What if the key to reducing your chronic pain was not in tackling the symptoms, but in regulating your emotions? A recent study shows that retraining your brain to deescalate negative emotions and enhance positive ones could be an effective therapy for persistent and long-lasting pain.
The study, conducted by researchers from the University of New South Wales (UNSW) and Sydney and Neuroscience Research Australia (NeuRA), involved 89 participants across Australia aged 26-77 years-old, who suffered from chronic pain. They took part in a nine-week program to develop mindfulness, emotional regulation skills, and distress tolerance to help weather an emotional crisis.
The researchers learned that chronic pain isn't just sensory, it's also connected to patients' emotional state. It was even reported to increase anxiety and depression, and emotional dysregulation was a regular feature of the condition among the people they spoke with. What's more, many people noted their pain was significantly worse in times of stress. It could also lead to a vicious circle, with stress bringing on more pain, and causing more stress.
Some of that is commonly known. More recently, however, a 2021 study showed a measurable change in the brain caused by chronic pain; more specifically, in the decrease of a neurotransmitter called gamma-aminobutyric acid (GABA) in the prefrontal cortex. That's the part of the brain that controls emotions, and GABA is the brain chemical that helps calm your circuits. As such, the researchers hypothesized that if we can relax the brain, we can avoid emotional distress and reduce chronic pain.
Their program, dubbed Pain and Emotion Therapy, takes the form of eight group sessions on Zoom with the participants, a supporting handbook with more info and worksheets, and a mobile app to guide patients through tasks in each of the skills required to develop better emotional regulation.
The research team, led by UNSW's Professor Sylvia Gustin and Dr. Nell Norman-Nott, carried out a randomized controlled trial with half the participants undergoing this therapy, and the other half only following their usual pain treatments. When they were assessed after nine weeks and after six months, those who got the brain retraining therapy showed a significant improvement in emotion dysregulation, compared to the control group, and also benefited from improved sleep quality.
Those who received Pain and Emotion Therapy also reported lower pain intensity. There was a substantial difference in this factor between the two groups at the six-month mark. One patient reported it was easy to implement this therapy and found it relevant to her everyday life, in comparison to Cognitive Behavioral Therapy. Another reported being able to reduce her morphine intake for pain reduction, and an increase in energy levels.
While the results published in the medical journal JAMA Network Open are encouraging, they come from a small trial. The researchers intend to expand their work, with the next phase of trials beginning in 2026: adults in Australia can sign up via this link to participate in the completely online nine-week study next year, so the team can gather more data.
If it proves to be effective for larger numbers of people, this could be a major breakthrough for the 20-30% of the global population who suffer for months to decades from chronic pain. Gustin and Norman-Nott also emphasize that their program can be delivered remotely and online, which means it could reach people in far-flung and rural areas without the need for special spaces or equipment – and potentially improve more lives.
Sources: UNSW, NeuRA via Scimex
