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Chronic pain management

Cognitive Behavioural Therapy (CBT) for pain management

Cognitive Behavioural Therapy (CBT) is widely recognised as an effective psychological treatment for chronic pain. Chronic pain is defined as not just a physical condition but also an emotional and psychological condition. Many individuals experiencing chronic pain suffer from anxiety, depression, feelings of helplessness and avoidance or disengagement from previously enjoyed activities. This can exacerbate their pain experience and create a vicious cycle of suffering. By addressing the psychological aspects of pain, CBT helps individuals lead more active and fulfilling lives despite their conditions.


CBT for chronic pain is designed to address both the physical and psychological aspects of pain. The primary psychological challenges associated with chronic pain include negative thought patterns, emotional distress, and maladaptive behaviours, all of which can magnify their perception of pain. For instance, a common issue is catastrophic thinking, where the person may think the worst about their pain or their future, leading to increased anxiety, depression and avoidance.


The therapy involves several key strategies to target these problems. CBT works by helping individuals recognise and challenge negative and unhelpful patterns of thoughts, beliefs and attitudes. Through techniques such as cognitive restructuring, people learn to identify and alter irrational or unhelpful thoughts, such as the belief that pain is unbearable or will never improve. By changing how they think about pain, they can change how they feel and react to it. Mindfulness and cognitive therapy approaches can also help to change the person’s experience of pain itself, thereby reducing pain intensity and distress.


Behavioural techniques are also used in CBT for chronic pain. These include pacing (learning to re-engage with activities without creating a pain flare up), behavioural experiments (testing out theories on what may occur if an activity is trialled) and identifying and eliminating unhelpful behaviours (often labelled “safety behaviours”). These strategies can help reduce the frequency and intensity of flare ups that can worsen pain, while utilising the person’s resources to maximise functioning.


Another important component of CBT is developing coping strategies to deal with pain more effectively. This might involve learning problem-solving skills to deal with pain-related challenges or addressing unhelpful coping strategies such as drug and alcohol use or avoidance of important activities. It may also involve engaging in new social and lifestyle approaches to assist with leading a more meaningful and enjoyable life.


Research has demonstrated that CBT for chronic pain is an effective treatment. Research indicates that individuals who undergo CBT experience significant improvements in pain intensity, mood difficulties such as depression and anxiety, and overall functioning. Importantly, these benefits are often maintained over the long term, suggesting that CBT helps individuals develop lasting skills for managing pain.


Gus has had a longstanding interest in the use of psychological strategies for chronic pain. This led to him completing a Masters Degree in Science (Pain Management) at the University of Sydney, graduating in 2015. He has worked extensively with people living with chronic pain in his private practice in particular.

Do you need help with chronic pain management?

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