Academic journal article International Journal of Psychology and Psychological Therapy

Mindfulness for Neuropathic Pain: A Case Study

Academic journal article International Journal of Psychology and Psychological Therapy

Mindfulness for Neuropathic Pain: A Case Study

Article excerpt

The following is a case study of a 62-year-old female, who for the past 18 years has experienced chronic Neuropathic Pain (NP) as a result of a stroke. NP is a chronic pain condition that can be extremely debilitating, and difficult to manage with pain medication. This study investigates the efficacy of 12-weeks of daily Mindfulness practice in reducing the pain intensity experienced by this individual. An additional goal was to investigate if Mindfulness had an impact on the individual's psychological functioning and well-being. Pain levels, psychological functioning, and well-being were assessed at baseline, post intervention, and at a 3-month follow up.

Neuropathic Pain (NP) is a complex chronic pain state that is defined by The International Association for the Study of Pain (IASP) as "pains resulting from disease or damage of the peripheral or central nervous systems, and from dysfunction of the nervous system" (Scadding, 2003, p. 8). The pain may be spontaneous, stimulus-evoked, or a combination of both. NP is thought to affect approximately 6-8% of the general population (Mulvey, Bennett, Liwowsky, & Freynhagen, 2014) with a higher prevalence being observed in populations with health related problems. Research suggests that 26.4% of individuals suffering from type 2 diabetes experience NP symptoms (Davies, Brophy, Williams, & Taylor, 2006), whilst 58% of individuals with Multiple Sclerosis report symptoms of neuropathic origin (Helme, 2006). In comparison to nociceptive pain, which is generally short lived and adaptive, NP is often chronic and maladaptive (Woolf, 2004). Mulvey, et al. (2014) state that compared to nociceptive pain, NP is associated with a higher pain levels, greater need for pain relief, sleep disturbances, and poorer physical, cognitive and social functioning impacting on daily living (Bouhassira, LantériMinet, Attal, Laurent, & Touboul, 2008; Cruccu & Truini, 2010; Rayment, Hjermstad, Aass, Kaasa, Caraceni, Strasser, Heitzer, Fainsinger, & Bennett , 2013; Torrance, Smith, Bennett, & Lee, 2006). Management of NP tends to focus on pharmacological treatment, with antidepressants, anticonvulsants and opioids commonly being prescribed to patients. However, medical management of NP is often limited and can deliver unwanted side effects (Helme, 2006). In a UK study, where individuals suffering from NP were followed for a year, it was discovered that only 30-50% of individuals (this percentage varied depending on the aetiology of NP) had a stable and effective treatment regime (Hall, Carroll, Parry, & McQuay, 2006).

Considering the chronic nature and prevalence of NP and its impact on quality of life, it is concerning that traditional pain management approaches are falling short of effectively reducing pain of a neuropathic origin. Several psychological treatments have been suggested for the treatment of chronic pain (Turk, Swanson, & Tunks, 2008). Recent developments point to the efficacy of Mindfulness Based Interventions (MBI's) in the treatment of chronic pain conditions.

Mindfulness is an ancient practice, which derives from Buddhism but is also found in many other Eastern philosophies. Mindfulness is predominantly concerned with becoming aware of current thoughts, feelings and sensations, and has been defined as "paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" (Kabat-Zinn, 1994, p. 4). In recent decades Mindfulness has been adapted for secular use within a variety of formats within Western society including Mindfulness-Based Stress Reduction (MbSR) (Kabat-Zinn, 1982), Mindfulness-Based Cognitive Therapy (MBCT) (Segal, Williams, & Teasdale, 2002), Dialectical Behaviour Therapy (DBT) (Linehan, 1993a, 1993b) and Acceptance and Commitment Therapy (ACT) (Hayes, 1999).

As a therapeutic intervention, Mindfulness based approaches are increasingly becoming recognised as techniques that can be applied to a range of medical and psychological disorders, and have shown to be an effective intervention in managing symptoms associated with clinical disorders, such as stress (Morone, Lynch, Losasso, Liebe, & Greco, 2012), depression (Finucane & Mercer, 2006), anxiety (Call, Miron, & Orcutt, 2013), and eating disorders (Kristeller, Wolever, & Sheets, 2014). …

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