Cognitive Therapy and Fibromyalgia

Cognitive Therapy and Fibromyalgia

Cognitive therapy is a form of talk therapy that focuses on identifying and changing unhelpful, automatic thoughts and behaviors. This form of therapy has proven effective in helping patients with chronic pain conditions such as fibromyalgia, in part because it addresses the psychological factors that contribute to the experience of chronic pain.

An American study from September 2023 supports the effectiveness of cognitive therapy for this patient group. The study included 114 participants who were divided into two groups.

One group received treatment with cognitive behavioral therapy, while the other received education about the condition and how they could help alleviate their own pain.

It turned out that the participants who received cognitive therapy experienced less pain and had a different perspective on the pain eight weeks after therapy. This was revealed through surveys, self-assessments of pain levels, and MRI scans of the brain.

The study was published in the scientific journal Arthritis and Rheumatology*.

Nina Melhus is a cognitive therapist trained in the Dialoggruppen cognitive method. The article is based on the Dialoggruppen’s working method

Awareness, self-insight, and acceptance

It is human nature to resist what you do not want. A chronic and debilitating diagnosis like fibromyalgia is, understandably, difficult to accept. The symptoms and pain themselves can be difficult to manage. On top of that, there are all the everyday situations where you have expectations about something you’re supposed to accomplish or participate in, and where your daily condition or pain puts a stop to your plans and desires. And as if that weren’t enough, fibromyalgia is an invisible illness, and unfortunately, there are still quite a few prejudices surrounding it. Having a condition where the symptoms are so diffuse, so fluctuating, and at the same time invisible, is especially painful if you feel you aren’t being believed.

In cognitive therapy, acceptance is a key concept. Most of us lack effective strategies for simply accepting situations that feel unfair and painful. But learning techniques to accept even what feels unacceptable can lead to a better quality of life and more joy despite the circumstances. An old saying goes: “It’s not about how you feel, but how you handle it.” It’s easy to say, but not so easy to do on your own. This is where cognitive therapy can be of great help. Through increased awareness and self-insight, you learn how to more easily accept that things are as they are.

The Victim Mechanism

In the Dialogue Group’s cognitive method, we talk about the victim mechanism. When you get sick and receive a discouraging diagnosis, most people “play the victim.” In other words, you become a “victim of circumstances” and can be overwhelmed by feelings of powerlessness, resignation, hopelessness, frustration, and despair. These are painful and extremely energy-draining emotions.

We all carry different vulnerabilities in our emotional baggage. Vulnerability is about all the old pains and sorrows that may have accumulated over time. Through therapy, we work to recognize the victim mechanism, explore which vulnerabilities are at play, and create an understanding of why emotional expression can sometimes become very intense. By understanding your own vulnerabilities, it becomes easier to meet yourself with understanding and empathy, and to learn techniques to avoid, or to lift yourself out of, the victim state.

Body, Cognition, and Energy

Furthermore, we examine the connection between the cognitive (thoughts and actions), your energy level at any given time, and the endocrine system (the body’s hormonal system). Not least, we explore how our emotions and needs influence the whole picture. Body, cognition, and energy influence one another. For example, typical fibromyalgia symptoms such as low energy/fatigue and pain are experienced as stress by the body. Stress is a known trigger for fibromyalgia symptoms. The body reacts by producing the stress hormones adrenaline and cortisol. The body’s alarm system is activated, and pain, mental noise, and anxiety increase. In turn, this can trigger anxiety and catastrophic thoughts, which in turn drain your energy. A painful and self-perpetuating cycle.

The goal is to create balance in energy, body, and cognition through effective strategies for managing stress, thoughts, and actions, as well as managing your own energy.

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Help for Self-Help

Through cognitive therapy, you will learn techniques for dealing with difficult situations in an effective way, reducing catastrophic thinking, and changing maladaptive behaviors that can worsen your symptoms.

Cognitive therapy can be a valuable supplement to the treatment of fibromyalgia. By identifying and changing maladaptive thought patterns and developing better coping strategies, cognitive therapy can help reduce pain, improve quality of life, and provide a sense of control over one’s own condition. Better for you as a patient, and thus also better for those around you.  
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Nina Melhus                                                                                                                                              
Cognitive Therapist/Registered Homeopath MNLH                                                                                        
Certified Functional Breathing Instructor                                                                  
www.pustbevisst.no

*Source: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.42672
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