, paradoxically exacerbating one’s situation. Additionally, especially with chronic pain, avoidance of discomfort (physical and emotional) often results in isolation and inactivity, thus robbing an individual of participation in valued activities. Acceptance and commitment therapy (ACT), a 3rd wave spinoff of cognitive behavioral therapy, is now considered an evidence-based therapeutic treatment for chronic pain that is set apart from other, more commonsense solutions.

ACT poses a useful alternative to control-based treatments and operates on a set of 6 core processes within a unified model called psychological flexibility—“the capacity to be directly, consciously, and fully in contact with the present moment without needless defense and to persist or change one’s behaviors in the service of one’s goals.”