Cognitive Behaviorial Therapy (CBT) and Fibromyalgia

Fibromyalgia is a long-term condition that causes pain throughout the body and may produce other symptoms such as IBS, insomnia, headaches, low concentration, fatigue and increased sensitivity to pain.

Pain can be particularly distressing and there is considerable research which shows cognitive behavioral therapy (CBT)  may help provide relief. CBT can:

  • alter the way you view your pain by influencing your thoughts, emotions and behaviors related to pain and coping strategies
  • help you diminish pain so that it interferes less with your quality of life
  • change the physical response in the brain that makes pain worse.   Pain causes stress, and stress affects pain control chemicals in the brain, such as norepinephrine and serotonin.  CBT reduces the arousal that impacts these chemicals and can make the body’s natural pain relief response more powerful.

The primary goals of CBT are to change unhelpful thinking and self-defeating behaviors. Using specific tasks and self-observation, you learn to think of pain as something other than a negative factor that controls your life. Over time, the idea that you’re helpless reduces and you learn that you can manage the pain.

CBT is particularly helpful for defining and setting limits, which is important if you suffer from fibromyalgia as you may tend to live your life in extremes. You may push yourself too far causing distressing symptoms. This unhelpful behaviour can undermine how you view yourself, and you may think of yourself as a failure, unable to cope with the simplest task. An important aim of CBT is to help you discover middle ground, learning to prioritize your responsibilities and drop some of the less important tasks or delegate them to others.

CBT usually consists of several one-hour sessions. You receive homework which may involve:

  • Keeping a diary which serves as a general guide for setting limits and planning activities.  You might use the diary to track stress factors, such as a job that may be improving or worsening the pain.
  • Challenging and reversing negative thoughts and beliefs. For example ‘Because I  can’t control this disease I must be useless.’  becomes the coping statement ‘I can cope with small tasks most days.’
  • Setting limits designed to keep both mental and physical stress within manageable levels, so that you do not become discouraged by overdoing it. For example, tasks are broken down into incremental steps which you focus on one step at a time.
  • Seeking out enjoyable low-energy activities that you can conveniently schedule.
  • Prioritizing and learning to drop some of the less critical tasks or delegate them to others.

 Further information:  British Association Behavioral & Cognitive Psychotherapies