Behavioral Therapy

Studies continue to show that when fibromyalgia patients deal with the specific conditions of their disorder and their lives, they feel better. Cognitive-behavioral therapy (CBT) enhances a patients' belief in their own abilities and helps them develop methods for dealing with stressful situations. CBT is a known effective method for dealing with chronic pain from arthritic conditions. Some evidence also suggests that cognitive-behavioral therapy can help some patients with fibromyalgia. In one study, 25% of patients achieved long-lasting improvement.

The Goals of CBT. The primary goals of CBT (also called cognitive therapy) are to change any distorted perceptions and self-defeating behavoirs. Using specific tasks and self-observation, patients learn to think of pain as something other than a negative factor that dominates their life. Over time, the idea that they are helpless against the pain goes away and, instead, they learn that they can manage the pain.  

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Cognitive therapy is particularly helpful in defining and setting limits -- a behavior that is extremely important for these patients. Many fibromyalgia patients live their lives in extremes. They first become heroes or martyrs, doggedly pushing themselves past the point of endurance until they collapse and withdraw. This inevitable backlash reverses their self-perception, and they then view themselves as complete failures, unable to cope with the simplest task. One important aim of cognitive therapy is to help such patients discover a middle route, whereby they can prioritize their responsibilities and drop some of the less important tasks or delegate them to others. Learning these coping skills can eventually lead to a more manageable life and to less of an absolutist perspective on themselves and others.