Effects of anger suppression on pain severity and pain behaviors among chronic pain patients: Evaluation of an ironic process model.

Abstract

Attempts by CLBP patients to suppress anger may aggravate pain related to their clinical condition through ironically increased feelings of anger.

Sustained Pain Reduction Through Affective Self-awareness in Fibromyalgia: A Randomized Controlled Trial

“…However, CBT emphasizes modifying maladaptive thinking and behavioral responses to pain, and typically either avoids patients' negative emotional experiences, or attempts to reduce negative emotions as directly as possible. In contrast, ASA emphasizes the value of approaching or confronting one's stressful experiences, developing awareness of one's emotions and motivations, and encouraging verbal rather than somatic expression 27,28,60 .…”

Pain-Related Rumination, But Not Magnification or Helplessness, Mediates Race and Sex Differences in Experimental Pain

“…Research suggests that emotional suppression, particularly anger suppression, is associated with worse pain 4,58,59 , whereas emotional disclosure, especially for high catastrophizers, is associated with positive pain-related outcomes 45,54,75 . Learning new ways to adaptively express their pain-related concerns (e.g., through structured written/emotional disclosure 45 ) may help high ruminators disengage from unhelpful "cognitive churning" and direct their attention and behavior to more valued life activities.…”

“…Similarly, catastrophizing has been found to mediate sex differences in pain intensity and pain 4 behavior 25,41,77 . To our knowledge, the relevant literature has treated catastrophizing as a unitary construct.…”

Anger Suppression Predicts Pain, Emotional, and Cardiovascular Responses to the Cold Pressor

“…In our prior investigations [26,27], we explored whether differences between suppression and control group on pain ratings were statistically mediated by group differences in pain-evoked anger responses. Here, we attempted to replicate this finding using self-reported suppression ratings as the predictor.…”

“…Further, significant variance in self-reported pain severity is accounted for by concurrent changes in anger and irritation, but not anxiety or positive emotion. The effects of suppression appear to extend to clinical pain as well [27]. Among chronic low back pain patients, suppression during an anger-provoking event predicted clinically relevant pain behaviors and self-reported pain severity during a subsequent standardized structured pain behavior task [28].…”