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Attachment Theory and Chronic Pain

Social scientists help us understand the theories behind pain and disability. For patients with chronic pain, pain intensity and disability are linked with anxiety, self-efficacy, and attachment styles. Self-efficacy refers to people's beliefs about their ability to do something.

For example, someone in pain with a strong sense of pain self-efficacy feels able to appproach the difficult task of overcoming pain. This person sees pain as a challenge not a threat. Someone with low pain self-efficacy is more threatened than challenged by the pain experience.

Attachment styles refers to how each person relates to others. Four types of attachment styles include secure, anxious, fearful (anxious and avoids others), or dismissive (avoids others).

In this study 152 patients entering a chronic pain rehab center took several surveys. Each survey was a tool to measure levels of pain self-efficacy, attachment style, and pain intensity. The relationship of anxiety and closeness as it is linked with pain was examined. Differences in style and self-efficacy were compared between men and women.

The authors found that people with secure attachment to others have a shorter duration of pain. Women were more comfortable with closeness and better able to ask for help. Self-efficacy was higher for people with secure relationship styles. Patients with secure attachments had lower levels of anxiety.

Patients with lower levels of anxiety had lower levels of pain. People with higher levels of pain self-efficacy had less disability. Attachment style didn't seem to be directly linked with disability or pain intensity.

Overall there was proof that pain self-efficacy is linked with anxiety, adult attachment style, and perceptions of pain and disability. Insecure, anxious patients are more likely to have chronic pain. People who are more comfortable with closeness, who have high levels of pain self-efficacy, and low levels of anxiety are less likely to become disabled.

The authors suggest treatment of chronic pain patients must focus on attachment styles. Strategies for patients in pain should include secure relationship-based or emotion-focused psychotherapy. Treatment can be individual based on what each patient psycho-social profile may be.

References: Pamela Meredith, et al. Adult Attachment, Anxiety, and Pain Self-Efficacy as Predictors of Pain Intensity and Disability. In Pain. July 2006. Vol. 123. No. 1-2. Pp. 146-154.

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