Chair: Regine Klinger, Germany
Johan Vlaeyen, Belgium
Pain is a biologically relevant and vital signal of bodily threat, urging the individual to protect him/herself. Immediate protective responses to pain include increased arousal, orientation to the sources of threat, and various safety-seeking behaviors including escape and avoidance. Given its eminent survival value, pain is a strong motivator for learning. Responding to the repeated occurrence of the same painful event increases when harm risks are high (sensitization), and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is of particular relevance in explaining the development of chronic pain problems: It is adaptive in short term, but paradoxically may have detrimental long-term effects. Pain does not occur in a vacuum, and the urge to act competes with other demands in the person’s environment.
In this presentation, I will present four modules, each featuring a particular aspect of the behavioral approach to chronic pain. I will discuss 1. how individuals learn to predict and control pain learning. 2. How learning principles can be utilized to empower individuals to increase their range of activities towards their individual valued life goals in the face of persistent pain, 3. How individuals can overcome obstacles in recovery from a pain event, such as fear of reinjury, and 4. How pacing and emotional regulation can be integrated in the behavioral approach to chronic pain. I will also review of the state of the art regarding the effectiveness of these approaches.