Chronic Pain & Somatic Symptoms
Somatic Symptom and Related Disorders (DSM-5-TR)
Persistent pain or somatic symptoms with significant psychological components. Includes somatic symptom disorder, illness anxiety, and chronic pain conditions. CBT for chronic pain, clinical hypnotherapy, and acceptance-based approaches have evidence.
Prevalence: ~20% of adults have chronic pain; ~5-7% high-impact chronic pain
20 Therapeutic Approaches
Sorted by evidence tier: guideline-recommended first, then RCT-supported, then emerging/limited evidence.
Guideline-Recommended (2)
RCT-Supported (14)
Somatic
Biofeedback
Various (Sterman / Schwartz / Green) · 1960
Cognitive-Behavioral
CBT
Aaron Beck · 1964
Cognitive-Behavioral
CBT-I
Spielman / Perlis · 1987
Trauma-Focused
EMDR
Francine Shapiro · 1989
Cognitive-Behavioral
iCBT
Various (Andersson / Titov) · 2000
Psychoanalytic
ISTDP
Habib Davanloo · 1980
Effect: d = 0.68
~40-50% improvement
Psychedelic
KAP
Various (Wolfson, Bennett) · 2010
Integrative
MBSR
Jon Kabat-Zinn · 1979
Effect: g = 0.33
~25-35% pain reduction
Expressive
Music Therapy
Nordoff / Robbins · 1950
Psychoanalytic
Short-Term Psychodynamic
Davanloo / Sifneos / Malan · 1968
Trauma-Focused
Brainspotting
David Grand · 2003
Expressive
Dance/Movement Therapy
Marian Chace · 1942
Integrative
EFT Tapping
Gary Craig · 1995
Somatic
Somatic Experiencing
Peter Levine · 1997
Related Clinical Vignettes
Panic & Avoidance
Maya, 29, marketing manager
10 formulations
Treatment-Resistant Depression
Sofia, 38, software engineer
7 formulations
Men's Masked Depression
Marcus, 36, firefighter
8 formulations
Late-Life Depression & Meaning
Harold, 74, retired engineer
6 formulations
OCD & the Meaning of Obsessions
Nathan, 26, seminary student
6 formulations
Complex Relational Trauma
Darius, 34, veteran, currently unemployed
11 formulations