As a sex therapist and trauma therapist, I often work with patients who experience chronic pain and worries about experiencing pain in the future. I share with clients an experience of working alongside my father on the farm growing up.

It was not uncommon that my father would experience a physical injury in the routine course of working with livestock or around farm machinery. I have vivid memories of my father noticing a physical injury and, as they say, "rubbing some dirt on it" and moving on to keep working, all with a smile on his face.

His relationship to physical pain has stuck in my mind as I have worked with many of the chronic pain patients in clinical practice. In contrast to my father, chronic pain patients often worry about their pain and catastrophize about it, which only intensifies and prolongs their experience of pain.

Recently, I presented a poster at the American Psychological Association (APA) conference on how specific early maladaptive schemas (EMSs) have been found to be associated with the experience of current and chronic pain and health concerns in chronic pain patients.

The 18 EMSs consist of a pervasive pattern of thoughts and beliefs about oneself or the world that were developed through negative childhood experiences and persist into adulthood. For example, defectiveness — the belief that one is inherently defective or not good enough — was the strongest predictor for current pain, while enmeshment — being too closely involved with others — was associated with less pain.

This particular finding wasn't surprising to me. I have seen a pattern over the years of treating couples who have their individual experience of pain intensify when they develop healthier emotional boundaries in their relationship.

The good news is that EMSs can be treated and corrected through psychotherapy, thus reducing the experience of pain and further developing one's capacity to manage and cope with chronic pain.

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For a fuller description of additional findings, please check out the poster on ResearchGate. This poster received an award for an outstanding poster presentation from Division 38, The Society for Health Psychology, of the APA.