Cognitive Behavior Therapy for Chronic Pain

painCognitive Behavior Therapy (CBT) is a widely researched, time limited psycho-therapeutic approach that has shown to be efficacious across many mental and behavioral conditions.  CBT encourages clients to adopt an active, problem solving approach to cope with the many challenges associated with chronic pain. Chronic pain is a condition, not a symptom, that lasts more than 3 months and persists beyond the expected healing time despite medication and other treatments.

Melzack & Wall developed the Gate Control Theory on pain and this has opened the door of understanding how pain can be modulated.  Pain ascends from the pain location and a gate in the brain can be opened and closed and the pain experience can be minimized.  The model suggests pain is a subjective experience that can be influenced by many factors, thoughts, feelings and behaviors.   The Neuromatrix Model of Pain shows the relationship between pain and stress.  The more stressed out we are, the more pain we are in.  This is an important relationship that can used to disrupt the pain-stress cycle.  There are psychological, biological and social components that influence your pain experience and your behavior.

The goals of a Cognitive Behavior Therapy program for Chronic Pain are to change the thoughts and behaviors associated with chronic pain by learning a variety of coping skills that give you a sense of control over the pain and the effects the pain has exerted on your life.  By addressing the negative thought patterns  your mood  improves and the negative impact of the pain is reduced.  It would be ideal to reduce the pain but the focus is on how to reduce pain related suffering.

Pain perception is related to the attention involved in detecting and orienting attention towards the sensory event.  When you pay attention to pain you are holding the gate open.  Distractions, thoughts of control over pain, belief that pain is predictable and manageable will close the gate and reduce the effects pain has on your life.

The Brain Performance Center offers an eight week program that includes education, cognitive restructuring, relaxation training, behavioral activation and relapse prevention.   To learn more about what the program has to offer please schedule a complimentary consultation call today, 817-500-4863.

What happens to your feelings when you slouch? Go all negative on you?

There have been studies that have confirmed that changes in body posture are related to a subject’s feelings and memory recall. However, until now, there hasn’t been a study that explores brain activity (EEG patterns) when combining body posture and emotional recall.

A recent study explored the electroencephalogram (EEG) patterns under erect and slouch body postures while recalling positive and negative events. The purpose of this study was to explore EEG patterns under both postures while recalling happy or depressive events.

Twenty-eight healthy college students were instructed to sit quietly with their eyes closed for 1 min, and then to sit in erect or slouch postures while recalling happy or depressive events for 1 min each. EEG, with linked-ear references, was recorded and analyzed under five conditions. The results showed that, independent of the body position, recalling happy events in a collapsed position significantly increased the high-frequency oscillatory activity than recalling depressive event in an erect posture. This suggests that it takes much more effort and time to evoke and maintain positive thoughts in a collapsed position. This was also confirmed by the significant increase in reaction time when attempting to recall positive events in the collapsed body position as compared to the erect body position.

The conclusion was that evoking positive thoughts in a slouch body position takes more effort or arousal than other positions as indicated by the significant increase in high-frequency oscillatory activities.

The implication for cognitive behavior therapy is that body posture matters; clients have more difficulty shifting to evoking a positive emotional state when sitting in a collapsed position than when sitting in an erect position. The study further supports the theory that body posture might affect our mental, emotion and memory recall.

This may have significant implications for people who are depressed. Walking in a slouch posture may decrease energy and increase negative emotion, such as sadness, loneliness, isolation and sleepiness. This slouch position accompanies feelings of ‘wanting to sit down, low energy, depressive feelings or being ‘zombie-like.’

Alternately, when walking in an erect posture and skipping, participants increased their energy and experienced more energetic, happy and positive feelings. In addition, they found that the erect posture makes subject much stronger to resist the downward pressure compared to the collapsed position.

In a therapy session, most depressed patients have a slumped collapsed posture which would inhibit accessing positive thoughts thus augmenting their depressive ones. To increase the access to positive thoughts, the patient benefits greatly by sitting erect and looking up. In this position, positive and negative thoughts can equally be accessed.

So, think about your posture, think about accessing positive thoughts, stand tall!!

Want to get in the ZONE – Put your game face on

Actually, it is more about putting your game “brain” on to get a clear brain-body connection and stay in the zone.  Ask yourself three questions: 1) Do you let your positive and negative thoughts intrude at critical moments? 2) Do you have a positive visualization or affirmation you use to help switch the brain into the “zone”? 3) Do you know how to stop the “fight or flight” reflex that comes out at crucial times?

If you answered these questions with a NO then you need a training strategy. Whether it is at work, at school, or an athletic event, to be at your best you need the brain to be at optimal arousal.  This includes an optimal balance of right hemisphere relative to left hemishpere, the various brain wave frequencies to be balanced and a personalized optimal breathing rate.

The link below will take you to Dr. Gordon who provides a good overview of what you can do to determine what your zone is, how to develop a zone culture, and how to stay in the zone.   It all comes down to train the brain.

http://www.mybrainsolutions.com/library/2012/08/in-the-zone-peak-performance/