Cognitive Behavior therapy Anxiety Disorder.
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Loneliness insomnia and change: the fear of these is even worse than the reality. By Mignon McLaughlin The Second Neurotic's Notebook1966 Find out about Cognitive Behavior Therapy Anxiety Disorder
The Mystery of Fibromyalgia and How Cognitive-behavioral Therapy Can Help
Fibromyalgia syndrome (FMS) is the medical terminology used to represent a complex clinical disorder of symptoms characterized by soft tissue pain, stiffness, and altered deep pain threshold with psychological fallout. It can mimic or accompany symptoms of joint injury, but it is not an arthritic or neurological condition. The disorder affects between 3 to 6 million people – or as many as one in 50 Americans. About 80 and 90 percent of those diagnosed with fibromyalgia are women.
There is usually an emotional overlay of depression and anxiety that affects the sufferer. There are numerous reasons why this is true. Many within the medical community have discounted fibromyalgia as a bona fide disease. Patients have been told that they are over-dramatizing their pain and that the stiffness or soreness has been psychologically induced. Others have been told that the condition was fabricated for attention or perceived by health providers as feigned helplessness. These assertions from medical experts make patients with FMS feel ignored, mistrusted, alone and without support. Patients often turn to self-blame, which fuels the pain cycle.
The pain and symptoms of fibromyalgia are real and have a definite physical basis. There is no known cause for fibromyalgia. Some researchers have speculated that physical trauma or viral influences have triggered FMS syndrome in many patients. There are no known abnormalities in the muscle tissue of fibromyalgia patients that would account for the disease.
Current research has focused on regions of the FMS patient’s brain and the susceptibility of certain brain locations to pain sensitivity. The brain receives a pain signal from the muscles and stays in a state of alert. For unknown reasons, the brain fails to let go of the pain signal and sets up a chronic pattern or pain syndrome. The brain stays in a constant feedback loop, consisting of a system of amplified pain signals.
Recent brain scan research studies have shed new light on this disorder. Results published in the May 2008 edition of the Journal of American College of Rheumatology shows that neuroscientists have been able to conduct scanning technology to areas of the brain affected by fibromyalgia. Mild pressure on trigger points of the patient has produced measurable brain response in processing the sensation of pain. The elevated response of pain in FMS patient’s brain scans was significantly different from those in the control group of the study. This is one of several studies that validate the reality of fibromyalgia as a disorder affecting the brain's response to muscular and neuropathic pain. Hopefully, future studies will lead to new treatment options.
Currently, treatment options consist of the use of a multidisciplinary approach. Medication management, physical therapy, meditation, exercise, alternative therapies, and cognitive-behavioral therapy are useful. CBT is a valuable therapeutic treatment option for those suffering from pain syndromes. One of the byproducts of pain can be the escalation of anxiety and depression. Likewise, anxiety and depression can intensify the impact of pain and make it more debilitating.
Cognitive-behavioral therapy’s goal is to teach the FMS patient to embrace pain rather than fight it. Cognitive distortions, such as magnification and “catastrophizing” need to be addressed so that patients learn to de-escalate fueling the pain process. How one thinks about his pain affects its impact. One can learn to rationally respond to pain by sayin
- "Although this problem is difficult, I can learn to manage it."
- "What's the use of getting all upset about my pain, it won't help anyway."
- "If I relax and walk into my pain, maybe all this will feel less troublesome."
- "I'm not alone in this. I have the support of my family and friends."
- "I'm not helpless, I have many strategies I can try to minimize the effect of my pain. Just keep moving!"
Cognitive-behavioral therapy can assist the fibromyalgia patient to identify stressful triggers that exacerbate pain. This may involve examining family struggles, exploring inner-conflict, and working with core, self-defeating assumptions that affect thinking and behavior. Teaching the patient mindfulness meditation as a way of relaxing the sympathetic nervous system is beneficial.
Through the use of CBT, a therapist can provide the fibromyalgia patient with structured homework assignments that will help pain sufferers to experiment with new behaviors such as increased involvement and activities. Motivating the client to set realistic goals for everyday functioning can be helpful. Encouraging a multidisciplinary approach involving exercise, physical therapy, rehabilitation and pain management are essential.
Fibromyalgia patients fear that their disorder will cause them to lose the ability to function at work and at home. Teaching patients to focus on what they can do rather than their limitations is important. There is a tendency for fibromyalgia patients to distort reality by focusing on negative perceptions to the exclusion of the positive. Helping the patient and family to accept physical limitations is a necessary component to successful treatment.
Fibromyalgia patients can easily get enmeshed in a cycle of pain and associated emotional symptoms. It is the goal of cognitive-behavioral therapy to assist the patient in coming to terms with his disorder and making plans to manage it. This is accomplished through acceptance and teaching the patient positive ways of thinking about his condition and multiple ways of treating it.
About the Author
James P. Krehbiel is a Licensed Professional Counselor and Nationally Certified Cognitive-Behavioral Therapist. His first book, Stepping Out of the Bubble is available at www.booklocker.com. He specializes in working with children and adults experiencing anxiety and depressive disorders. He is the Shrink Rap columnist for TheImproper.com, an upscale news and entertainment resource located in NYC. He has published numerous counseling-related articles, most available via Google searches. He can be reached at jkboardroomsuites@yahoo.com.
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Can Any one who has had success with Cognitive Behaviour Therapy give me some advice please????
I am having these sessions for my agoraphobia and anxiety disorder as its pretty bad and I can't really go out hardly anywhere.Has anybody had success with their cbt and if so can you give me some advice to help it work well for me to and what you did to get as well as you are now!! I am so desperate to be well again. I want to live my life again so if anybody can help me with some advice or cbt techniques that they have learnt that help while coping with those bad anxiety situations then please help me.Thanks so much!!xx.
i succeeded after hospitalization, go and purchase the " feeling good handbook". bottom line with cbt is that you have to challenge your irrational thoughts that are causing you too become anxious and fearful. you mentioned you cannot go out of the house? you have and were born outside of your house, you have been out of your house many times in your life, and nothing happened to you. your fears are baseless and irrational, if your house was on fire would you fear going outside of your home? if you had to walk to a store everyday to obtain food of you would starve, would you still continue to stay in the house? your fears are irrational, and baseless. there is nothing wrong with you except that you have irrational fears, i just dont think that doctors should label this stuff an illness, just irrational thoughts. your perception of the world has to change, their is nothing bad about leaving your home, nothing will happen to you leaving your house. my neighbor really upset me when someone burglarized my house, she saw them do it, and when i had her subpeonaed to show up in court to identify the perpetrators that got my widescreen, jewelry etc. she then advised me that if she leaves her house she gets completely sick to her stomach and has panic attacks, she refused to go to court and the perps got off free!!!! i never spoke to her again! i moved out! you do not have to live in fear, but you chose too. you make a choice to be scared and submit yourself to anxiety and make yourself sick because you went out of your house. you can talk to 50 shrinks, and take meds etc. but the fact is, you werent born in a house and you went to schools etc, you go to the doctor etc. therefore just do it, leave your house and dont think about it. besides, your going to gain weight sitting on the couch waiting for a social security check ea month when you could be makin some doe. life is short, dont let some doctors lable you as having an illness, the more illnesses they have, the more they get paid. stop selling yourself short, read the feeling good handbook, youll be surprised. good luck...
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