Cognitive Behavioral Therapy for Chronic Pain

People suffering from chronic pain can spend a lot of time thinking about—obsessing about—the pain, convincing themselves it is making them useless and helpless. Some individuals become depressed and angry that their pain is interfering with their relationships, and projecting that it could even cost them their job. Cognitive behavioral therapy can help the chronic pain sufferers stop those thoughts in their tracks and as a result, alleviate their pain.

The goal of cognitive behavioral therapy is to change the way you think about pain so that your body and mind respond better when you experience symptoms. For example, when you feel a familiar pain starting, you probably have a sense of how it will progress. If you are used to the pain being severe or long lasting, you may expect the pain to become more intense. This thinking may make you feel out of control or helpless. A stress response like this can trigger physical changes in your body, such as a rise in blood pressure, the release of stress hormones, muscle tension, and more pain. However, when you shift your thinking away from the pain and change your focus to more positive aspects of your life, you change the way your body responds to the anticipated pain and stress.

In other words, cognitive behavioral therapy help patients identify negative thoughts and then, change them; ultimately changing the way your mind influences your body.

What to Expect

In cognitive behavioral therapy, you will be taught specific exercises that will give you more of a feeling of control and increase your ability to cope with chronic pain. Your therapist will give you homework to encourage you to change the way you respond to your symptoms. You will then be taught how to practice changing a certain behavior until the next session. Sessions usually run one hour and can be individual or group therapy.

Try Out a Cognitive-Behavioral Therapy Technique

The goal of this technique is to reframe your thoughts to change your mental and, ultimately, physical patterns.

1. Write down a negative thought about your pain on one side of an index card. For example, "Why me? Am I being punished?"

2. On the other side of the card, write down a rational comeback to the thought. For example, "There are lots of people who have persistent pain. I am not alone, and I am not being singled out."

3. Repeat steps 1 and 2 for at least two more negative thoughts about your pain. Here are some more examples to get you started.

Negative Thought: "I can't even lift my grandchild. She probably thinks I don't love her anymore."

Rational Comeback: "There are many ways to show love. I can sit and ask her to crawl into my lap."

Negative Thought: "What kind of parent am I? I can't even play ball with my kids."

Rational Comeback: "I spend a lot of time with my children in other ways. I can still go to their games and enjoy watching them play."

4. Carry these cards in your wallet or purse and reach for them whenever a negative or destructive thought about your pain comes to mind. Read the "rational comeback" you have written to give yourself a different way to think about the situation.  By thinking about the situation differently, you will be changing your physical response, clearing the way for a healthier you.

Note: Don't let negative, distorted or destructive thoughts get the best of you. Take back control of your life and contact your doctor to get a recommendation for a cognitive-behavioral therapist.


Levy, Suzanne. "Cognitive-Behavioral Therapy can Stop Pain Obsession." Health.  6 May, 2008.,,20189554,00.html. Web. 22 Mar. 2010.

Mayo Clinic Staff. "Cognitive Behavioral Therapy." Web. 22 Marc. 2010.

"Using Cognitive-Behavioral Therapy to Control Your Chronic Pain." Health. 20 Apr. 2008.,,20189561,00.html. 22 Mar. 2010.