I see you’re in pain – The effects of partner validation on emotions in people with chronic pain

Abstract

Background and aims Chronic pain not only affects the person in pain, but can also have a negative impact on relationships with loved ones. Research shows that chronic pain is associated with difficulties in marital relationships, which in turn is related to a variety of negative outcomes such as psychological distress and conflict within the family. This suggests that couples where chronic physical pain is present also struggle with emotional pain and relationship problems, and thus targeting relationship skills and interpersonal functioning might be helpful for these couples. Although studies in this area are promising, their numbers are few. In the present study, validation as a way of communicating is suggested for handling emotional expression in interpersonal interactions. Validation communicates understanding and acceptance of the other person's experience, and it has been shown to have a down-regulating effect on negative emotions. It has previously been demonstrated to be important for these couples. However, the feasibility and effects of increasing partner validation in these couples are unknown. Therefore, the aim of the present study was to investigate if a brief training session in validation for spouses would result in more validating and fewer invalidating responses towards their partners with pain, and to investigate if changes in these behavioural responses were associated with changes in emotion and pain level in the partner with pain. Methods Participants were 20 couples where at least one partner reported chronic pain. The study employed a within-groups design in which spouses of people with pain received validation training (without their partner's knowledge), and their validating and invalidating responses were rated pre- and post-intervention using a reliable observational scale. Also, positive and negative affect and subjective pain level in the persons with pain were rated pre- and post-intervention. Results Results showed that the validation training was associated with increased validating and decreased invalidating responses in the partners. Their spouses with chronic pain reported a decrease in negative affect from pre- to post-training. Conclusions Our results indicate that the partner or closest family member, after brief validation training, increased validating responses and decreased invalidating responses towards the person with pain, which had an immediate positive impact on emotions in the other person. Implications This study suggests that using validation in interpersonal interactions is a promising tool for couples where chronic pain is present.

Couples coping with chronic pain: How do intercouple interactions relate to pain coping?

“…In line with the model, validation training was in a recent study found to increase the frequency of validating responses while decreasing invalidating responses, and this had a positive effect on emotions in the person with pain [2]. Further, a significant association was in another study found between invalidation from the partner and pain disability [37].…”

“…A few studies on validating and invalidating partner responses have recently been presented. Findings indicate that validation is associated with decreases in negative affect [2] and that invalidation is associated with higher pain disability [37]. As it leads to opposite predictions from those of the operant model when it comes to the effect of negative/invalidating partner responses, the model might explain some of the mixed results observed within the operant framework.…”

“…Including the partner in treatment programs has been suggested, for instance by having partners attend a validation training program [2]. Such programs could be more successful if we understood how specific aspects of intercouple interactions relate to the patient's pain experience and coping.…”

Importance for patients of feeling accepted and understood by physicians before and after multimodal pain rehabilitation

“…This study adds to the growing body of literature which implicates the value of validation in the context of chronic pain; validating feedback (or at least lack of invalidating feedback) has been found to increase emotional wellbeing [4], reduce physiological arousal [5,6], increase pain tolerance and adherence [7], reduce ratings of pain intensity and frustration [8] and counteract the interference caused by pain catastrophizing on individuals' ability to recall information [9] compared with invalidating feedback. Thus, communicating understanding and acceptance in the context of pain, may have worthwhile and far-reaching consequences.…”

Reversal of the Norm: Pressure Discrepancies on the Two Sides of the Septum in Chronic Kidney Disease Patients with Congestive Heart Failure

“…Further research is needed on how to implement such elements in psychological treatment; there are examples in the literature of psychological interventions that include training in validation for partners [55,56]. Similar interventions have been implemented in medical contexts, in which people who were suffering from medical conditions such as long-term pain showed more favorable emotional outcomes when their partners received training in validation [57]. Hence, training partners in emotional communication and possibly implementing communication training to an extended social network and even medical professionals might be helpful for infertile women and might influence their sense of social support.…”