 Psychological Assessment and Therapy
Frequently Asked Questions
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Psychological Assessment and Therapy
(by Jeffrey Pingel, Ph.D.)
What is the difference between psychological assessment and psychological therapy?
Psychological assessment may occur early in
a person’s treatment at MHNI. A person's living circumstance, mood, ways of coping
with pain, stresses that may relate to the head pain, health habits, and patterns
of substance use (e.g., cigarette smoking, alcohol consumption, overuse of analgesic
medication) may be relevant to their headache condition. Psychological assessment
is for fact gathering only and may include objective testing of a person's coping
ability, mood, interpersonal problems, and cognitive difficulties.
Our team wants to be informed of any circumstance
and/or factor which can influence an individual's headache condition or recovery.
One of our physicians or nurses may suggest a referral to a MHNI psychologist for
an initial evaluation if an assessment seems appropriate.
Psychological therapy, on the other hand, involves
ongoing contact and sessions and thus involves more than one or two sessions with
an MHNI psychologist.
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What is psychological therapy and how might it help the headache sufferer?
Psychological therapy involves discussion with
a trained mental health professional (e.g., psychologist, psychiatrist, social worker,
etc.) about problems in living - unhappy relationships, uncomfortable emotions,
disturbing thoughts and experiences. People who seek psychological therapy are distressed
about a matter in their life. The purpose of the discussion is to get perspective
on the problem, solve it (if possible), and feel less distressed. Certain circumstances
won’t easily change so psychological therapy helps the person adapt and make the
best of the situation.
Some patients at MHNI believe that certain
family or work circumstances aggravate their headache. For example, I see several
individuals each year who describe this pattern: the headache worsens Sunday night
into Monday morning and is most severe on Monday and Tuesday; later in the week
toward the weekend the pain improves, and Saturday is the best day. Almost always
an interpersonal problem exists related to work or school. The goal of psychological
therapy is to identify the problem and discuss better ways to cope.
One problem the psychologists at MHNI and Chelsea
Community Hospital increasingly observe is an intense fear of head pain, a type
of anxiety reaction to escalating pain. This can result in overuse of pain pills
because the person feels panicky. Behavior therapies such as biofeedback and relaxation
are very helpful in lessening this reaction.
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Do all headache sufferers need psychological therapy?
The short and easy answer is: no. MHNI’s staff
understands that people with chronic headaches often doubt themselves, or are questioned
by family members, friends, and co-workers about their emotional well-being. Headache
sufferers (and their loved ones) want to make sense of their pain. There is a traditional
assumption that their pain is related to something they are doing to themselves
(e.g., not handling stress, feeling unmotivated and hopeless, losing their temper).
We often observe that emotional upset and aberrant
behavior is a result of intense and daily pain. The patient’s personality
returns to a steady state once the headaches are more controlled.
On the other hand, some individuals have a
history of severe depression or anxiety reactions, independent of the headache condition.
Such mood disturbance may affect the headache and interfere with the person’s response
to medical treatment. A person who is overly anxious or impatient about their headache
condition may prematurely give up on the proper use of daily medication.
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