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Cognitive Behavioral Therapy: Getting Through the Pain

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Pain is a normal, protective reaction to an injury or illness. It is a signal that it is time to pay attention to that area of your body and take care of a problem. Chronic pain is when the pain continues for weeks, months, or years. It may be related to chronic illnesses like arthritis, disorders of the nerves, or cancer pain. It may begin with an injury or short illness, but continue even when the physical damage is no longer evident.

For many, chronic pain management only includes tackling the physical symptoms of pain, but there are many cognitive, behavioral, and emotional aspects that can hamper or help healing. How you think and feel about your health or illness will impact your recovery and how much the pain will interfere with your everyday life.

What Do You Think of Your Pain?

Negative thought patterns like, “I’ll never get better” or “This pain stops me from doing everything” may influence the decisions you make about your healthcare. If you feel there is little to no chance of successful treatment, you may be less likely to seek beneficial treatment or may continue with unsuccessful treatments. On the other hand, if you believe success is possible, you are more likely to participate in seeking out and completing recovery treatments.

Stress can also be a major part of a pain cycle. Managing any chronic condition is stressful enough on its own. Aside from the stress of the illness itself, financial concerns and strained relationships secondary to the illness can add to stress. This regular stress stimulates physical responses in the body which can increase pain and delay healing.

Identifying these factors, learning better thought patterns, and developing better communication techniques can be important in managing chronic pain. Cognitive behavioral therapy (CBT) is a specialized form of therapy designed to help you take these steps and help you improve your quality of life.

Cognitive Behavioral Therapy: Positive Thinking and Positive Behaviors

A common assumption is that people with chronic pain are only imagining their pain. However, part of cognitive behavioral therapy is to help acknowledge that the pain is real and develop healthy thought patterns to manage it. The therapy will be based on your specific need, but often involves creating realistic beliefs about pain, treatment options, and outcomes. Your therapist will help you to:

  • Develop positive thinking and self-talk
  • Reduce behaviors that continue an illness-way-of-life
  • Increase positive behaviors that get you toward your goal
  • Improve communication skills with family and medical team
  • Develop pain-management skills

The overall goal is to replace ways of living that do not work with methods that do. The changes will help you gain more control over your life, instead of living solely through what pain you have.

Cognitive behavioral therapy may be done in a one-on-one or group setting depending on your needs. Your therapy may also include others, like a spouse or family members. Most often, the treatment is short term and lasts between 6-20 sessions and requires practice and homework to be most effective.

United Approach

Chronic pain is often caused or exacerbated by a combination of issues, some which can be immediately addressed, while others may take longer to resolve. Cognitive behavioral therapy in the meantime can play a role in helping you manage pain and improve your quality of life. It will help you develop the skills to reshape your thinking to improve your treatment effects and decrease new cycles of pain. If you or a loved one have chronic pain, talk to your doctor about adding cognitive behavioral therapy to your care plan so you can move toward better days.


American Chronic Pain Association (ACPA)

National Association of Cognitive—Behavioral Therapists


Canadian Psychological Association

Chronic Pain Association of Canada


Chronic pain. Association for Behavioral and Cognitive Therapies website. Available at: Accessed October 14, 2014.

Chronic pain. The Merck Manual Professional Edition website. Available at: Updated April 2014. Accessed October 14, 2014.

NINDS chronic pain information page. National Institute of Neurological Disorders and Stroke website. Available at: Updated September 4, 2012. Accessed October 14, 2014.

What is cognitive behavioral therapy? Association for Behavioral and Cognitive Therapies website. Available at: Accessed October 14, 2014.

Last reviewed September 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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