Cognitive Behavioural Therapy

For some people suffering from chronic pain, learning how to think about their pain in a different way may change their experience of the pain.

Cognitive behavioural therapy (CBT) is an evidence-based psychological treatment, proven effective by many studies and used by counsellors and psychologists around the world.  It’s essentially a three-step concept which suggests that how we think about a situation affects how we feel about it, which in turn guides actions or behaviour. Another way of explaining this is that it’s the meaning or interpretation we ascribe to a situation that affects our emotions and actions, not the situation in its objective reality.

CBT provides a set of skills based on these principles which encourage an individual to take control of their thoughts, to “be in the driver’s seat” and in doing so, exert an influence on their feelings and behaviour. The idea that we can choose our thoughts, and the powerful flow on effect this can have on emotions and actions, are the central principles of CBT. It is widely used in therapy as a treatment for anxiety and depression, but may also benefit those suffering from chronic pain.

Basic example of CBT in action:
THOUGHTS: My boss is mean and horrible and he hates me
FEELINGS: Anxiety, stress, sadness
ACTIONS: Avoid boss, reduced productivity in the workplace, possible resignation
Looking at the thoughts again: are they objective, or do they contain opinion and interpretation?

My boss is mean and horrible and he hates me

Each of the words in bold is an example of an opinion or interpretation distinct from the objective reality of the situation. Does our subject really know that his boss hates him? How can he be certain that his behaviour is due to him being “mean’ and “horrible”?

See how an adjustment in thinking or “cognitive reframe” changes this picture:

THOUGHTS: My boss is under a lot of stress, so sometimes he is a bit short with his employees.
FEELINGS: Compassion, understanding
ACTIONS: Gets on with the job, doesn’t dwell on the behaviour of his boss.
Skills in CBT can be learned through sessions with a counsellor or psychologist. There is a wealth of information on the internet, from articles to “how to” videos.

Cognitive Behavioural Therapy: The Facts
• Scientific studies have revealed changes in brain activity in people receiving CBT, suggesting brain function is improved by the treatment

• CBT has been found to be just as effective as antidepressant medications for some people with depression, and also works well in combination with medications

• There is evidence to suggest CBT may be more effective than medication in preventing a relapse of depressive symptoms, due to the focus on teaching the participant to develop a more positive way of interpreting their world

• CBT has helped to reduce the frequency and intensity of panic attacks in people suffering from anxiety

• For those affected by phobias, CBT is effective in modifying the beliefs behind the fears, addressing the cause to prevent the effect.