Mastering negative emotions reduces chronic pain

How can chronic pain—pain that has persisted for more than three months, often years, and which affects 20 to 30 percent of the population—be relieved? Australian researchers are proposing a new approach, based on a program combining mindfulness, emotional control, and distress tolerance, which they evaluated in a clinical trial. And the results, published May 6 in JAMA Network Open , prove the relevance of this strategy.

“Chronic pain is more than a sensory experience; it has a very emotional dimension,” one of the researchers, Nell Norman-Nott of the University of New South Wales in Sydney, told New Scientist . “ In fact, around 80% of people living with chronic pain have higher levels of anxiety and depression ” than the general population. Negative emotions associated with chronic pain include anger and worry. There is also difficulty regulating emotions—in simple terms, being able to soothe negative emotions by reinforcing positive ones.

To break the “ vicious cycle ” of pain that amplifies negative emotions, which worsen the pain, Nell Norman-Nott and her colleagues tested a new strategy on 89 volunteers, mostly women, whose pain had started an average of 16 years earlier. They were divided into two groups: half of them attended online group sessions with a therapist for eight weeks, while the other half continued their usual pain treatment.

One week after the protocol ended, “ there were [in the first group] notable improvements in emotional dysregulation, depression, anxiety, sleep disturbances, and overall well-being, ” reports Cosmos , an Australian science news site. Six months later, participants still had better emotional control “and reported that their pain was significantly less .”

In 2021, the research team observed that chronic pain caused changes in the brain. “ We showed that pain led to a decrease in a brain neurotransmitter, GABA, in the prefrontal cortex, […] the part of the brain responsible for managing and controlling emotions,” recalls Sylvia Gustin, who led the clinical trial.