November 27, 2006 – Psychotherapy should be used more in the treatment of chronic pain in the elderly, according to psychologist Marie-Josée Rivard1. It could even help reduce medication intake.
Speaker at the congress of the Quebec Pain Society2, held recently in Laval, Marie-Josée Rivard demonstrated that depression is often related to pain in seniors, but that its symptoms are difficult to detect in this population.
“Up to 58% of seniors with chronic pain are depressed,” she said. And the longer the pain persists, the more the psychological distress is important and difficult to treat. “
Restructure negative thoughts
Cognitive Behavioral Therapy (CBT) involves restructuring the negative or unrealistic thoughts that fuel psychological distress. This is what makes it a valuable tool for managing and reducing chronic pain.
“Studies indicate that this approach is, in general, very effective in reducing pain and that its effects are maintained over time, ie four to six months following treatment,” explains Marie-Josée Rivard.
However, if CBT is known for its effectiveness even in the elderly, its use in this clientele has only been the subject of very few studies for the moment.
Aim for quality of life
“With the elderly, we must listen to enlightening words to clarify the diagnosis of depression associated with pain, because they do not immediately say that they are depressed,” says the psychologist.
So you have to fight some false beliefs or expectations to get results. The patient must understand that if he does not see his pain disappear, he can at least manage it and reduce it. “He thus sees the possibility of improving his quality of life and that gives him the motivation to continue,” says Marie-Josée Rivard.
CBT also allows seniors to use new tools to reduce their chronic pain, such as relaxation, self-hypnosis and physical activity.
In short, CBT makes the patient play an active role in reducing their pain, which allows them to be more active – physically and socially. This gives him more control over his life, which is one of the main steps to take to get out of depression.
Martin LaSalle – PasseportSanté.net
1. Marie-Josée Rivard is a psychologist at the Pain Center at the McGill University Health Center.
2. To find out more about the Quebec Pain Society: www.sqd.ca [consulté le 22 novembre 2006].
