The COMPASS framework for chronic pain and posttraumatic stress disorder: navigating the transition from threat to
Belle Zaccari1,2,3, Steffany Moonaz4, Marlysa B Sullivan5,6
1Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States.
Abstract:
Chronic pain and PTSD (CP + PTSD) have a high rate of co-prevalence. Existing frameworks and models have driven the development of few simultaneous treatment approaches, though the prevailing psychological models and treatments for this comorbidity are pathogenic, incomplete, and fail to consider the whole-person impact of CP + PTSD. This warrants consideration of novel treatment perspectives and approaches. Salutogenesis offers an alternative paradigm and is a transdiagnostic and transdisciplinary perspective that addresses the complex, multifaceted dimensions of CP + PTSD and supports whole-person well-being. We present the Connectedness, Optimism and hope, Mind-body regulation, Purpose and values, Awareness of the body, Self-efficacy, and Safety (COMPASS) framework to illustrate how a person with CP + PTSD can use yoga practices to navigate experiences perceived as threatening, in order to cultivate safety and resilience. The discussion highlights ways the COMPASS framework can be foundational to interdisciplinary care and utilized by healthcare and research professionals to deliver a whole-person approach to CP + PTSD. We conclude by suggesting next steps for applying COMPASS in clinical and research settings.
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