Fewer Pills: Cognitive Behavioral Therapy for Chronic Pain

CBT for Chronic Pain

When you experience chronic pain, the last thing you want to hear is that its ‘in your head’. 

Some of us view life as a series of circumstances which simply happen to us.  CBT says that we create our own experiences and sensations.  It goes on to suggest that by changing our negative thoughts and behaviors, we can alter our perception pain itself.

chronic pain
Amanda Wakefield, Clinical Psychologist

Tuning out the "Pain Alarm"

First, discussing our physical sensations with a therapist can help to change the thoughts, emotions, and behaviors correlated with our physical discomfort.  Developing coping skills empowers us, and often allows for a shift in the way we perceive physical sensations, as Amanda Wakefield explains:

“Imagine that you’re at your home or office and hear a car alarm going off.  At first it is very distracting, until you poke your head out the window and see there’s no burglar.  Checking-in to ensure there is no harm being done allows our brain to ‘tune-out’ the alarm.  We can similarly ‘check-in’ with our physical selves to lessen pain signals–perhaps even ignore them completely.”

CBT can also change our emotional response to the physical sensations we perceive.  It is common for certain emotions to go along with physical discomfort such as fear, worry, hopelessness, and anxiety. 

These feelings tend to make us want to isolate, which can sometimes go against our instincts to be eager and active. Amanda explains that with some clients she encourages ‘mindful overdoing‘, the idea that toughing it out through chronic pain can sometimes be in our best interest.  Amanda coaches her clients to endure certain discomfort when it generally aligns with the person’s values.  Ultimately, achieving ‘balance is the goal:

“I recently had a client who wanted to attend their friend’s wedding, but knew that hitting the dance floor would cost them two days’ rest afterwards.  Together, we decided that this was a reasonable price to pay to get to spend quality time with friends and family.”

Overall, Amanda stresses the importance of balance in life.  Through proper planning, we can work with the natural rhythms of mental/physical illness and live a fulfilling, well-rounded life.  

Physical Health, Mental Health, and the Missing Link

Just like Amanda, Tony Brenner believes in a holistic approach.  We asked Tony to reflect on his experiences practicing CBT for pain relief. 


“I once had an acupuncture client report that talking about the tension in his body helped as much as the acupuncture itself–perhaps even more.  He reported pain relief from tense shoulders.”

pain cycle

Discussing strategies like this with a professional allow us to socialize much more normally while still respecting the limits of our bodies.  Amanda reports that programs with CBT can result in a decreased need for opiates by approximately 50%. Stay tuned for our next post focusing on the research supporting this developing field!

Learn more about alternatives to medication at the bottom of this page.