CBT for Chronic Pain

What is chronic pain?

The sensation of pain is an unpleasant sensory and emotional experience associated with actual or potential damage to your body. Pain is your body’s normal reaction to an injury or illness, a way to alert you that something is wrong, and time is needed to allow healing to occur. Biological, psychological, and social factors can all contribute to the experience of pain.

What are the symptoms of chronic pain?

Chronic pain is characterized by a variety of symptoms which may include some or all of the following:

  • Joint pain
  • Muscle aches
  • Burning pain
  • Pain-related behaviours – which can be verbal (e.g. verbal descriptions of the intensity, location, and quality of pain; vocalizations of distress) or nonverbal (e.g. withdrawing from activities/avoidance, taking pain medication, or pain related body postures or facial expressions)

Chronic pain affects your physical health, your emotions, and your daily activities over time. The pain can lead to a variety of symptoms, such as:

  • Mood difficulties, including low mood, anxiety/worrying, and irritability
  • Fatigue
  • Sleep problems
  • Loss of interest and pleasure in activities
  • Loss of stamina and flexibility, due to decreased activity
  • Substance use
  • Suicidal thoughts

When is it time to get help?

Pain is common and universally experienced. However, when your concerns about your pain are pervasive, interfering with everyday functioning, and causing increased disruptions and impairments in your daily life activities (e.g., inactivity, avoidance, fear, mood difficulties), it may be time to seek help. For example, when you are finding yourself avoiding most situations that are unpleasant or painful and/or when you find that you are often experiencing many thoughts, feelings, or behaviours related to the chronic pain (e.g., thoughts about the seriousness of your pain, high levels of anxiety/worry about your pain and health, spending a lot of time and energy devoted to your pain), your chronic pain may be disrupting your life.

How CBT can help manage chronic pain

Cognitive-behavioural therapy (CBT) is considered the gold-standard psychological treatment for chronic pain. CBT for chronic pain is aimed at changing client’s negative thoughts and behaviours that serve to maintain and exacerbate the experience of pain, and teaching adaptive ways of coping and ways of safely reintroducing enjoyable activities into their lives.

Key components of CBT for chronic pain include:

1. Psychoeducation – to learn about the relationship between how we think, feel, and act, and to understand the impact and cycle of pain

2. Relaxation Training (e.g., diaphragmatic breathing, visual imagery, progressive muscle relaxation)

3. Cognitive Restructuring – identifying and reframing unhelpful thoughts related to pain into positive coping thoughts

4. Time-Based Activity Pacing – learning how to become more active without overdoing it

5. Graded Homework Assignments – designed to decrease avoidance of activities and reintroduce a healthy, more active lifestyle (e.g., scheduling and completing valued activities)

Other components that may be included in treatment when applicable include sleep hygiene, problem solving, mindfulness-based meditation, and anger management strategies.

How can the team at Oakville Centre for Cognitive Therapy help?

At Oakville Centre for Cognitive Therapy (OCCT), we have a number of highly skilled and experienced clinicians who can provide assistance to those who may be suffering from chronic pain and related difficulties. Our psychologists complete an initial assessment of the presenting difficulties and develop an evidence-based treatment plan to help the client achieve their goals. To arrange an appointment, please call us at 905-338-1397 or email us at admin@oakvillecbt.ca or via our Contact Us page.

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