Chronic pain affects not just how you feel physically, but your emotional health, as well. Effective pain management addresses the physical symptoms, but must also help those who live with chronic pain cope emotionally on a day-to-day basis. One technique that been demonstrated to be helpful is positive writing intervention.
You may remember a call for participants for a study about chronic pain that we posted last summer. The researcher, Kathryn Lynn Ziemer has now finished the study, which was used for her dissertation for a Ph.D. in counseling psychology. A few weeks ago, I interviewed Kahryn about the background for thestudy, the results and what happens next.
Kathryn is originally from Minnesota and currently in her fifth year of graduate school at the University of Maryland College Park. She became interested in chronic pain when she worked with veterans at a VA medical center. "Chronic pain took such a psychological toll on injured veterans,", she explains. "They didn't feel the feelings were taken into account by healthcare professionals." Witnessing this, as well as the difficulties experienced by people who have chronic pain in getting to appointments for e.g., counseling, she became inspired to help people "deal with pain psychologically, without having to travel."
Kathryn describes the central question of her study as being about "finding a way to help people with chronic pain feel better and have better quality of life. Could writing about the pain experience in a certain way be helpful?" The study utilized two different ways of writing. Participants who were asked to use self-compassionate writing wrote about understanding the pain and distress and were essentially asked to "be kinder to themselves," Kathryn explains. Participants who were asked to write using self-efficacy writing focused on "active approaches to dealing with pain." Participants were asked to engage in three writing sessions one week apart, each preceded and followed by rating their experience of their pain.
When she analyzed the results, Kathryn discovered that "people in both categories of writing experienced less pain after three weeks of writing. Directly after writing, there was more positive emotion, but it wasn't sustained from week to week. Self-compassionate writing had less intensive pain after three weeks. That group of participants were accepting of the pain experience and the emotions that go with it."
Surprisingly, self-efficacy was the opposite. Kathryn speculates that as "self-efficacy writing required people to think about how they cope with the pain, the focus on pain may have made them feel all there were no great ways of coping."
Future Research and Use in Practice
Kathryn is continuing her analysis of the results of the study, as well as thinking of other avenues of research related to using writing as a coping technique for chronic pain. She is interested in looking at "what was it about the self-compassionate writing that made the pain less intrusive – was it writing about the pain experience in general or about the emotions?" She'd also like to look at "who benefits more from writing. Some participants enjoyed the experience, some didn't think it was helpful."
Exploring the subject of writing to deal with chronic pain isn't just an intellectual exercise for Kathryn. She believes that finding the answers to some of these questions could help create an intervention that would be helpful to people who are struggling with chronic pain. More research in this area could help psychologists and counselors target treatment where it would be most helpful. Using writing "could be used when people are feeling a lot of pain and distress. It's convenient — it can be done at home, in the moment." Kathryn explained that writing would be "used in conjunction with other treatments, for instance more intensive therapy or support groups once a week, with writing used as a 'pick me up' in between sessions."
In the near future, Kathryn will start her pain management rotation in preparation for working in clinical practice with people who live with chronic pain. "It's such a widespread condition and there's a lot of dissatisfaction around treatment." Kathryn wants to help individuals living chronic pain, as well as "use my own experience and research in advocacy. It's the ultimate goal of my work." She also explains that her work has taken on a personal meaning. Not only in terms of her professional experience working with veterans, but "after my research, my father developed chronic pain in his back and a friend of mine developed rheumatoid arthritis. It gives my research that much more meaning."
Kathryn extends her thanks to everyone who participated and to the HealthCentral, and RA communities for spreading the word about the study. On a personal note, I'd like to thank Kathryn for her efforts in expanding the knowledge about chronic pain.
Do you use writing to help you cope with pain?
Lene is the author of Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain