Cognitive Therapy Basics

Biofeedback studies have shown that Fibromyalgia patients who received treatments had fewer tender points, lower pain intensity and morning stiffness.  Biofeedback is a technique in which patients are trained to improve their health by learning to control certain internal bodily processes such as muscle tension causing pain, blood pressure, or anxiety.  It is a basic way of learning self-control tools that will be used throughout life. Recent biofeedback developments now provide a tool for improving functioning of the central nervous system.

Biofeedback is non-invasive and painless. It can expose the sources of physical pain, like headache or back pain, and gives us the information we need to reduce or eliminate the pain. It can help people with Fibromyalgia and Chronic Fatigue by eliminating pain and improving energy.

The most frequently used types of biofeedback therapy:  Electromyography (EMG) – measures muscle tension, Thermal biofeedback – measures skin temperature, and Neurofeedback or electroencephalography (EEG) – measures brain wave activity.

During a biofeedback session electrodes are attached to the skin. The electrodes feed information into devices that measure one’s internal involuntary responses.  The patient is then given mental exercises by the practitioner. This allows the mental activities that cause the physiologic responses to be identified, which make it possible to teach the patient how to gain control over them.  When a person has learned how to control his/her symptoms, the feedback displays the positive changes.

Biofeedback has been proven to be an effective therapy for many conditions.  It is primarily used to treat high blood pressure, chronic pain, tension headache, migraine headache, and urinary incontinence.  Studies have shown that most patients who respond best from biofeedback have conditions that are brought on by or made worse by stress.  This would imply that relaxation is the most important factor for success.

The FM treatment using electro-encephalogram (EEG) is based on the research of Mary Lee Esty, Ph.D.; Stuart Donaldson, Ph.D.; and Len Ochs, Ph.D. Technology is used to detect and treat brain dysfunction that has been caused by a mild traumatic brain injury such as in an automobile accident. Patients first have a brain mapping performed to identify areas of the brain which have been injured and are functioning abnormally in terms of brain-wave activity. Electrical activity produced by the brain reflects a person’s level of functioning and can be monitored by EEG. A condition known as “EEG slowing” is present in people who have suffered damage to the brain and nervous system as a result of trauma and go on to develop Fibromyalgia or other chronic conditions.

The Flexyx Neurotherapy System (FNS) is both a brainwave biofeedback and treatment system, as well as an evaluation system. It is for patients with central nervous system dysfunctions, cognitive dysfunction (memory, etc.), mood disorders, low energy, movement difficulties, trouble with balance, and pain problems.  FNS is an advanced form of biofeedback which, returns a feedback signal to the patient connected to the EEG. This form of EEG uses electrodes connected to the skin.  Researchers have found that FM patients concentrate better when they close their eyes, which lessens sensory stimulation.

Flexyx Neurofeedback System is also non-invasive and painless.  The patient sits in a comfortable chair and wears dark glasses that generate feedback. The patient need only relax.  The treatment measures brain waves, and directs the brain waves back to the person as a reflection (mirrored).  FNS resets the natural, self-regulation skills we are unaware of in our brain and nervous system so they can function normally.  This makes it possible to implement the best treatment plan.

After the treatments are completed, surface Electromyography (sEMG) therapy is usually conducted to help retrain muscles, and Myofascial Release Therapy is used to restore proper muscle balance, obtain optimum posture, and address other neuromuscular problems.  There may be other treatment options discussed and utilized depending on the findings and your therapist.

The hope is to help chronic pain sufferers develop greater awareness and deliberate control over the physiological processes that are outside conscious awareness.

Some migraineurs are considered fortunate since they are capable of experiencing prodromal symptoms. Prodromal symptoms alert the patient when they are about to have a migraine attack. Prodromal symptom does not offer any relief but at least it allows the migraineur to plan for the down period they are about to go into. Provided a migraineur has learnt the cognitive behavioral therapy they are in a position to use the prodromal symptoms to short circuit the migraine headache.In cognitive behavioral therapy the aim is to consciously manipulate and recognize the role that the behavior of a patient plays in the development of the headaches. The therapist and the patient will both work to establish the patients behavior when they feel they are about to have a headache. For the patients who are not lucky enough to experience prodromal symptoms they work with their therapist to establish the patients behavior when the pain starts. After establishing the patient’s behavior, the therapist and patient then develop alternative behaviors for the patient to try in place of the earlier ones. The hope is that by changing the patient’s behavior they might be able to change the migraine.There are several issues that cognitive behavioral therapy seeks to establish. The therapist works with the patient to achieve the following.

There are several behavioral therapy techniques, the most common include: self-talk, reframing, desensitization, role-playing and positive thinking.By itself cognitive behavioral therapy is helpful but much more helpful when combined with preventive drug therapy. A study carried out I 1989 showed that minimal-therapist contact behavioral therapy and clinic- based therapy had almost equal success rates. This was true when observed initially and on a follow up six months later. It is therefore true that Minimal contact therapy offers an affordable and effective alternative to clinic based therapy which might be more expensive.

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Cognitive-Behavioral Therapy (CBT) is often used to teach Fibromyalgia and other chronic pain sufferers how to cope with their illnesses.  It is said to help treat many conditions and diseases like FM, back pain, rheumatoid arthritis and cancer.  It helps determine how well a patient manages their pain and teaches them how to take control of it.  Depression plays a key role in the inability to be proactive in our treatment.  So, our state of mind is very important when it comes to getting better.

Studies show that when FM patients effectively deal with the particular symptoms and over-lapping conditions of their illness and of their lives, they feel better. Cognitive-behavioral therapy (CBT) increases a patients’ belief in their own power to cope with the things they face and helps them develop ways for dealing with depression and stressful situations.

The goal of CBT is to make patients aware of self-defeating behaviors and emotions so that they can be changed consciously. Healthy, positive thoughts and emotions supersede the negative, resulting in a powerful influence on your life and lessening your pain.  Over time, the idea that you are helpless against the pain goes away and, instead, you learn that you can manage the pain.  Many studies show an improved quality of life and overall reduction in average pain scores.

Cognitive behavioral therapy has shown to be as beneficial as anti-depressant medications for patients with depression.  In one large study there were considerably higher results of reaction and remission from depression when cognitive behavior therapy was used in addition to anti-depressant medications than when either method was used alone.  CBT is used to change the patients negative feelings and social withdrawal.

Cognitive therapy is very helpful in defining and setting limits (something I know I have a problem with) and is vitally important for FM patients. Many “Fibromytes” live their lives in extremes. We push ourselves too far and suddenly we break-down. This reverses the way we view ourselves, we become demoralized, feel worthless, and give up our power to cope with the simplest tasks. One important goal of cognitive therapy is to help us find a middle ground. Patients learn to prioritize their responsibilities, and drop some of the less important tasks or delegate them to others. My biggest problem is just saying “NO”.  I want to please everyone and prove to them and myself that I can do whatever is asked of me.  When I reach my limits and cannot complete a task, I tend to go through a period of self-loathing.  Learning to say “NO” and other coping skills can ultimately lead to a more manageable life. We can learn to view ourselves and others in a better light.

CBT is also a useful treatment for anxiety disorders, including phobias, panic attacks, and obsessive-compulsive disorders. In CBT, patients learn to be aware of and change negative thinking patterns. It is a way to gain conscious control over unwanted thoughts or feelings which are, as a rule, connected to anxiety.  Those of us who suffer from panic attacks learn our bodies’ negative responses and actions during an attack and CBT helps us find ways to counteract the reason for the attacks.  CBT can also help improve quality of sleep so we can hopefully reduce some of our medications.

Cognitive therapy requires approximately six to twenty sessions that last one hour.  The cognitive therapy program may involve keeping a diary to look at all aspects of your daily activities, coping skills and mind-set.  This helps you learn what changes need to be made, limits that need to be set and a way to organize and prioritize activities.  Many of these things contribute to stress and can make your pain better or worse.  Setting limits keeps us from getting discouraged and helps us learn to take each task one step at a time.  CBT also helps us confront negative thoughts and emotions and we are taught how to reverse them.  It all boils down to self-perception:  self-loathing, worthlessness, helplessness, hopelessness, negative self-talk, believing that other people view us the same way.  CBT helps us reverse those thought processes so we can pick ourselves up and keep going.  Patients will learn to find things we once enjoyed doing and make the time to do them with the help of learning how to schedule activities without being overwhelmed.

As we know accomplishing too much too soon can often cause a relapse of symptoms. We should respect these relapses and slow down. We should not consider them a sign of failure.  That’s just how Fibromyalgia works. Don’t be so hard on yourself!