Cognitive Behavioral Therapy (CBT) For Pain Management

By Linda Ritchie, PhD

Center For Life Strategies

. http://centerforlifestrategies.com/

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Cognitive Behavioral Therapy (CBT) For Pain Management

We have all experienced pain at some point in our lives. Pain is an indicator that something is wrong and for that purpose it is helpful. It is our body's way of screaming out to us, “Help! I'm hurt. I'm injured. Do something!”

Pain demands our attention. If you did not experience pain, you might seriously hurt yourself without knowing it, or you might have a medical condition that needs treatment and not realize there is a problem. Pain may be sharp or dull, may come and go or it may be constant. Regardless, nobody welcomes pain and anyone in pain will do almost anything to get rid of it.

In recent years, Cognitive Behavioral Therapy (CBT), a specific type of psychotherapy, has proven to be extremely effective in helping people manage chronic pain. CBT is problem-oriented, directive, and psycho-educational with the goals of changing thoughts, improving skills, and modifying emotional states. It is a collaborative approach to therapy with the therapist and the client working together to identify and solve problems.

Pain is processed in the brain and activates certain thoughts, memories and emotions. These thoughts, memories and emotions can have a significant impact upon the body's experience of pain.

There is a connection between our beliefs and thoughts and the functioning of our bodies. Self-defeating thoughts and beliefs can actually intensify pain. Thoughts such as “What's the use, I have tried everything and nothing works,” work to reinforce the pain cycle. This type of negative thinking has been shown to create very real physical chemical changes and constricted blood flow that further inhibits the body's ability to manage pain.

CBT focuses on the interaction of thoughts, feelings, and behavior. It helps people understand that their thoughts and behaviors affect their experience of pain and that they play a role in controlling it. It includes training in numerous pain coping strategies, such as progressive relaxation and visual imaging to help decrease muscle tension, reduce emotional distress, and divert attention away from the pain. Cognitive restructuring helps people identify, evaluate and respond to overly negative thoughts about their pain. A variety of techniques are used to change thinking, mood, and behavior.

It is not unusual for people experiencing chronic pain to also experience anxiety and depression. Effectively managing the symptoms of these conditions can decrease the impact of the pain and make it less bothersome.

Pain may be treated in a variety of ways depending upon its severity. Many times a multidisciplinary approach that includes a team of healthcare specialists such as a physician, physical therapist, psychotherapist, and chiropractor is needed.