Gestalt therapeutic practice, physiotherapists and people with chronic pain: a literature review

My interest in chronic pain started very early in my career as a physiotherapist. Chronic pain is widespread in our community with one in five people affected under 65 and one in three over 65 (Blyth, March, Nicholas, and Cousins, 2005; Vos, et al., 2012). Chronic pain can be a significant source of suffering and distress and can have a profound impact on a person's life. People with chronic pain find their way to many different health care professionals but are considered difficult to treat by some due to the anger, distress and suffering often exhibited (Halpern, 2014). Also, many physiotherapists and other health professionals avoid contact with people who have chronic pain due to their own emotional reactions and responses (Synnott, O'Keeffe, Bunzli, Dankaerts, O'Sullivan, P., and O' Sullivan, K., 2015). This is despite the evidence showing that people with chronic pain respond to a comprehensive and relational approach, where the person with chronic pain is seen, validated and their lived experiences understood (Cohen and Quintner, 2011; Main and George, 2011; Nicholas and George, 2011). Until I did my training as a Gestalt therapist I often felt anxious or uncertain in the face of a client's suffering from chronic pain. My training provided me with clearer understanding, insight, empathy and compassion into my own and the others responses that now allows me to engage more fully with people with chronic pain. Patient outcomes are improved with a deeper engagement and this has been shown to minimise disability (Edwards, Jones, Thacker, and Swisher, 2014; Nijs, Van Wilgen, Van Oosterwijck, Van Ittersum, and Meeus, 2011). The following literature review has emerged from my experiences as a physiotherapist who works with Gestalt therapy, theory and practice to understand the meaning people with chronic pain make of their pain experiences and how my understanding supports their recovery.