Reducing Irrational Beliefs and Pain Severity in Patients Suffering from Non-Cardiac Chest Pain (NCCP): A Comparison of Relaxation Training and Metaphor Therapy

Abstract

BackgroundPatients suffering from non-cardiac chest pain (NCCP) can interpret their chest pain wrongly despite having received a correct diagnosis. The objective of this study was to compare the efficacy of the relaxation method with metaphor therapy for reducing irrational beliefs and pain severity in patients with NCCP.MethodsUsing a randomized controlled trial, 33 participants were randomly divided into a relaxation training group (n= 13), a metaphor therapy group (n = 10), and a control group (n = 10), and were studied for 4 weeks. The two tools used in this research were the Brief Pain Inventory (BPI) index for determining the degree of pain and the short version of the Jones Irrational Belief Test. Metaphor therapy and a relaxation technique based on Öst's treatment were used as the interventions. The collected data were analyzed with a multivariate analysis of covariance (MANCOVA), a Chi-square test, and the Bonferroni procedure of post-hoc analysis.ResultsThe relaxation training method was significantly more effective than both metaphor therapy and the lack of treatment in reducing the patients' beliefs of hopelessness in the face of changes and emotional irresponsibility, as well as the pain severity. Metaphor therapy was not effective on any of these factors. In fact, the results did not support the effectiveness of metaphor therapy.ConclusionsRegarding the effectiveness of the relaxation method as compared with metaphor therapy and the lack of treatment in the control group, this study suggests that relaxation should be paid greater attention as a method for improving the status of patients. In addition, more studies are needed to determine the effectiveness of metaphor therapy in this area.

Psychological symptoms predicted chest pain intensity and discomfort in cardiac rehabilitation patients

“…In line with the results of several studies regarding the relationship between psychological symptoms and pain severity and discomfort in patients with noncardiac chest pain,[4567] our results showed that psychological symptoms are an important factor in the pain severity and discomfort experienced by cardiac patients. According to the results, anxiety is the most important factor in the pain severity and discomfort experienced by patients.…”

Those who perceive their disease as a physiological or psychological risk factor experience more anxiety at the beginning of the cardiac rehabilitation program

“…Meanwhile, enhancing patients' knowledge about their illness can alter their perception and, thus, maximize treatment benefits (9) and receptivity to intervention (18). Moreover, encouraging perceived control over the current situation and discouraging maladaptive beliefs (19) can confer positive internal and external changes in cardiac patients. Although we controlled for educational level as a variable in the statistical analyses, one of the main limitations of this study was that illiterate individuals accounted for 36% of the study population.…”

Cognitive Restructuring Based on Metaphor Therapy to Challenge the Irrational Beliefs of Drug Addicts Undergoing Buprenorphine Treatment

“…In line with the recommendation of Bahremand et al (21) and Sahebi (22,25), IMT was conducted in ten sessions of one hour duration in such a manner that in each session, two metaphoric stories corresponding to one of the irrational beliefs were presented to the patient and he was requested to establish a relationship between the metaphor and his thoughts, emotions, and behaviors, especially those related to drug addiction. At the end of each session, the patient was provided with behavioral assignment forms and he was requested to review the metaphors in his mind every day.…”

“…Although extensive cognitive interventions are used worldwide to change the attitudes of patients, individual metaphor therapy (IMT) is one of the methods less commonly studied (21). Stories, myths, and allegories are all regarded as factors involved in the correction, restructur-ing, and treatment of attitudes, and they play a prominent role in solving the internal conflicts of humans (22).…”

“…On the other hand, consistent with the finding of Powell et al (45) that IMT does not affect the promotion of self-concept, the findings of this research revealed that IMT has no significant effect on the reduction of beliefs such as blame proneness, emotional irresponsibility, problem avoidance, dependency, and hopelessness regarding change. Additionally, the results of a previous study (21) showed that IMT is not effective in reducing irrational be-liefs. One reason for this could be the content of stories and metaphors being presented in such a way that they could not transfer their message well.…”