Fibromyalgia Cognitive Behavioral Therapy: How Therapy Can Help

We may not think of psychological treatment as a way to find respite for the physical symptoms of an illness, particularly a chronic illness. However, for people experiencing fibromyalgia, a chronic disorder that causes pain and fatigue, research demonstrates that mental health treatment can be useful. Cognitive behavioral therapy, or CBT, is one of the most common approaches used to treat a variety of conditions and may be beneficial for those living with fibromyalgia. If you are experiencing fibromyalgia symptoms, keep reading to learn more about the positive impacts CBT can have on your life. 

What is fibromyalgia?

Fibromyalgia is a chronic pain disorder. People with fibromyalgia may experience pain on a regular basis, typically throughout their whole body or in multiple areas of the body. They may also have difficulties with sleeping and feel frequent fatigue. Additional symptoms of fibromyalgia can include:

• Pain that patients describe as “aching, burning, or throbbing”
• Pain concentrated in particular areas, including the head, limbs, chest, back, or stomach 
• Insomnia
• Chronic fatigue
• Feeling as though one’s whole body is bruised and that any touch or pressure is painful
• Soreness and stiffness in muscles and joints
• “Fibro fog”, or cognitive difficulties such as trouble thinking clearly, concentrating, or remembering events
• Numbness and tingling in the limbs
• Digestive concerns, including constipation, bloating, and discomfort
• Increased sensitivity to noise, temperature, light, odors, and textures

Risk factors for fibromyalgia

The exact causes of fibromyalgia are not well understood. Moreover, there is no current cure for the condition, though there are some promising treatments. Fibromyalgia can run in families, but you do not need to have a history of fibromyalgia in your family to develop the condition. Fibromyalgia can affect people of all ages and identities. Still, it is more common in women than in men, and most people with fibromyalgia develop it as they become older. You may be more likely to experience fibromyalgia if you have a history of any of the below conditions:

• Rheumatoid arthritis
• Depression
• Ankylosing spondylitis
• Anxiety
• Systemic lupus erythematosus (often referred to as lupus)
• Osteoarthritis
• Irritable bowel syndrome (IBS)
• Chronic pain, especially chronic back pain

What is cognitive behavioral therapy (CBT)?

Cognitive behavioral therapy (CBT) is widely considered to be the gold standard in psychological treatment for a range of different mental health conditions. Research has indicated that CBT can have a positive impact on chronic illnesses and ailments with physical symptoms, including fibromyalgia.

Cognitive behavioral therapy is a form of talk therapy that can be enhanced by the therapeutic relationship between the therapist and the client. The basic premise of CBT is that a person’s thoughts, attitudes, and assumptions have a significant impact on their life and that shifting such thoughts, attitudes, and assumptions can change a person’s life in a positive way.

In a course of cognitive behavioral therapy, a therapist works with their client to identify ineffective or unhelpful thought or assumption patterns. Once those patterns have been identified, the client can recognize and understand the unhealthy impact they’re having and draw links between negative thought patterns and negative life events. The client and the therapist can then work together to replace ineffective thought patterns with those that are more beneficial, which may translate into positive life changes. 

Cognitive behavioral therapy for fibromyalgia

Since cognitive behavioral therapy is a psychological treatment, and fibromyalgia is a chronic disorder with primarily physical symptoms, some people may not consider using CBT to treat fibromyalgia. They may believe the therapy won’t work, or they might worry that if CBT does reduce their symptoms, this will indicate the fibromyalgia was “all in their head” all along. 

Using psychological treatment for a physical illness does not mean it’s any less physical. The body and brain can be strongly connected, and CBT has been found to be successful in providing treatment for a variety of physical ailments. The therapy may even create physiological changes within a patient’s brain, which can lessen pain.

Evidence suggests that engaging in cognitive behavioral therapy may help patients with fibromyalgia make behavioral modifications that improve their symptoms in the following ways:

• Higher tolerance for exercise and learning to exercise in a way that does not result in a flare-up of symptoms
• Improved sleep habits and hygiene, leading to a reduction in insomnia
• Identifying activities that frequently lead to pain and adjusting such activities in a way that reduces the likelihood of pain 
• Improved alertness and cognitive function and decreased fatigue
• Reduced symptoms of depression and anxiety
• Greater consistency in following treatment regimens recommended by a patient’s primary care physician and/or specialists
• Learning to pace oneself during symptom flare-ups, leading to an improvement in pain-related functioning 

One study published in the clinical journal Arthritis Care Research found that completing an eight-week course of cognitive behavioral therapy treatment reduced functional disability, depression, fear of movement, and pain catastrophizing in adolescents with fibromyalgia. Another study published in the Arthritis Research & Therapy journal compared the efficacy of CBT treatment to the use of pain medicine in fibromyalgia treatment. Not only was CBT found to increase quality-of-life measures, but it was also a more cost-effective treatment option than pharmacological intervention. 

Finding support for fibromyalgia and chronic pain

If you are interested in learning more about ways cognitive behavioral therapy can help reduce your fibromyalgia symptoms, you may want to speak to a licensed therapist trained in providing CBT. The chronic pain and fatigue associated with fibromyalgia can sometimes impede mobility and make leaving the house a complicated prospect. If this is the case for you, you may want to consider online therapy through a platform like BetterHelp. 

With online therapy, you can receive personalized care on your schedule and timeline. Having the ability to speak with your therapist at any time through in-app messaging may help you feel less alone on your physical and mental health journey. If you match with a provider who doesn’t feel like the right fit for you, you can easily switch to a new one to receive the quality support you need.

The efficacy of online therapy for chronic pain

Research has demonstrated that therapy delivered online can have similar efficacy levels to traditional in-person therapy for a range of conditions, including fibromyalgia. One study found that online cognitive behavioral therapy for fibromyalgia patients improved their mood and symptoms and made therapy more available. If you are considering psychological treatment for fibromyalgia, getting online therapy through an internet therapy delivery platform such as BetterHelp may be a helpful option for you.