Encouraging Emotional Awareness, Expression of Life Stress in Women With Chronic Urogenital Pain

An intensive life stress emotional awareness expression interview may improve physical but not psychological symptoms in women with chronic urogenital pain, according to a study published in Pain Medicine.

Researchers developed a 4-phase life stress interview to determine whether women with chronic urogenital pain could derive benefits (somatic and/or psychological) from disclosing stressors and gaining awareness of the links between stress, emotions, and symptoms.

A total of 62 patients (average age, 45) from a multidisciplinary women’s urology center were randomly assigned to receive a single 90-minute life stress interview or treatment as usual. Participant were asked to self-report pain severity, pain interference, pelvic floor symptoms, and psychological symptoms (eg, anxiety and depression) at baseline and 6 weeks after the intervention. Demographic characteristics were comparable between groups at baseline, with the exception of higher baseline pain interference and depression in the control group (P =.006 for both).

During the interview, patients were asked to report significant medical conditions, stressful or traumatic life experiences (eg, neglect or physical and/or sexual abuse), and to share 2 important relational emotions (eg, empowerment, autonomy, connection). The patients then reflected upon what they had learned about themselves through the interview and were given information about the relationship between emotions, emotional suppression, and health.

The interview vs control condition was associated with lower pain severity (P =.038) and reduced pelvic floor symptoms (P =.006 vs P =.93, respectively). At the 6-month follow-up, pain interference (P =.62), anxiety symptoms (P =.30), and depression symptoms (P =.66) were comparable in both groups.

Study limitations include the absence of active control conditions (ie, an emotionally neutral interview).

 “[This study] provide[s] evidence that emotion-focused and experientially-based techniques may also be effective for various chronic pain conditions,” noted the study authors.

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Carty JN, et al. The effects of a life stress emotional awareness and expression interview for women with chronic urogenital pain: A randomized controlled trial [published online October 1, 2018] Pain Medicine. doi:10.1093/pm/pny182