Our search for different ways to treat pain has led us to some very questionable treatments. Prescription opioids are among the most questionable. But then there are also psychotherapeutic treatments, like cognitive behavioral therapy (CBT). Do they really work?
Chronic pain is one of the most profound medical conditions in modern medicine. An estimated 21% of adults are experiencing chronic pain at any given point in time. That means one in five people you interact with on a daily basis are experiencing some level of persistent pain. Those with the worst pain may reach the point at which they are willing to try anything. Even CBT is on the table.
CBT Is a Talking Therapy
The first thing to know about CBT is that it is a talking therapy. Patients and therapists spend their weekly sessions talking things through. CBT can be offered on its own, but pain management doctors are more likely to recommend combining it with other therapies and strategies.
You might also be interested to know that CBT was originally developed as a psychotherapeutic treatment for alcohol and drug addiction. It has proved moderately successful over the years. When pain medicine doctors began looking into it, they discovered they could apply the same principles to treating chronic pain.
CBT’s Core Principles
CBT is built on three core principles. First, thought patterns inform behaviors. Second, both thoughts and behaviors influence how a person feels physically, mentally, and emotionally. Third, altering patterns and behaviors can change the way a person feels.
The two main goals of CBT, regardless of the setting, are to identify negative thoughts and behaviors and then modify them to improve the outcome. So in a drug addiction scenario, a therapist wants to help the patient uncover those negative thoughts and behaviors that contribute to the addiction experience. Once identified, both can be modified in order to combat addiction.
Alongside modified thoughts and behaviors are coping mechanisms. It is necessary to introduce such mechanisms because modifying thoughts and behaviors does not always lead to full and complete recovery. Outcomes may be better, but still not optimal.
CBT as a Pain Treatment
Pain medicine doctors who believe CBT is an appropriate tool for managing pain understand the intrinsic link between what a person thinks and how he feels. As just one example, negative thoughts create stress in the brain. Under stress, the brain releases certain chemicals that can enhance pain signals. So a chronic pain patient under stress almost always feels worse.
Reducing stress also reduces the brain chemicals associated with it. Pain signals are less pronounced, and the patient feels better. Although my description is an oversimplification of the concept, it still illustrates how CBT can be used to alleviate pain.
Helping people change what they think about pain can help them modify their behaviors. Combining positive thoughts with new behaviors makes it easier to avoid situations that exacerbate pain. The end result is less pain overall.
Combining CBT With Other Strategies
The pain medicine specialists at KindlyMD, a Utah organization that runs multiple health clinics, say it is often best to combine CBT with other strategies. In their case, they might recommend plant-based medicines accessible through a Utah Medical Card. They might also recommend physical therapy, yoga, or relaxation techniques.
To the extent that CBT can help alleviate pain, it is all about changing thought patterns and behaviors. It is rooted in the understanding that what a person thinks about pain impacts what he actually feels, both directly and indirectly. Change thought patterns and you change how a person feels.
