If you have been following my posts this month you know that I’ve been sharing information on Chronic Pain. If you have chronic pain, or if you have a loved one with chronic pain, this may be the first time you’ve ever heard of a psychologist treating pain, and you are probably wonder what we even do in terms of treating pain. 
As the month goes on I’ll provide more information about techniques of cognitive-behavioral therapy for chronic pain (CBT-CP), but today I want to tell you about the underlying pain theory (Gate Control Theory) that guides CBT-CP and how this theory is different from another one (Specificity Theory) that explains acute pain well (like when you stub your toe) but doesn’t work so well when it’s applied to chronic pain.
This article (http://www.spine-health.com/conditions/chronic-pain/modern-theories-chronic-pain) provides more details on the Specificity Theory versus Gate Control theory of chronic pain. It’s a bit lengthy, so I’m going to explain very briefly, and simplistically, what the difference is. But, if you have chronic pain, or know someone who does, the article is worth reading.
So…. the Specificity Theory (picture compliments of www.rosslab.neurobio.pitt.edu). The Specificity Theory basically says that the amount of pain a person feels is directly related to how much tissue damage was done during the initial injury. One the tissue has healed so should the pain. There are a few problems with this theory:
- People can continue to feel pain after injuries have healed.
- People can feel different levels of pain even if they have experienced a similar amount of tissue damage.
- People’s pain tolerance differs, so someone with a little bit of tissue damage may feel more pain than a person with a lot of tissue damage, who might not feel very much pain.
Enter the Gate Control Theory of Pain (picture compliments of wps.prenhall.com). The Gate Control Theory has been around since the 1960s and was developed to help understand how the mind influences a person’s perception of pain. Essentially, this theory says that pain is more than simply a result of the nerve impulses that are sent from the body to the brain, but that pain messages from the body to the brain are influenced by other messages that are going to, or coming from, the brain. There is a theoretical “gate” in the spinal cord that opens and closes based on these other messages that allows the actual “pain message” to pass through more or less easily (picture compliments of www.nursing-help.com).
Some examples of these “other messages” that open the pain gate include depression, anxiety, focusing on pain, negative thoughts, lack of movement, and lack of supportive others. Examples of messages that close the pain gate are positive thoughts, diaphragmatic breathing, progressive muscle relaxation, laughter, distraction, physical movement, and support from others.
So, when a psychologist is treating chronic pain, we are focusing on ways in which we can close the pain gate more readily! Again, I encourage you to read this article http://www.spine-health.com/conditions/chronic-pain/modern-theories-chronic-pain if you want a more in-depth explanation, and feel free to call me if you have questions about this!