How Cognitive Behavioral Therapy Can Help with Managing Chronic Pain

You have likely heard of Cognitive Behavioral Therapy as a treatment for people who are suffering with anxiety and panic disorders, or with moderate to severe depression. While CBT was originally developed for emotional disorders, it may surprise you to learn that this approach can also be helpful for people with chronic pain from conditions like fibromyalgia or diabetic neuropathy. Here are some things you need to know about this type of treatment, how it can help with the pain, and why it works well in tandem with other methods.

Understanding the Basics

The underlying premise associated with CBT is that the range of negative emotions triggered by your health issue magnifies the pain you are experiencing. For example, the fact that you are living with fibromyalgia every day of your life leads to feelings of isolation, remorse, anger, and a host of other negative reactions. While it’s perfectly understandable that you would experience these and other emotions, they are actually making the pain worse.

Choosing to see a therapist and engage in a series of treatments using CBT is intended to help you gain more control of your emotions. As you begin to eliminate them one by one, that leaves room for more positive thinking. While your pain does not go away completely, you find that it interferes with your life less, and you find it easier to manage.

3 Domains of CBT

Thoughts

The thinking that goes on inside is the cognition domain and refers to all that happens inwardly, such as thoughts, images, memories, dreams, beliefs, attitudes, and where attention goes. All of these can contribute to negative thinking.

Feelings

This includes emotional and physical feelings and how an individual might understand and cope with them. Emotions can cause symptoms such as sleep disturbances, fatigue, and eating changes.

Behavior

This domain includes the way in which thoughts and feelings might make a situation worse, such as avoiding certain activities that would help to improve mood. It might also include the behavior that only leads to worsening mood, feelings, and thoughts, such as ruminating or berating oneself.

The way one responds to circumstances in life can have an influence on mood and feelings and thoughts. For instance, if Timothy was let go from his job after 14 years, he could either experience depressive thoughts, such as thinking that they no longer needed him or that he was letting his family down. Of course, this in turn would trigger certain feelings such as depression, discomfort, and hopelessness. And this in turn might lead to avoiding friends and family or activities he used to enjoy. And, of course, all of this could contribute to the experience of chronic pain.

However, he might see it as an opportunity to make a change in his life. He might have a positive thought about all the skills he has acquired over the years and how he can apply them elsewhere. As a result, he might feel optimistic, excited, and motivated, and he might start behaving in ways to acquire that new opportunity such as networking, planning for the future, and building a new career.

The difference in this example began in the way that Timothy inwardly responded to his circumstances. CBT would assist Timothy in finding the thoughts that might have led to depression or anxiety or stress, all of which can lead to chronic pain, and change those towards positive ones in order to change his life.

CBT in Action

In order for the treatments to have effect, it’s necessary for you to identify the emotions that are complicating your condition. As is true in many aspects of life, a problem that is given a name is easier to address than one that remains unknown or at least a little fuzzy in the mind. As part of the time you spend with the therapist, you will learn to examine each emotion as it appears.

Perhaps you suffer with a lot of discomfort in your feet and lower legs thanks to the neuropathy brought on by your type 2 diabetes. The stinging sensation coupled with areas that are numb leave you feeling discouraged and somehow less of a person. The therapist will have you zero in on those negative thoughts and consciously make the effort to replace them with positive ones. In this scenario, instead of discouragement and a sense of being inferior, you will seek to remind yourself that you still have all of your toes, you can still walk, and that your mind is just as sharp as it ever was. In other words, the pain triggered by the neuropathy is not enough to control every aspect of your life.

Using It For Pain Management

The use of cognitive behavioral therapy for pain management has three basic components:

Making the Connection

The first is helping patients understand the connection between thoughts, emotions, and their pain. This in turn can empower a patient to have more control over the pain they experience.

Coping with Pain

The second part of using CBT for pain management is providing coping techniques to use when pain becomes intense. Some of these coping mechanisms are relaxation techniques and the use of cues that immediately bring on a relaxed state. Using these tools can help to decrease muscle tension, reduce emotional stress, and divert attention away from stress. This also includes helping a patient find the thought pattern that contributes to the pain. Monitoring and documenting thoughts helps to easily identify the connections between them and the specific reactions to certain events in the day. For instance, if John wasn’t able to meet the expectations of his boss, and as a result had the thought, “I am worthless,” this might lead to feeling shameful and perhaps to worse pain in the body. Replacing thoughts with those that are more life affirming can facilitate pain relief.

Problem Solving

This component of CBT is the application of skills in daily life. For instance, learning when to use the techniques learned when pain flares up and becomes intense. Clinicians and patients might develop a plan together in order to manage chronic pain while not in treatment.

Cognitive Behavioral Therapy can be an essential ingredient in pain management.  In fact, it is widely being used for a variety of physical and psychological illness, in addition to facilitating mental wellbeing, reducing anxiety, minimizing depression, and managing emotional and physical pain.

Progress and Setbacks

Like any type of treatment for physical or mental distress, CBT does not make everything all better after one or two treatments. You may experience setbacks along the way. Don’t beat yourself up if discarding negative thinking does not come easy at first. Many people require time to make the transition to a more positive frame of mind.

When you do have a day when it seems that no amount of effort has an impact, tell your therapist all about it. You will most likely be reminded of the days when you were able to reverse your thought processes and the pain was easier to manage.

Remember that CBT does not cure the underlying physical cause of the pain. That’s not its purpose. What it will do is provide you with a powerful tool that helps lessen the pain and its impact on your life. You will still make use of medication to deal with the underlying symptoms, although you are likely to find that the need to take something specifically for the pain will diminish.

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