Counselling for TMJD
Orofacial pain refers to the trigeminal system affecting the face, jaw, mouth and neck. It is associated with dental problems, nerve disorders and most commonly, TMJ dysfunction. Orofacial pain shares certain characteristics with other chronic pain conditions such as symptoms, physical findings, greater prevalence amongst women and significant psychological distress (Rollman et al, 2012). Often, chronic pain can lead to depression and anxiety.
Mental health and chronic pain coexist in a vicious cycle which takes great emotional toll, impacting mood, energy and relationships. According to Rollman, et al. (2012), only half of the people who suffer with orofacial pain seek treatment for their complaints. The statistic surprised me as orofacial pain represents 20-25% of chronic pain conditions (orofacialpain.org) and can affect daily habits such as eating, drinking, speaking and sleeping. Conventional methods may help to relieve physical symptoms but how do we manage issues such as perceived stress which is known to increase clenching, grinding and other bruxism-related symptoms (Chemelo et al, 2020.). Tension from constant overuse of the jaw muscles can be reduced by exploring the impact of mental health conditions and understanding the relationship between chronic pain, stress and emotions.
Counselling can help empower individuals through a deeper understanding of their pain condition and the role which psychological factors play (Van der Meer, 2024). I work with acute and chronic TMJ patients to explore the root cause of unconscious tensing and identify held stress patterns through self-exploration. My work includes psychoeducation for clients to build on tools and resources, allowing them to develop a sense of agency and take action in easing their symptoms. Most people fail to notice their stress until the body sends signals via physical tension such as headaches, migraines or fatigue. Pain demands our attention which is why I encourage my clients to notice and name their stress before symptoms become chronic or debilitating.
Self regulation is a term applied to building a friendly relationship with the body (Van der Kolk, 2014). To lower arousal in a heightened nervous system, you may first need to build internal resources to safely access your vulnerable parts before any talking occur. As an integrative therapist, I work with the mind, body and emotion in a private and confidential space where you can build feelings of trust, rapport and safety through our therapeutic relationship. Eventually, your jaw may feel a permission to let go. I do not adhere to one single approach and respect the window of tolerance will vary from person to person. Therefore, I move authentically between different ways of working, depending on the individual client.
Further studies are needed on psychological interventions to highlight the benefits of counselling for TMJ Dysfunction (Van der Meer, 2024). However, through clinical observation and previous experience working with TMJ clients, I have witnessed the correlation between stress and TMJ Dysfunction. Therefore, my opinion is that counselling can be just as effective as other methods of treatment, particularly when included as part of a multidisciplinary approach.
References:
Chemelo, V.D.S., et al. (2020). Is There Association Between Stress and Bruxism? A Systematic Review and Meta-Analysis. Frontiers in Neurology. 11. DOI: 10.3389/fneur.2020.590779
Chronic pain. (no date). Orofacial pain.www.orofacialpain.org.uk. (Accessed on 19/07/2026)
Rollman A. et al. (2012). Care seeking for orofacial pain. J Orofac Pain. 26. 206-214. Accessed from: https://pubmed.ncbi.nlm.nih.gov/22838005/
Van Der Meer,H.A. (2024). Counselling for patients with a temporomandibular disorder: A scoping review and concept analysis. Journal of Oral Rehabilitation. 51. 11. pp.2484-2497. DOI: https://doi.org/10.1111/joor.13827
Van der Kolk, B. (2014). The Body Keeps The Score. Penguin. London:UK
