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Pain has the unusual ability to teach one about human limits, or more precisely one's own forbearance, resilience, and tolerance of threat.Pain, especially chronic pain, challenges our ability to behave in a coherent and consistent way when threatened by harm.However, the overall effect sizes of treatments for adults, across all trials, are modest.Reasons for the relatively modest treatment effects are discussed within the context of all treatments for chronic pain being disappointing when measured by the average.It is clear that treatment benefit can be achieved with cognitive behavioural methods.It is possible to effect change in pain, mood, and disability, changes not achieved by chance or by exposure to any other treatment.
Most evidence is available for treatments of adult pain, although adolescent chronic pain treatments are also reviewed.
People typically draw upon the coping skills and resources they have available to them, and have used successfully for other threatening or aversive life events; however, in chronic pain, they find them wanting.
What can appear abnormal is the stubborn perseverance in using techniques that have proved inadequate, unfitting, and ultimately unhelpful to the problems of chronic pain.
In chronic pain, behaviour is defined broadly to include private events such as thoughts and feelings that initiate, maintain, or exacerbate suffering.
The psychology of chronic pain is a psychology of the normal.