The ACT model – Acceptance and Commitment Therapy – is the most effective psychotherapy for the management of chronic pain
This is according to the National Institute for Clinical Excellence (NICE), the independent UK agency with a mandate to provide evidence-based guidance for healthcare professionals to achieve the highest possible standards of care. to patients.
The NICE guidelines are based on clinical trials, which have shown that the ACT model has a positive effect not so much on “pure” pain, caused by the disease, but on “dirty” pain.
The latter is a term used to refer to the psychological suffering that occurs when physical suffering affects the quality of life.
ACT acts on pathologies linked to chronic pain
Patients with chronic pain usually suffer from depression, anxiety, sleep disturbances and anger, which inevitably amplifies the physical pain, lowering the tolerance threshold.
ACT acts on these aspects, leading the patient to abandon these avoidance strategies that humans instinctively implement when faced with something they cannot control, but which themselves are a source of suffering.
An example? Avoid people because because of the pain I am a burden.
This only increases the feeling of loneliness, of not being loved, and also exacerbates the physical suffering.
But often it is our own thoughts that give us the role of “burden” and not the reality of the situation.
As the acronym ACT indicates, therapy aims to gain acceptance, a word that is difficult to say in front of a person in pain.
Acceptance does not mean resignation or fatalism, but awareness of the present which includes pain but is not to be seen through it.
Helping the patient to move towards what is important, towards what is of value to the person himself despite the pain, is what this model of psychotherapy aims at.
A model which, according to the NICE guidelines, also helps the patient to have greater therapeutic adherence and increases the effectiveness of the drug.
Depression or anger also trigger a feeling of mistrust vis-à-vis the therapy followed: “The pain persists so what’s the point? “.
Psychotherapy works on dirty pain, affects primary pain perception, and increases awareness of the need to adhere to therapy properly.
If the drug is taken correctly, it increases its effectiveness.
Illness, like pain, can represent times in which we experience unwanted emotions, disturbing thoughts, experiences of helplessness and loss of autonomy, so it is not always easy to live and dwell on. ” evolve in a manner consistent with its own values.
The therapeutic course proposes to remain in a position of listening and accepting the suffering, in order to then seek a new repertoire of actions, psychological and physical, in coherence with the identified values.
Thus, the therapy takes place through a journey that develops through the six processes of the ACT model (acceptance of the experience, defusion, contact with the present moment, sense of continuity with oneself, contact with one’s values and committed action. ), applied against the background of chronic pain.
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