Pain Theories and Treatment Presentation PSYCH/628 November 10, 2014 Week 4 Team B presentation 1 Introduction Gate Control Theory Behavioral Pain Theory Use of Psychogenic Pain in Theories Evidence-Based Interventions in Theories “Pain is major health problem that affects more than 50 million American, costing more than $100 billion annually” (Straub, 2012 p. 418). This cost is a direct effect of health care cost and lost of wages and is most sort for treatment by patients. Often pain is formed through biological, psychological, and sociobehavioral forces. Pain signals that something is wrong and to take precautions but, not feeling on the other hand can be harmful. Because pain is such a strong motivator for action, it is considered one of the body's most important protective mechanisms. Pain is divided into three categories known as acute, recurrent, and chronic pain. There are several theories of pain that have been formulated such as the gate control theory and behavioral pain theory that will be discussed and defined within this presentation. The presentation will discussed psychogenic pain as the chosen pain disorder selected by Team B. As part of this specific disorder (psychogenic pain) the way in which this pain disorder can be understood through the use of the gate control theory and behavioral pain theory will be defined. Also, potential evidence-based interventions in regards to the two theories (gate control & behavioral pain) and there use in treatment planning will be discussed. 2 Gate Control Theory “In 1965, Ronald Melzack and Peter wall outlined a gate control theory (GCT) that moved past some of the shortcomings of earlier theories” (Straub, 2012 p. 428). This theory involves a mechanism in the brain acts as a gate to increase or decrease the flow of nerve impulses from the peripheral fibers to the central nervous system. As depicted in diagram above "open" gate allows the flow of nerve impulses, and the brain can perceive pain. A "closed" gate does not allow flow of nerve impulses, decreasing the perception of pain (Srivastava, 2010). The gate control theory looks at the complex structure of the of the central nervous system that involves the central and peripheral nervous systems. “In the gate control theory, the experience of pain depends on a complex interplay of these two systems as they each process pain signals in their own way (Deardorff, 2003). 3 Behavioral Pain Theory Physiological Theory Cognitive Theory There are two types of pain; fundamental “sensory” pain, the intensity of which is a direct function of the intensity of various pain stimuli, and “psychological” pain, the intensity of which is highly modifiable by such factors as hypnotism, placebos, and the sociocultural setting in which the stimulus occurs(Department of Psychology, State University of New York at Stony Brook, Stony Brook, N.Y. , 2014). Physiological, cognitive, and behavioral theories .

1. Pain Theories and Treatment Presentation
PSYCH/628
November 10, 2014
Week 4 Team B presentation
1
Introduction
Gate Control Theory
Behavioral Pain Theory
Use of Psychogenic Pain in Theories
Evidence-Based Interventions in Theories

2. “Pain is major health problem that affects more than 50 million
American, costing more than $100 billion annually” (Straub,
2012 p. 418). This cost is a direct effect of health care cost and
lost of wages and is most sort for treatment by patients. Often
pain is formed through biological, psychological, and
sociobehavioral forces. Pain signals that something is wrong
and to take precautions but, not feeling on the other hand can be
harmful. Because pain is such a strong motivator for action, it is
considered one of the body's most important protective
mechanisms. Pain is divided into three categories known as
acute, recurrent, and chronic pain. There are several theories of
pain that have been formulated such as the gate control theory
and behavioral pain theory that will be discussed and defined
within this presentation. The presentation will discussed
psychogenic pain as the chosen pain disorder selected by Team
B. As part of this specific disorder (psychogenic pain) the way
in which this pain disorder can be understood through the use of
the gate control theory and behavioral pain theory will be
defined. Also, potential evidence-based interventions in regards
to the two theories (gate control & behavioral pain) and there
use in treatment planning will be discussed.
2
Gate Control Theory

3. “In 1965, Ronald Melzack and Peter wall outlined a gate control
theory (GCT) that moved past some of the shortcomings of
earlier theories” (Straub, 2012 p. 428). This theory involves a
mechanism in the brain acts as a gate to increase or decrease the
flow of nerve impulses from the peripheral fibers to the central
nervous system. As depicted in diagram above "open" gate
allows the flow of nerve impulses, and the brain can perceive
pain. A "closed" gate does not allow flow of nerve impulses,
decreasing the perception of pain (Srivastava, 2010). The gate
control theory looks at the complex structure of the of the
central nervous system that involves the central and peripheral
nervous systems. “In the gate control theory, the experience of
pain depends on a complex interplay of these two systems as
they each process pain signals in their own way (Deardorff,
2003).
3
Behavioral Pain Theory
Physiological Theory
Cognitive Theory
There are two types of pain; fundamental “sensory” pain, the
intensity of which is a direct function of the intensity of various

4. pain stimuli, and “psychological” pain, the intensity of which is
highly modifiable by such factors as hypnotism, placebos, and
the sociocultural setting in which the stimulus
occurs(Department of Psychology, State University of New
York at Stony Brook, Stony Brook, N.Y. , 2014).
Physiological, cognitive, and behavioral theories of pain have
their own view in regards to the nature of the two kinds of pain.
According to physiological theory and cognitive theory,
“psychological” pain and “sensory” pain are both internal
processes, with the former influencing the latter as central
processes influence peripheral processes (Department of
Psychology, State University of New York at Stony Brook,
Stony Brook, N.Y., 2014) . According to behavioral theory,
“sensory” pain is a reflex and “psychological” pain is an
instrumental act (an operant).
Behavioral pain theory suggest that neither kind of pain is an
internal procesh however they are overt behaviors (Department
of Psychology, State University of New York at Stony Brook,
Stony Brook, N.Y., 2014) . Although both physiological theory
and cognitive theory agree that pain is internal, they also
disagree with commonsense intuitions at other points. The two
theories do not explain the subjective experience of pain than is
behavioral theory. They have not generated treatments for pain
that are better to those generated by behavioral theory. There is
no basis for the frequent claim by anti-behaviorist philosophers,
health care professionals, and psychologists that behaviorism,
because it cannot explain pain, is less capable of explaining
mental phenomena than physiology or cognition ( Department
of Psychology, State University of New York at Stony Brook,
Stony Brook, N.Y., 2014)
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5. Psychogenic Pain
Gate Control Theory
(Bing, 2014)
Psychogenic pain is not classified as “true physical pain”
(Thomas, 2003, p. 1). Some psychogenic pain can be caused
from injuries the person sustained. Back pain can be caused
from a vehicle accident, which can increase with age. Gender
and sociocultural factors can play a factor with the gate control
theory and psychogenic pain (Straub, 2014). A women may be
more prone to headaches (migraines) then men. “Surveys of
American adults suffering chronic lower back pain,
postoperative dental pain and other pain syndromes have shown
significant differences in the level of pain reported by
Americans of African, Hispanic, Asian, and European descent
(Faucett and others, 1994)” (Straub, 2014, p. 434).
5
Psychogenic Pain
Behavioral Pain Theory
(Bing, 2014)

6. Even though the pain is real, mental disorders can play a “role
in intensifying the pain” (Psychiatric Disorders, 2014, p. 1).
Psychogenic pain can increase with mental disorders, such as
depression, stress, bipolar disorder, obsessive-compulsive
disorder, panic attacks, and more (Psychiatric Disorders, 2014).
Some people have increased mental problems, he or she may
have increased psychogenetic pain. A depressed person may
feel more lower back pain, increased headaches. Severe
stomach pain can be a person’s nerves, stress, or other mental
health problems. Behavioral therapy can help a person focus on
the particular situation instead of the pain. “Behavioral theory
claims that neither kind of pain is an internal process-that both
are overt behaviors (Ruchlin, 1985, p. 43).
6
Evidence-Based Interventions
Gate Control Theory
Medications
NSAIDs
Surgery
Acupuncture
Massage Therapy

7. Gate control theory deals with the spinal cord sending signals to
the brain about pain some treatment options would be
medications such as NSAIDs that would lower inflammation and
irritation it will give relief and reduce the amount of pain.
Surgery would be another treatment plan yet it is something that
is to the extreme. Surgery is aimed towards eradicating the
source of pain. Other options that are less invasive are
massages. They would stimulate the blood flow relieve the
muscles and increase somatosensory information that would be
sent to the gate control. Stimulation/acupuncture can stimulate
the nerve cells that release endorphins and increase stimulation
that gets close to the pain which sends signals to the gate.
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Evidence-Based Interventions cont.
Behavioral Pain Theory
Changing a persons experience about pain
Setting goals to focus on factors of pain
Sense of control over pain
Responding to pain triggers
Increase exercise and activity levels
When it comes to behavioral pain cognitive behavioral therapy

8. would be the treatment plan used to help rebuild ones behavior
towards pain. Changing the individuals experience with the pain
with new ways of thinking and responding to pain would be one
way. Another is focusing on certain factors of pain and setting
some goals on changing those factors. Teaching the individuals
new ways of having a sense of control over pain and having
self-efficacy and teaching one new skills to respond to pain
triggers. My first option would be to increase activity levels and
exercise in order to relieve pain and inflammation the body
maybe experiencing.
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Psychogenic Pain
Psychotherapy
Talk therapy
Pain coping training
Relaxation therapy
Stress management
Antidepressants
Non-narcotic pain killers
over the counter pain relievers
Reduces inflammation
Swelling
Irritation
Evidence-Based Interventions cont.
Psychogenic pain can consist of some mental and emotional
problems that can interfere with one’s pain. The treatment
options for psychogenic pain are psychotherapy that include
talk therapy, pain coping training, relaxation therapy, and stress
management. Anti depressants re also used to help individuals

9. with their pain associated with their emotional and mental
symptoms. Lastly non-narcotic pain killers such as over the
counter pain relievers can help reduce inflammation that Is
associated with the swelling and irritation. For the treatment
plan using the non-narcotic pain killers with the psychotherapy
treatments would be best for someone who experiences
psychogenic pain. This would help one not have to deal with
pain medications that become addicting and helps relieve some
of the pain until they learn how to fix it with the psychotherapy
treatment options.
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Conclusion
Theories of Pain
Pain Disorders
Evidence-based Interventions
Treatment Planning
Measuring pain is not an easy task since it is considered an
subjective experience. According to Straub (2012) “Pain is a
major public health problem, affecting more than 50 million
American, costing over $100 billion annually” (p. 418). Pain
sends a signal letting a person know that something is not right
or to precede with caution. There are several types of pain
experienced such as acute, recurrent, and chronic. Pain can be

10. measured through physical, behavioral, and self-reports
measures. Several theories are used to explain pain perception
that consist of the gate control theory and behavioral theory.
The gate control theory put forth by Melzack and Wall is the
idea that physical pain is not a direct result of activation of pain
receptor neurons, but rather its perception is modulated by
interaction between different neurons. The behavioral theory of
pain, this theory depends on the premise that all kinds of human
behaviors are basically acquired via conditioning. It also
suggest that a persons rate of success is based on the way they
may behave. Psychogenic pain is a pain disorder that is
associated with psychological factors. Some forms of mental or
emotional problems can contribute or cause pain as well as
prolong it symptoms. A person with psychogenic pain may
complain of pain that does not match his or her symptoms.
Psychogenic pains can take the form of headaches, muscle
pains, back pain and stomach pains. The diagnosis of
psychogenic pain is made only when all other causes of and for
pain are ruled out. Evidence-based intervention for psychogenic
pain consist of psychotherapy, anti-depressants, and non-
narcotic pain killers.
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References
Straub, R. (2012). Health Psychology: A biopsychosocial
approach. Worth Publishers
Srivastava, A. (2010). Pain: Physiological Consideration.
Homeopathic Journal, 3(9). Retrieved from
http://www.homeorizon.com/homeopathic-
articles/Neurology/pain-physiological-consideration
Deardorff, W. (2003). Modern ideas: The gate control theory of
chronic pain. Retrieved from http://www.spine-
health.com/conditions/chronic-pain/modern-ideas-gate-control-
theory-chronic-pain
Psychiatric Disorders, (2014). Information on psychiatric

11. disorders and mental health issues
http://psychiatric –disorders.com
Ruchlin, H. (1985). Pain and Behavior. Behavioral and brain
Sciences 8(1) p. 43-53
doi://http://dx.doi.org/10.1017/2014/0525X00019488
Howard Rachlina1
a1 Department of Psychology, State University of New York at
Stony Brook, Stony Brook, N.Y. 11794
Diagram retrieved from
http://www.homeorizon.com/homeopathic-
articles/Neurology/pain-physiological-consideration
Clip Art retrieved from http://www.bing.com
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