What’s a pain psychologist? Dr. Melissa Geraghty can explain.Jan 22, 2019
[Some of this article was updated in October 2023]
Dr. Melissa Geraghty is a licensed clinical health psychologist with expertise in pain psychotherapy. She has a deeply personal interest in her work with patients as someone with multiple chronic pain conditions herself. Chronic pain and its treatment is poorly understood in general – the mental and emotional aspect even less so.
Dr. Geraghty spoke with me about what a pain psychologist does and how good mental health care is part of chronic pain treatment.
What is a pain psychologist and what do you do?
My psychotherapeutic style is based on Acceptance & Commitment Therapy (ACT). I teach patients to focus on living one's values and how to function despite pain. This increases a person’s quality of life by learning how to still do things one cares about despite pain levels.
I teach coping skills, mindfulness, engage in experiential therapy, exposure therapy, expressive therapy, etc. I also assist patients in grieving the loss of their old, able-bodied self. We explore how to increase awareness of body functioning and sensations, and how to pace oneself in daily life and any upcoming events.
As needed, I provide couples therapy and/or family therapy to increase their families understanding of pain and how their family can be supportive. I discuss how, while physical pain is not a choice, we can work on our psychological suffering to improve our mental well-being and overall functioning. I also make sure my patients have a proper medical team, help them navigate the medical system, mentally prepare patients for procedures and surgeries, and I do my best to coordinate care amongst all healthcare professionals. I also treat any comorbid psychological conditions, such as depression, anxiety, PTSD, etc. We also process the implications of having an invisible disability or a disability that requires mobility assistance, such as how to deal with comments from strangers if a patient with an invisible disability has a disabled parking placard. The list goes on!!
Are you sought out or do you get referrals? In other words, do people know about pain psychologist or are they unaware of the resource?
Most people have not heard of a pain psychologist, sadly. In many cases, by the time the patient has reached me, they have been to several medical doctors, psychologists or counselors, physical therapists, etc, and they had many unfortunate experiences with medical professionals. People typically find me through word of mouth.
What are the first few appointments with you like? What are the goals?
My goal in the first few appointments is to gather a biopsychosocialspiritual history on the patient. We get to know one another better and discuss how treatment will be customized to their needs. I also ask what they hope to get out of therapy.
Are people resistant to or skeptical of the value of pain psychology?
Yes. Many people assume I will think the pain is all in their heads and they have a conversion disorder and will be dismissed. I have never met a patient in pain that was faking. It can also be difficult for people with pain to understand just how interconnected physical pain and emotional pain is. When a person is able to target their psychologically suffering, they are able to more fully live life despite pain.
Many people also have been exposed to pop psychology ideas of, for example, mindfulness. They try it once, say it didn’t help, and dismiss it… The true focus of mindfulness is on experiencing all mental and physical states and building resiliency. I have to spend a lot of time at the start of therapy addressing myths such as this.
How do you think your own history of chronic conditions and chronic pain this has influenced your practice and career?
I have well over 50 medical conditions that involve pain, including: Tethered Cord Syndrome, Fibromyalgia, CRPS, ME/CFS, Chronic Migraine… Being able to relate to closely to my patients allows them to feel comfortable bringing up any topic to me as they know I will not judge them.
My patients and their families also look at me as hope, that if I can be a doctor despite my numerous pain conditions, they can also live their values. I’m very open and honest about how life with chronic pain is not easy, and there are many days I absolutely struggle, but I also fall back on the coping skills and strategies I teach my patients.
This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnoses, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.
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