Alexithymia and cancer pain: The effect of psychological intervention

Background: Alexithymia is likely to be involved in the pain experience of cancer patients, but the extent to which psychological interventions may modify both pain and alexithymia is unclear. Methods: A group of 52 consecutive cancer patients were enrolled in a 6-month multicomponent psychological intervention trial, and compared to 52 control patients who received standard medical care. Validated scales for pain, alexithymia, coping with disease, illness behavior, psychological distress, and psychosocial functioning were administered at baseline and 6 months later. Results: Pain was strongly associated with alexithymia and several psychological dimensions. Although at baseline patients in the intervention group had worse psychological and somatic health, at follow-up their level of pain intensity, alexithymia, and somatic concerns had significantly improved compared to control patients. Patients in the intervention group showed dramatic improvements in pain perception, alexithymia, and other psychological variables, while control patients showed an unexpected significant worsening of alexithymia, depression, and adjustment to disease. Multiple regression showed that psychological intervention and alexithymia were both independently associated with the reduction in pain perception. Conclusions: These findings confirm the close association between alexithymia and pain, and show that multicomponent psychological intervention may significantly reduce both alexithymia and cancer pain. Although the present findings need replication, they should strongly encourage clinicians to provide patients with psychological interventions targeting alexithymic difficulties and helping patients to cope better with both feelings and somatic perception.