ÀNCORA: AN INTEGRATED PROTOCOL FOR CHRONIC PAIN MANAGEMENT BASED ON BIOFEEDBACK, MINDFULNESS, COMPASSION AND PSYCHOTHERAPY. CASE STUDY

L. Ferrante, G. Morabito | Mindful Sicilia, Centro Clinico Dolore, Catania, Italy

We present an innovative, integrated intervention for chronic pain management that combines biofeedback, mindfulness, compassion-focused practices, and psychotherapy, illustrating its application through a single-case study. Current literature confirms the individual efficacy of these modalities—specifically relaxation techniques, mindfulness, cognitive behavioral therapy, compassion-focused therapy, and biofeedback—in managing chronic pain. Our protocol synthesizes these distinct approaches into a sustainable, brief, and highly efficient treatment modality.
Method. The protocol is structured into three distinct phases. Phase One (Anamnesis and Psychoeducation): Sessions 1 and 2 involve gathering clinical, psychological, and pain histories, alongside psychometric and psychophysiological assessments. Session 3 provides pain psychoeducation, assessment feedback, and the implementation of an individualized treatment plan. Phase Two (Treatment): The protocol comprises a flexible number of individual sessions (minimum of five, tailored to patient needs) and two group sessions. Individual sessions aim to promote body awareness, differentiate between physical pain and psychological suffering ("clean" vs. "dirty" pain), and develop relaxation, emotional regulation, coping, and pain acceptance skills. Group sessions aim to cultivate “common humanity” to reduce shame, self-criticism, and secondary suffering. Phase Three (Conclusion and Follow-up): Focuses on defining a personalized pain management toolkit. While the individual components of this treatment have yielded excellent results, we describe the first patient to complete the full integrated protocol: a 24-year-old female diagnosed with migraine.
Results and Conclusions. Post-intervention, the patient reported reduced pain perception, enhanced pain management and relief, an increased sense of control, greater grounding during pain episodes, and heightened compassion toward the affected body part. Biofeedback sessions successfully targeted self-regulation, awareness, and pain tolerance. By integrating physiological data into mindfulness and compassion-based psychotherapy, biofeedback effectively visualizes processes that otherwise remain implicit within the therapeutic relationship. This integration facilitates somatic exploration, breathing techniques, and compassionate visualization, promoting a welcoming rather than rejecting stance toward pain. This study demonstrates promising results regarding the immediacy of clinical outcomes and the rapid establishment of a deep therapeutic alliance. Furthermore, this patient-centered approach enhances treatment adherence and self-efficacy.