Study Notes on Psychological Treatments for Physical Disorders

Clinicians have recognized that stress and related psychological and sociocultural factors contribute to physical disorders.
As a result, psychological treatments are increasingly applied to a range of medical problems (Antoni et al., 2024; Meyers, 2023).

Common psychological interventions include:
- Relaxation training
- Biofeedback
- Meditation
- Hypnosis
- Cognitive interventions
- Support groups
- Therapies aimed at increasing awareness and expression of emotions.
The field integrating these psychological and physical approaches is known as behavioral medicine.

Behavioral Medicine: A field that combines psychological and physical interventions to treat or prevent medical problems.

Therapists teach clients to relax their muscles voluntarily, based on the idea that physical relaxation leads to psychological relaxation.
Applications: Used widely for treating high blood pressure, somatic symptom disorders, headaches, insomnia, asthma, diabetes, pain, vascular diseases, and side effects from cancer treatments (Andersen et al., 2024; Antoni et al., 2024, 2023).

Relaxation Training: A treatment procedure that teaches clients to relax at will, enabling them to calm themselves in stressful situations.

New programs, techniques, and products for stress relief are frequently introduced. Examples include spa treatments such as relaxing in a chocolate spa.

Biofeedback: Involves therapists using real-time electrical signals from the body to train clients to control physiological processes like heart rate and muscle tension.
Clients are connected to a monitor that provides continuous feedback about their bodily activities, allowing them to learn to control physiological responses.

The most common form of biofeedback utilizes an Electromyograph (EMG):
- Provides feedback on muscular tension.
- Electrodes typically placed on forehead muscles detect subtle electrical activity related to muscle tension.
- Converted into visual images or sounds indicating changes in tension.

Through guided observation of muscle tension, clients can learn to relax their muscles voluntarily.
Example Study: A classic study involved using EMG feedback to treat 16 patients with facial pain caused by jaw muscle tension, leading to reduced pain after treatment (Dohrmann & Laskin, 1978).

Effective in treating headaches, muscular disabilities from strokes or accidents, heartbeat irregularities, asthma, high blood pressure, stuttering, and pain (Schmidt et al., 2023; Strada & Portenoy, 2022).

Percentage of chronic pain in different income groups:
- 32% of low-income individuals with chronic knee or leg pain.
- 19% of high-income individuals with similar conditions.
- 37% of low-income individuals with chronic neck or back pain.
- 26% of high-income individuals with similar conditions (Information from: Anson, 2017).

Historically practiced but recently acknowledged by Western professionals for its effectiveness in relieving physical distress.
Meditation: A technique to turn one’s concentration inward, achieving a change in consciousness and ignoring stressors temporarily.

Regular meditators report feelings of peace, engagement, and creativity.
Used to manage pain, high blood pressure, heart conditions, asthma, skin disorders, diabetes, insomnia, and viral infections (Merschel, 2022; Strada & Portenoy, 2022).

A specific form noted for its use in managing severe pain. Mindfulness meditators focus on thoughts and feelings without judgment, decreasing negative responses to pain (Bower & Kuhlman, 2023; Edwards & Vowles, 2022).

Combines physical and psychological techniques, such as body posturing, controlled breathing, and relaxation exercises.
An unusual practice called goat yoga includes baby goats that interact with practitioners, enhancing the yoga experience through playful engagement.

Involves inducing a suggestible state where individuals may act unusually or recall forgotten memories (self-hypnosis). Used as an adjunct in psychotherapy and to treat various physical conditions.
Particularly effective for pain control and treating skin diseases, asthma, insomnia, high blood pressure, and infections (Bai, 2023; Williams et al., 2022).

Patients are taught to adopt new attitudes towards their physical ailments, focusing on coping strategies (Abrahamsen et al., 2023; Antoni et al., 2024, 2023).
Self-Instruction Training: Helps patients manage severe pain by substituting negative self-statements with positive ones, thereby enhancing coping mechanisms (Ashar et al., 2022; Meichenbaum, 2017; 1993; 1975).

Despite prescribing psychological interventions for various medical problems, many patients show resistance to these treatments.

Psychological interventions reduce negative emotions like anxiety and depression, thus potentially alleviating physical ailments.
Benefits observed in patients participating in support groups and therapies focused on emotional awareness and expression (Köstlin et al., 2023; Pester et al., 2022).

Emotional processing (discussion or writing about feelings) has improved health outcomes for patients with conditions like asthma, arthritis, HIV, and cancer (Gao, 2022; Maslej et al., 2020; Pennebaker & Smyth, 2016).

Isolation during the Covid-19 pandemic heightened personal stress, impacting health.
Individual coping strategies: An example includes a man practicing climbing indoors and a woman practicing yoga during social distancing restrictions.

Psychological interventions are shown to be equally effective for physical problems. Psychological techniques often prove more effective when combined with medical treatments (Antoni et al., 2024, 2023; Riley, 2022).
Example: Combination of medication and psychological treatments (support groups, mindfulness, relaxation training) has been more effective than medication alone for coronary heart disease patients (Carlson, Baydoun, & Flynn, 2024; Tofler, 2023, 2022).

Medical practitioners are moving away from traditional treatment paradigms, incorporating more psychological treatments into physical health care.