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Chronic Pain, Fibromyalgia, and Psychology

Have you heard of the “biopsychosocial” model of chronic pain?

Through years of research, the biopsychosocial model has come to stand out as the most widely accepted model for conceptualizing and treating chronic pain1. So what is this model?

The biopsychosocial model highlights something that many people intuitively understand, that the mind and body are inextricably connected.

From a biopsychosocial perspective, there are 3 components that impact not only the experience of pain, but also the ability to manage and successfully treat pain while living a full life:

Diagram of health1.The first component is the biological component, which includes the physical and neurological aspects of pain. For example, joints, muscles, pain receptors in the brain, etc. are all part of the “bio” in the biopsychosocial model. People are pretty familiar with the physical aspect of pain, but if we stop there, then we really do miss the big picture of the pain experience.


2.Next we come to the “psycho” part of the model, and I’m not talking about Norman Bates. This refers to the psychological factors that significantly contribute to our experience of pain, such as our emotions and cognitions (thoughts). Now this is not to say that pain is “all in your head” (although pain receptors are in our brains so, in a way, pain kind of is all in our heads and very real, but I digress).

Have you ever noticed how two people can experience the same physical injury but seem to react in two very different ways? I know I have. Not only have I seen people report different levels of pain in reaction to similar injuries, but the pain impacts their daily functioning, activity level, and life satisfaction in very different ways. That’s the psychological aspect of pain. Did you know that the thoughts you have about your pain can actually increase or decrease the intensity of pain you perceive? Yes, that’s what I’m talking about and it’s true. Additionally, co-occurring mental health illnesses can also impact pain.

On the one side of things, chronic pain can precede and lead to the development of a variety of mental health concerns, such as depression and anxiety. However, mental illness can also precede or coincide with pain. Regardless of which came first, mental illness and chronic pain tango with each other in such a way as to exacerbate both conditions. Even if you do not have a mental health illness, you do have emotions and thoughts, so you can’t ignore this component.


Psychologist having session with her patient in her private consulting room3.Finally, we come to the third component in the biopsychosocial model of pain, the social aspect. This includes social factors that can impact pain, such as life stressors, relationship conflict, social and cultural expectations, social support or isolation, and the list goes on. Think of the stereotypical “tough guy” who is in pain, but you would never know it because he rarely mentions it so as to keep up the tough image, and may even be at risk for further injury because of it. Or, picture the corporate executive who is juggling multiple high profile projects at work, facing a possible relationship break-up at home, and just found out that a loved one is ill. With all of these social stressors, this person’s pain level will likely increase.

Believe it or not, social factors do significantly impact our experience of pain and our functioning in pain.  The “bio,” “psycho,” and “social” components are quite intertwined, and each feeds off of and influences the other to create this thing called pain.   But how can you treat pain from a biopsychosocial model? How do I target the psychosocial aspects and incorporate that into my overall pain management treatment plan?

Enter, the psychologist. Psychological interventions are now recognized as effective additions to pain treatment, including fibromyalgia pain management. Cognitive Behavioral Therapy (CBT) is the most widely used psychological treatment to help people with.

While there are different types of CBT, in general, the interventions target the thoughts and behaviors that contribute to the experience and management of pain, as well as targeting comorbid factors such as depression, poor sleep, and life satisfaction. A meta-analysis of several research studies found that people with fibromyalgia who engaged in some type of CBT significantly reduced depression associated with fibromyalgia2.

Additionally, the results found a significant increase in “pain self-efficacy,” which is how well you believe you are coping with and managing your pain, and the other behavioral and emotional consequences of fibromyalgia. Including some form of CBT into your treatment regimen for fibromyalgia is a holistic approach with proven benefits.

The Medical Fitness Network can help you find a qualified, experienced psychologist in your area to help you maximize your fibromyalgia pain relief and enjoy life the way you desire!

Please use our search portal to find an experienced psychologist. 

Let a psychologist be a part of your health care team.

  1. Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., Turk, D. C. (2007). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133, 581-624.
  2. Bernardy, K., Fuber, N., Kollner, V., & Hauser, W. (2010). Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome: A systematic review and metaanalysis of randomized controlled trials. The Journal of Rheumatology, 37, 1991-2005.