Cognitive-Behavioral Therapy For Pain Management

Submitted by tomrue on

People who live with chronic pain sometimes endure chronic suffering. Some try a number of different medications (opioids, antidepresants, muscle relaxants, etc.) which can help.

Certain medications are especially prone to causing dependence or being over-used because the their brain builds tolerance and higher doses are required for relief.

Others may take the medication precisely as medically directed, or even try major surgery, and still have trouble getting through the day or night.

I strongly encourage anyone who suffers from chronic pain - whether it results from an injury or a congenital deformity (for example, scoliosis), depression, or other reasons to start by seeing a Medical Doctor who specializes in treatment of pain managementm for a diagnosis and to determine the best course(s) of treatment.

Normally, pain is healthy and necessary for survival. It is not a bad thing; it is an essential "alarm" system built into the body to alert us that something is wrong. However, sometimes it seems like it will never go away. There are always ways to either make chronic pain lessen, or else find ways to cope with it. The chances are very slim, however, that either can be done without help from healthcare professionals.

Evidence based practices in counseling and psychotherapy are known to help bring changes in the patient's experience of pain, who can learns to return to a lifestyle allowing enjoyment of life's pleasures. One of the most commonly used forms of therapy or counseling to aid in lessening of chronic pain is Cognitive Behavioral Therapy.

CBT is not new. Some of the fundamental aspects of CBT have been identified in various ancient philosophical traditions, particularly Stoicism.[1] Aaron Beck's original treatment manual for depression states, "The philosophical origins of cognitive therapy can be traced back to the Stoic philosophers".[2]

The particular therapeutic techniques vary within the different approaches of CBT according to the issues being addresed, but when the target issue is pain, techniques may include keeping a diary of significant events and associated feelings, thoughts and behaviors; questioning and testing beliefs (cognitions), assumptions, evaluations and beliefs that might be unhelpful and unrealistic; gradually facing activities which may have been avoided; [3] and trying out new ways of reacting. Relaxation, mindfulness and distraction techniques are also commonly included.[4]

"Patients should think of themselves as being a part of the solution".

If you suffer from any physical condition that includes chronic pain as a symptom, or know anyone who does, I recommend these sites, supported by the National Institutes of Health:

  • Pain In Action includes reading material on alternatives for medication management and an online peer support group
  • PainEDU.org clinically oriented, free multidisciplinary CME

A few other accredited websites include the following. Note that some are supported by pharmaceutical companies, but an aware reader will be able to assess what is useful.

If your pain is severe enough that you are seeking medical help for it, it might make sense to try more thann one approach.

If you would like to meet with me for CBT counseling about reducing and dealing with chronic pain, please schedule an appointment.

Footnotes

  1. Robertson, D (2010). The Philosophy of Cognitive-Behavioural Therapy: Stoicism as Rational and Cognitive Psychotherapy. London: Karnac. ISBN 978-1855757561.
  2. Aaron T. Beck MD, A. John Rush MD, Brian F. Shaw PhD, Gary Emery (1979) Cognitive Therapy of Depression, p. 8.
  3. Mayo Clinic (2008), website, Chronic pain can interfere with sexuality, 12/13/2008.
  4. Jon Cabot-Zinn (1994) Where Ever you Go There You are, New York: Hyperion, ISBN 0-7868-8070-8