Psychological Flexibility for Chronic Physical-Sexual Pains Based on ACT Psychotherapy in Women with Breast Cancer

Chronic postsurgical pain (CPSP) is a common postoperative adverse event affecting up to half of women undergoing breast cancer surgery, while epidemiological studies have prospectively investigated the role of preoperative, intraoperative, and postoperative risk factors for pain onset and chronicity, if half of women report pain persisting for 1 to 2 years after breast cancer surgery (Bruce et al.,2013). Thus, the present study investigates ACT-based psychotherapy in psychological flexibility of women and its impact on their physical and sexual chronic pains.Material and Methodology:Among 37 volunteer cancer-suffering women who had undergone surgery for 1-2 months (high school or above, below 55 years old), 16 patients were randomly selected and put into two 8-person groups (experiment and control). Pretest and posttest was administered to them using questionnaire PASS-20 (20-item self -report instrument investigating 4 factors of anxiety, cognition, fear, avoidance, and physiology) and the Multidimensional Sexual Self-Concept Questionnaire (Fisher and Snell,1995) and pain severity checklist from zero (no pain) to 10 (maximum pain). Control group underwent 6 sessions (4 individual sessions and 2 group-therapy sessions) of psychotherapy with acceptance and commitment therapy(ACT) approach.Findings Findings indicate that women of experimental group were able to create in themselves psychological flexibility-related changes (decreased depression, pain-associated anxiety, physical, psychological, and sexual disability using acceptance and commitment therapy which has 4 processes of flexibility (pain acceptance, value-based action, psychological acceptance, awareness) and also benefited from higher sexual self concept.Conclusion: Since ACT-based psychotherapy using the process, connection with the present moment, consciously acceptance, investigation of values and discovering of new solutions, and implementation commitment leads to patients’ increased psychological flexibility and enjoys better physical and sexual conditions with more awareness regarding life at the present moment and experiential avoidance of pain, hope of finding new solutions along with therapist and decreased fears due to facing fear in real life, they achieve increased life quality and more satisfaction, thus besides necessary medical treatments, use of this method of psychotherapy can be effective in improving and increasing the life quality of these women.