“There is a consensus among experts that fibromyalgia syndrome may not be a single disease, and that subgroups of fibromyalgia patients may be identifiable,” Juan V. Luciano, PhD, a psychologist and researcher at Parc Sanitari Sant Joan de Déu in Barcelona, Spain. He adds, “Developing meaningful treatments that patients benefit from over their lifetime remains a major challenge in providing clinical care” for the illness.
Outside of pharmaceuticals, two of the most studied methods of treatment for fibromyalgia patients are exercise and a very specific kind of therapy called cognitive behavioral therapy (CBT), a type of talk therapy that can help you identify and cope with specific challenges, including fibromyalgia symptoms. Exercise is used to help alleviate pain while CBT is used to help address the psychological aspects associated with fibromyalgia. “Through CBT, fibromyalgic patients learn techniques that help them to manage their symptoms better and develop a different attitude towards pain — more acceptance and less catastrophising,” says Luciano.
The Big Idea
The main objective in using CBT to help your fibromyalgia specifically is that of changing negative and pessimistic thoughts, including self-defeating behaviors. For example, have you noticed how frequently you entertain negative thoughts about yourself and your inability to move and live the way you used to or wished to? Very few of us understand just how much that kind of behavior actually reinforces our pain, fatigue, and mental and emotional states. “Using specific tasks and self-observation, patients learn to think of pain as something other than a negative factor that controls their life. Over time, the idea that they are helpless goes away and they learn that they can manage the pain,” says the New York Times.
So the idea here is to manage your fibromyalgia instead of letting it manage you. And this is done by changing the way you think about it. That does not happen overnight. It’s a process and requires a variety of methods.
How Does It Work?
According to the Royal College of Psychiatrists, here’s what you can expect when you take advantage of CBT:
- Meet with a cognitive behavioral therapist 5-20 times for 30-60 minutes (approximately 6 weeks – 6 months)
- After some preliminary work, you and your therapist will break down the larger problem of fibromyalgia into smaller chunks
- Usually you will keep a diary or journal in order to identify patterns of thought, emotions, bodily feelings, and actions
- The therapist will help you work out the best way to adjust those patterns from unhelpful to empowering or liberating
- They will also help you set limits and prioritize in order to manage the mental and physical stress that discourages so many fibromyalgia patients
Cognitive behavioral therapy does not fix your symptoms or mindset in one session or overnight. Many fibro patients are so frustrated that they feel that CBT is not worth their time at this stage. After all, when you feel so poorly or just plain miserable, it can be very difficult to get motivated or even concentrate. But that’s one of the advantages of a CBT therapist. They are there to guide you through the process.
But Does It Really Work?
Several studies have shown that cognitive behavioral therapy is comparable to medications used to reduce pain and negative moods in fibromyalgia patients. Furthermore, CBT can cost significantly less than pharmaceutical treatments. However, not all insurance providers cover cognitive therapy. Don’t let that stop you though. There are many therapists who work with patients on a sliding scale. In fact, they often feature this in their online listing. You can easily find local, verified cognitive behavioral therapists using the Psychology Today directory. Another resource that can be a good option for those who are house-bound or in remote locations is a called Thumbtack. This resource connects you with therapists from all over the country who not only will often work on a sliding scale, but will conduct your session over the phone or on video chat. Just remember to specifically search for a “cognitive behavioral therapist” no matter which resource you use.
If, after going through CBT, you find yourself back in your old habits, don’t worry. The tools you get from your therapy are still applicable and it will be much easier to get out of the rut that fibromyalgia can put you in.
Have you tried cognitive behavioral therapy as part of your fibro treatment regimen? Please share your experience with us.