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Introduction to CBT for Chronic Pain


This is Carl, in his early days. Always on the go. Driven by a “need for speed,” he was captivated by planes, trains, and automobiles. His first love? The twin-engine turboprop. The day Carl hit 18, he enlisted in the Air Force. As a fighter pilot, he rocketed off to vast lands and far away places. He never wanted to leave. When he did, he loved teaching others how to fly and spending time with his nephews. No one could build model seaplanes like ‘ol Carl. Well, back in the day, before his nephews took that trophy. But, lately, Carl’s not been feeling like his old self. You see, the nagging pain started in his lower back about 8 years ago. He figured he’d pulled a nerve sitting in cockpits and has been waiting for it to go away. But it’s only gotten worse. Tom takes it easy to limit the pain. Most days, he sits on the couch watching old re-runs and TV movies. Part of him wishes he could be good ol’ fighting Carl again. But if he got out there, he figures the pain would only get worse. Carl’s thoughts about his pain when he’s alone affect his mood. He often feels down and on edge. This makes him think about his pain even more. Of course, he’s tried to get rid of it. But those pain meds he took for a short time didn’t really help and made him drowsy. And surgery is a definite no. But he doesn’t know what else he can do. So, Carl went to his doctor once more, who recommended he see a pain specialist, Dr. Michael. Dr. Michael helped Carl understand more about pain. He explained that acute, or short-term, pain is usually caused by tissue damage and goes away within 3 months. But chronic, or persistent, pain lasts longer, often well after healing has occurred. This is because pain is affected by more than the physical stuff. First, he said, chronic pain is affected by our thoughts, which act as powerful filters that affect how we feel pain. Second, it’s affected by our emotions anxiety and stress, for example, produce chemicals in the brain associated with pain. And third, chronic pain is affected by our actions, or behaviors. For example, avoiding physical activity weakens muscles. Inactivity can also trigger difficult emotions that affect how we experience pain. It’s like a vicious cycle. The good news is that we can turn down the volume on pain by learning to control these factors. Dr. Michael told Carl about a proven treatment option called “Cognitive Behavioral Therapy”, or “CBT”, for Chronic Pain. It has years of research behind it showing it can improve pain and its effects, and general well-being. It’s short, usually about 12 sessions. And it can be provided alone or together with other pain management approaches, like physical therapy, massage, and medication. All this blew Carl’s mind. He never realized how complex pain was and that talking to someone about how to make different choices could help it. He liked that there were skills he could learn to control his pain, rather than it controlling him. So, he agreed to give it a go. Though he probably won’t be flying fighter jets to start, he had a glimmer of hope of getting his life back. And so did his family. Learn more about CBT for Chronic Pain and see how things turned out for Carl at TreatmentWorksForVets.org.

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