Cognitive Behavioral Therapy

What is cognitive behavioral therapy?

Cognitive behavioral therapy is a common psychosocial therapy used in the treatment of many different chronic pain states. CBT theorizes that a maladaptive thought process can cause negative behaviors and emotions. In multiple studies, negative emotions have been shown to increase average pain scores.

The goal of CBT is to make you aware of negative thoughts and emotions so that you can consciously change them. Healthy positive thoughts and emotions replace the negative ones, causing a powerful impact on your life and decreasing your pain.


Many different disorders are treated successfully by CBT, including mood disorders (such as depression), anxiety disorders, and chronic pain. CBT has also been used to help those suffering from phobias, eating disorders, substance abuse, PTSD, ADHD, sleep disorders, and more.

How cognitive behavioral therapy works

The specific CBT methods used varies with each type of disorder, so it is important for the CBT therapist to be familiar with the patient and goals of therapy. Some of the common tools used in CBT include:

  • Journal writing: Patients are asked to keep a daily journal of the day’s events and associated feeling, emotions, and actions. They are asked to record the most stressful parts of their day and their associated pain scores.
  • Conditioning: The CBT therapist uses positive or negative reinforcement to encourage helpful behaviors.
  • Systematic desensitization: This is frequently used in patients with anxiety disorders. Patients imagine an uncomfortable or fearful situation, and the CBT therapist helps the patient to relax through it. Gradually the patient becomes desensitized to the fear-producing stimuli and instead associates relaxation with the stimuli.
  • Cognitive rehearsal: The patient imagines a problematic circumstance, and the therapist helps them through the process. Fears and negative emotions are identified, and the circumstance is thought about with a healthy frame of mind.

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