Cognitive behavioral therapy

[Guest guest]

HI, everyone,

Just my .02 on cognitive behavioral therapy and pain (aka CBT). First off, here is a great article about recent studies regarding CBT and chronic pain:

http://health.msn.com/womens-health/articlepage.aspx?cp-documentid=100165873 & page=1

Most of us have patterns of thought called "cognitive distortions." Here is a link to a list:

http://en.wikipedia.org/wiki/Cognitive_distortion

For example, "All or nothing thinking." In our case an example of these thoughts would be, "I will ALWAYS have this pain." or "I will NEVER get well again." "I will NEVER have a happy marriage or relationship, etc."

These distortions become habitual patterns of thinking, which actually CHANGE the structure of the brain in a way that is not helpful. These distortions also can impact your mood (ie-"My life will always be bad; I am a worthless person; something awful is going to happen I just know it will."). Your brain is changed to become stuck in these loops that can exacerbate and even cause chronic pain or depression or anxiety.

A psychotherapist trained in CBT will help you identify your distortions around pain (or depression or anxiety or whatever the presenting issue is) and challenge you to begin substituting the distortions with more rational, real thoughts.

Back to our example of a chronic pain patient. "I will never get well again." I would ask this patient, "Based on what evidence do you know that for sure? Miracles happen every day. You yourself have had significant progress in managing your pain. The longest a flare-up has ever lasted has been a month and then it's gone away, etc."

Another example with pain would be disqualifying the positive. Say a client comes in and they are very upset because they've had a flare-up. The distortion might be, "This flare-up means I'm back to square one. I'm never going to get well again. This will never go away." The distortions would be disqualifying the positive and all or nothing thinking. More helpful, rational thoughts might be, "My flare-ups are much fewer and far between. My pain level is significantly less than it was a year ago. I am doing things this month that I wouldn't dream of doing last month because my pain is better. Flare-ups may be part of the healing process and tomorrow might bring a pain-free day. Perhaps my pain will continue to reduce until it is gone."

As the client begins to come up with more rational, helpful, and adaptive habits of thinking studies show that the brain actually changes in response and MANY people have had a huge reduction in their pain.

It doesn't mean the pain is "all in your head" or that you're crazy, it just means that not only are you working to heal your body but you are also working to heal your mind. Since the mind is where pain is perceived it makes 100% sense to deal with that piece of the puzzle, too.

Another modality I use is this:

http://www.emdr.com/

Some clients need a bit of extra help, and experts think that EMDR gives the brain a bit of a jump start in healing issues such as trauma, depression, anxiety and even chronic pain.

I hope this helps and that it wasn't too much of a book. If anybody has questions, feel free to post or backchannel me.

I'm not writing this as mental health advice, just a bit of education on how CBT, EMDR, and psychotherapy can help reduce chronic pain.

Lindsey

[Guest guest]

Thank you SO much Lindsey....

That was great and certainly gives a good idea of just what CBT is and how it can help. Much appreciated. hugs hon

Dee

[Guest guest]

Thanks so much for taking the time to put that info together, Lindsey! I'm actually gonna take some time and study more about the main 10 cognitive distortions. I found your example of the first one, helpful. I'd say most people have 'some' distortions to some degree. Do you happen to have a list of examples for other nine? I like it when the examples are things you can relate to or understand better. I have scriptures that I am daily speaking out loud and meditating on. They are so comforting. They reinforce not only my faith, but the power behind that faith and my trust in the Lord that I will get passed all of this. Thanks again... ~ChelleLindsey wrote: HI, everyone, Just my .02 on cognitive behavioral therapy and pain (aka CBT). First off, here is a great article about recent studies regarding CBT and chronic pain: http://health.msn.com/womens-health/articlepage.aspx?cp-documentid=100165873 & page=1 Most of us have patterns of thought called "cognitive distortions." Here is a link to a list: http://en.wikipedia.org/wiki/Cognitive_distortion For example, "All or nothing thinking." In our case an example of these thoughts would be, "I will ALWAYS have this pain." or "I will NEVER get well again." "I will NEVER have a happy marriage or relationship, etc." These distortions become habitual patterns of thinking, which actually CHANGE the structure of the brain in a way that is not helpful. These distortions also can impact your mood (ie-"My life will always be bad; I am a

worthless person; something awful is going to happen I just know it will."). Your brain is changed to become stuck in these loops that can exacerbate and even cause chronic pain or depression or anxiety. A psychotherapist trained in CBT will help you identify your distortions around pain (or depression or anxiety or whatever the presenting issue is) and challenge you to begin substituting the distortions with more rational, real thoughts. Back to our example of a chronic pain patient. "I will never get well again." I would ask this patient, "Based on what evidence do you know that for sure? Miracles happen every day. You yourself have had significant progress in managing your pain. The longest a flare-up has ever lasted has been a month and then it's gone away, etc." Another example with pain would be disqualifying the positive. Say a

client comes in and they are very upset because they've had a flare-up. The distortion might be, "This flare-up means I'm back to square one. I'm never going to get well again. This will never go away." The distortions would be disqualifying the positive and all or nothing thinking. More helpful, rational thoughts might be, "My flare-ups are much fewer and far between. My pain level is significantly less than it was a year ago. I am doing things this month that I wouldn't dream of doing last month because my pain is better. Flare-ups may be part of the healing process and tomorrow might bring a pain-free day. Perhaps my pain will continue to reduce until it is gone." As the client begins to come up with more rational, helpful, and adaptive habits of thinking studies show that the brain actually changes in response and MANY people have had a huge reduction

in their pain. It doesn't mean the pain is "all in your head" or that you're crazy, it just means that not only are you working to heal your body but you are also working to heal your mind. Since the mind is where pain is perceived it makes 100% sense to deal with that piece of the puzzle, too. Another modality I use is this: http://www.emdr.com/ Some clients need a bit of extra help, and experts think that EMDR gives the brain a bit of a jump start in healing issues such as trauma, depression, anxiety and even chronic pain. I hope this helps and that it wasn't too much of a book. If anybody has questions, feel free to post or backchannel me. I'm not writing this as mental health advice, just a bit of education on how CBT, EMDR, and

psychotherapy can help reduce chronic pain. Lindsey

[Guest guest]

For anyone interested in pursuing this approach, a classic book on Cognitive Behavior Therapy is Feeling Good: The New Mood Therapy, by D. Burns, M.D. I first read it years ago andlast summer, after my relationship of four years ended and i had endless tapes running in my head, featuring thoughts like, " I'll never be in a relationship again, " " Noone will ever want to get involved with me at my age and with all my health issues, " " S. left me; therefore he must hate him and i must be unlovable, " " S. left me because i can't have intercourse, " etc. etc. etc., i went and picked up another copy. Identifying, challenging and rewriting all the distorted automatic thoughts we're constantly feeding ourselves is, i think, really crucial in dealing with the kinds of health challenges we all face.Thanks, Lindsey, for your synopsis!HollisThanks so much for taking the time to put that info together, Lindsey! I'm actually gonna take some time and study more about the main 10 cognitive distortions. I found your example of the first one, helpful. I'd say most people have 'some' distortions to some degree. Do you happen to have a list of examples for other nine? I like it when the examples are things you can relate to or understand better. I have scriptures that I am daily speaking out loud and meditating on. They are so comforting. They reinforce not only my faith, but the power behind that faith and my trust in the Lord that I will get passed all of this. Thanks again... ~Chelle Lindsey <gaia_ca (AT) yahoo (DOT) com> wrote: HI, everyone, Just my .02 on cognitive behavioral therapy and pain (aka CBT). First off, here is a great article about recent studies regarding CBT and chronic pain: http://health. msn.com/womens- health/articlepa ge.aspx?cp- documentid= 100165873 & page=1 Most of us have patterns of thought called " cognitive distortions. " Here is a link to a list: http://en.wikipedia .org/wiki/ Cognitive_ distortion For example, " All or nothing thinking. " In our case an example of these thoughts would be, " I will ALWAYS have this pain. " or " I will NEVER get well again. " " I will NEVER have a happy marriage or relationship, etc. " These distortions become habitual patterns of thinking, which actually CHANGE the structure of the brain in a way that is not helpful. These distortions also can impact your mood (ie- " My life will always be bad; I am a worthless person; something awful is going to happen I just know it will. " ). Your brain is changed to become stuck in these loops that can exacerbate and even cause chronic pain or depression or anxiety. A psychotherapist trained in CBT will help you identify your distortions around pain (or depression or anxiety or whatever the presenting issue is) and challenge you to begin substituting the distortions with more rational, real thoughts. Back to our example of a chronic pain patient. " I will never get well again. " I would ask this patient, " Based on what evidence do you know that for sure? Miracles happen every day. You yourself have had significant progress in managing your pain. The longest a flare-up has ever lasted has been a month and then it's gone away, etc. " Another example with pain would be disqualifying the positive. Say a client comes in and they are very upset because they've had a flare-up. The distortion might be, " This flare-up means I'm back to square one. I'm never going to get well again. This will never go away. " The distortions would be disqualifying the positive and all or nothing thinking. More helpful, rational thoughts might be, " My flare-ups are much fewer and far between. My pain level is significantly less than it was a year ago. I am doing things this month that I wouldn't dream of doing last month because my pain is better. Flare-ups may be part of the healing process and tomorrow might bring a pain-free day. Perhaps my pain will continue to reduce until it is gone. " As the client begins to come up with more rational, helpful, and adaptive habits of thinking studies show that the brain actually changes in response and MANY people have had a huge reduction in their pain. It doesn't mean the pain is " all in your head " or that you're crazy, it just means that not only are you working to heal your body but you are also working to heal your mind. Since the mind is where pain is perceived it makes 100% sense to deal with that piece of the puzzle, too. Another modality I use is this: http://www.emdr. com/ Some clients need a bit of extra help, and experts think that EMDR gives the brain a bit of a jump start in healing issues such as trauma, depression, anxiety and even chronic pain. I hope this helps and that it wasn't too much of a book. If anybody has questions, feel free to post or backchannel me. I'm not writing this as mental health advice, just a bit of education on how CBT, EMDR, and psychotherapy can help reduce chronic pain. Lindsey

[Guest guest]

Thanks, Hollis, for that info. Look how far you have you have come...almost a year and you are still hangin' tough! You go girl *finger snap* =0) I'll look for that book on Amazon, I'd like to read the reviews and some of the pages. When you wrote down the distortions, did you then focus on replacing those thoughts with better ones? Chellehgz wrote: For anyone interested in pursuing this approach, a classic book on Cognitive Behavior Therapy is Feeling Good: The New Mood Therapy, by D. Burns, M.D. I first read it years ago and last summer, after my relationship of four years ended and i had endless tapes running in my head, featuring thoughts like, "I'll never be in a relationship again,""Noone will ever want to get involved with me at my age and with all my health issues,""S. left me; therefore he must hate him and i must be unlovable,""S. left me because i can't have intercourse," etc. etc. etc., i went and picked up another copy. Identifying, challenging and rewriting all the

distorted automatic thoughts we're constantly feeding ourselves is, i think, really crucial in dealing with the kinds of health challenges we all face. Thanks, Lindsey, for your synopsis! Hollis Thanks so much for taking the time to put that info together, Lindsey! I'm actually gonna take some time and study more about the main 10 cognitive distortions. I found your example of the first one, helpful. I'd say most people have 'some' distortions to some degree. Do you happen to have a list of examples for other nine? I like it when the examples are things you can relate to or understand better. I have scriptures that I am daily speaking out loud and meditating on. They are so comforting. They reinforce not only my faith, but the power behind that faith and my trust in the Lord that I will get passed all of this. Thanks again... ~Chelle Lindsey <gaia_ca (AT) yahoo (DOT) com> wrote: HI, everyone, Just my .02 on cognitive behavioral therapy and pain (aka CBT). First off, here is a great article about recent studies regarding CBT and chronic pain: http://health. msn.com/womens- health/articlepa ge.aspx?cp- documentid= 100165873 & page=1 Most of us have patterns of thought called "cognitive distortions. " Here is a link to a list: http://en.wikipedia .org/wiki/ Cognitive_ distortion For example, "All or nothing thinking." In our case an example of these thoughts would be, "I will ALWAYS have this pain." or "I will NEVER get well again." "I will NEVER have a happy marriage or relationship, etc." These distortions become habitual patterns of thinking, which actually CHANGE the structure of the brain in a way that is not helpful. These distortions also can impact your mood (ie-"My life will always be bad; I am a worthless person; something awful is going to happen I just know it

will."). Your brain is changed to become stuck in these loops that can exacerbate and even cause chronic pain or depression or anxiety. A psychotherapist trained in CBT will help you identify your distortions around pain (or depression or anxiety or whatever the presenting issue is) and challenge you to begin substituting the distortions with more rational, real thoughts. Back to our example of a chronic pain patient. "I will never get well again." I would ask this patient, "Based on what evidence do you know that for sure? Miracles happen every day. You yourself have had significant progress in managing your pain. The longest a flare-up has ever lasted has been a month and then it's gone away, etc." Another example with pain would be disqualifying the positive. Say a client comes in and they are very upset because they've had a flare-up. The distortion might be, "This flare-up means I'm back to square one. I'm never going to get well again. This will never go away." The distortions would be disqualifying the positive and all or nothing thinking. More helpful, rational thoughts might be, "My flare-ups are much fewer and far between. My pain level is significantly less than it was a year ago. I am doing things this month that I wouldn't dream of doing last month because my pain is better. Flare-ups may be part of the healing process and tomorrow might bring a pain-free day. Perhaps my pain will continue to reduce until it is gone." As the client begins to come up with more rational, helpful, and adaptive habits of thinking studies show that the brain actually changes in response and MANY people have had a huge reduction in their pain. It doesn't mean the pain is "all in your head" or

that you're crazy, it just means that not only are you working to heal your body but you are also working to heal your mind. Since the mind is where pain is perceived it makes 100% sense to deal with that piece of the puzzle, too. Another modality I use is this: http://www.emdr. com/ Some clients need a bit of extra help, and experts think that EMDR gives the brain a bit of a jump start in healing issues such as trauma, depression, anxiety and even chronic pain. I hope this helps and that it wasn't too much of a book. If anybody has questions, feel free to post or backchannel me. I'm not writing this as mental health advice, just a bit of education on how CBT, EMDR, and psychotherapy can help reduce chronic pain. Lindsey

[Guest guest]

Chelle,Thanks for the nice and quiet supportive finger snap, Chelle. ;-)In answer to your question: yes, after " capturing " the automatic distorted thought/beliefand writing it down, you challenge the logic of it ( " Hmmm. . . S. showed me in so many ways over the years that he cared about me and loved me, soooo. . it's not really accurate to say he left me because i'm unlovable. " ). And then you replace it with a statement that does more accurately reflect the situation, without the distortion. ( " OK, i am someone who's capable of loving and being loved. I know it was painful in many ways for him, but his decision had to do with what he needs at this point in his life. It's not that he doesn't love me. It's clear that he does. " ) That kind of thing. (Maybe a little less wordy than that!)The book is filled with example after example of how to go about doing this process. It'sfocused mostly on depression, but the principles can be applied to really any issue you'redealing with.HollisThanks, Hollis, for that info. Look how far you have you have come...almost a year and you are still hangin' tough! You go girl *finger snap* =0) I'll look for that book on Amazon, I'd like to read the reviews and some of the pages. When you wrote down the distortions, did you then focus on replacing those thoughts with better ones? Chelle hgz <hgz (AT) verizon (DOT) net> wrote: For anyone interested in pursuing this approach, a classic book on Cognitive Behavior Therapy is Feeling Good: The New Mood Therapy, by D. Burns, M.D. I first read it years ago and last summer, after my relationship of four years ended and i had endless tapes running in my head, featuring thoughts like, " I'll never be in a relationship again, " " Noone will ever want to get involved with me at my age and with all my health issues, " " S. left me; therefore he must hate him and i must be unlovable, " " S. left me because i can't have intercourse, " etc. etc. etc., i went and picked up another copy. Identifying, challenging and rewriting all the distorted automatic thoughts we're constantly feeding ourselves is, i think, really crucial in dealing with the kinds of health challenges we all face. Thanks, Lindsey, for your synopsis! Hollis Thanks so much for taking the time to put that info together, Lindsey! I'm actually gonna take some time and study more about the main 10 cognitive distortions. I found your example of the first one, helpful. I'd say most people have 'some' distortions to some degree. Do you happen to have a list of examples for other nine? I like it when the examples are things you can relate to or understand better. I have scriptures that I am daily speaking out loud and meditating on. They are so comforting. They reinforce not only my faith, but the power behind that faith and my trust in the Lord that I will get passed all of this. Thanks again... ~Chelle Lindsey <gaia_ca (AT) yahoo (DOT) com> wrote: HI, everyone, Just my .02 on cognitive behavioral therapy and pain (aka CBT). First off, here is a great article about recent studies regarding CBT and chronic pain: http://health. msn.com/womens- health/articlepa ge.aspx?cp- documentid= 100165873 & page=1 Most of us have patterns of thought called " cognitive distortions. " Here is a link to a list: http://en.wikipedia .org/wiki/ Cognitive_ distortion For example, " All or nothing thinking. " In our case an example of these thoughts would be, " I will ALWAYS have this pain. " or " I will NEVER get well again. " " I will NEVER have a happy marriage or relationship, etc. " These distortions become habitual patterns of thinking, which actually CHANGE the structure of the brain in a way that is not helpful. These distortions also can impact your mood (ie- " My life will always be bad; I am a worthless person; something awful is going to happen I just know it will. " ). Your brain is changed to become stuck in these loops that can exacerbate and even cause chronic pain or depression or anxiety. A psychotherapist trained in CBT will help you identify your distortions around pain (or depression or anxiety or whatever the presenting issue is) and challenge you to begin substituting the distortions with more rational, real thoughts. Back to our example of a chronic pain patient. " I will never get well again. " I would ask this patient, " Based on what evidence do you know that for sure? Miracles happen every day. You yourself have had significant progress in managing your pain. The longest a flare-up has ever lasted has been a month and then it's gone away, etc. " Another example with pain would be disqualifying the positive. Say a client comes in and they are very upset because they've had a flare-up. The distortion might be, " This flare-up means I'm back to square one. I'm never going to get well again. This will never go away. " The distortions would be disqualifying the positive and all or nothing thinking. More helpful, rational thoughts might be, " My flare-ups are much fewer and far between. My pain level is significantly less than it was a year ago. I am doing things this month that I wouldn't dream of doing last month because my pain is better. Flare-ups may be part of the healing process and tomorrow might bring a pain-free day. Perhaps my pain will continue to reduce until it is gone. " As the client begins to come up with more rational, helpful, and adaptive habits of thinking studies show that the brain actually changes in response and MANY people have had a huge reduction in their pain. It doesn't mean the pain is " all in your head " or that you're crazy, it just means that not only are you working to heal your body but you are also working to heal your mind. Since the mind is where pain is perceived it makes 100% sense to deal with that piece of the puzzle, too. Another modality I use is this: http://www.emdr. com/ Some clients need a bit of extra help, and experts think that EMDR gives the brain a bit of a jump start in healing issues such as trauma, depression, anxiety and even chronic pain. I hope this helps and that it wasn't too much of a book. If anybody has questions, feel free to post or backchannel me. I'm not writing this as mental health advice, just a bit of education on how CBT, EMDR, and psychotherapy can help reduce chronic pain. Lindsey