The effectiveness of exposure-based treatments for people with disabling chronic pain is well-established and often impressive, but patients do not respond equally well, many drop out, and a proportion relapse once treatment is completed. It may just be there are limits to how much treatments for this population can achieve; after all, once pain becomes chronic there are no real cures and the known natural history of chronic pain is that it is likely to wax and wane over many years. But naturally, researchers and clinicians (and their patients) will always seek better outcomes.While exposure-based treatments in the pain field have typically been based on the idea that people are avoiding movements expected to be painful, in this issue of the Scandinavian Journal of Pain Linton and Fruzetti  take up a perspective proposed by Lumley et al.  and argue that many chronic pain patients may also have learnt to avoid a variety of personally relevant, emotional stimuli, associated with the behaviour, as well as pain. In this sense, restricting the exposure treatment to movements alone may not be enough, especially if the patients engage in safety behaviours, like cognitive avoidance , that may undermine any benefits for
Scandinavian Journal of Pain – de Gruyter
Published: Jul 1, 2014
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