Toward change: Targeting individual and interpersonal processes in therapeutic interventions for chronic pain

Abstract

Pain demands attention of the individual experiencing it, but also involves a dynamic process between the individual in pain and relevant observers. Observers may include healthcare providers, employers, friends, romantic partners, and family members, among others. Observers can play an important role in understanding of pain diagnosis and treatment, in helping patients feel motivated to participate in treatments and engage in self-care behaviors, and in the individual’s long-term coping with chronic pain. Interpersonal processes that underlie communication about pain are dynamic and may change over time due to learned responses from the individual or observer. For example, the characteristics of the individual in pain may influence the observer’s likelihood of offering assistance or providing empathic support versus their likelihood of criticizing and invalidating the individual in pain. In turn, the observer’s reaction may influence the individual in pain such as leading to positive or negative expectations for pain treatment or leading to feelings of empathic understanding versus feelings of being stigmatized. In this chapter, we summarize individual and interpersonal processes from the perspective of the individual in pain versus the observer. Next, we highlight examples of interventions that aim to modify these individual or interpersonal processes to move toward change in the pain experience. Last, we present ideas for future research to develop novel treatments targeted toward change in individual or interpersonal processes that underlie pain communication.