The Mystery of Fibromyalgia and How Cognitive-Behavioral Therapy Can Help

Fibromyalgia syndrome (FMS) is the medicalmanagement, physical therapy, meditation,
terminology used to represent a complex clinicalexercise, alternative therapies, and
disorder of symptoms characterized by softcognitive-behavioral therapy are useful. CBT is a
tissue pain, stiffness, and altered deep painvaluable therapeutic treatment option for those
threshold with psychological fallout. It can mimic orsuffering from pain syndromes. One of the
accompany symptoms of joint injury, but it is notbyproducts of pain can be the escalation of
an arthritic or neurological condition. The disorderanxiety and depression. Likewise, anxiety and
affects between 3 to 6 million people - or asdepression can intensify the impact of pain and
many as one in 50 Americans. About 80 and 90make it more debilitating.
percent of those diagnosed with fibromyalgia areCognitive-behavioral therapy's goal is to teach the
women.FMS patient to embrace pain rather than fight it.
There is usually an emotional overlay ofCognitive distortions, such as magnification and
depression and anxiety that affects the sufferer."catastrophizing" need to be addressed so that
There are numerous reasons why this is true.patients learn to de-escalate fueling the pain
Many within the medical community haveprocess. How one thinks about his pain affects its
discounted fibromyalgia as a bona fide disease.impact. One can learn to rationally respond to pain
Patients have been told that they areby saying:o "Although this problem is difficult, I can
over-dramatizing their pain and that the stiffnesslearn to manage it."o "What's the use of getting all
or soreness has been psychologically induced.upset about my pain, it won't help anyway."o "If I
Others have been told that the condition wasrelax and walk into my pain, maybe all this will feel
fabricated for attention or perceived by healthless troublesome."o "I'm not alone in this. I have
providers as feigned helplessness. Thesethe support of my family and friends."o "I'm not
assertions from medical experts make patientshelpless, I have many strategies I can try to
with FMS feel ignored, mistrusted, alone andminimize the effect of my pain. Just keep
without support. Patients often turn to self-blame,moving!"
which fuels the pain cycle.Cognitive-behavioral therapy can assist the
The pain and symptoms of fibromyalgia are realfibromyalgia patient to identify stressful triggers
and have a definite physical basis.that exacerbate pain. This may involve examining
There is no known cause for fibromyalgia. Somefamily struggles, exploring inner-conflict, and
researchers have speculated that physical traumaworking with core, self-defeating assumptions that
or viral influences have triggered FMS syndrome inaffect thinking and behavior. Teaching the patient
many patients. There are no known abnormalitiesmindfulness meditation as a way of relaxing the
in the muscle tissue of fibromyalgia patients thatsympathetic nervous system is beneficial.
would account for the disease.Through the use of CBT, a therapist can provide
Current research has focused on regions of thethe fibromyalgia patient with structured
FMS patient's brain and the susceptibility of certainhomework assignments that will help pain
brain locations to pain sensitivity. The brainsufferers to experiment with new behaviors such
receives a pain signal from the muscles and staysas increased involvement and activities. Motivating
in a state of alert. For unknown reasons, the brainthe client to set realistic goals for everyday
fails to let go of the pain signal and sets up afunctioning can be helpful. Encouraging a
chronic pattern or pain syndrome. The brain staysmultidisciplinary approach involving exercise,
in a constant feedback loop, consisting of aphysical therapy, rehabilitation and pain
system of amplified pain signals.management are essential.
Recent brain scan research studies have shedFibromyalgia patients fear that their disorder will
new light on this disorder. Results published in thecause them to lose the ability to function at work
May 2008 edition of the Journal of Americanand at home. Teaching patients to focus on what
College of Rheumatology shows thatthey can do rather than their limitations is
neuroscientists have been able to conductimportant. There is a tendency for fibromyalgia
scanning technology to areas of the brainpatients to distort reality by focusing on negative
affected by fibromyalgia. Mild pressure on triggerperceptions to the exclusion of the positive.
points of the patient has produced measurableHelping the patient and family to accept physical
brain response in processing the sensation of pain.limitations is a necessary component to successful
The elevated response of pain in FMS patient'streatment.
brain scans was significantly different from thoseFibromyalgia patients can easily get enmeshed in a
in the control group of the study. This is one ofcycle of pain and associated emotional symptoms.
several studies that validate the reality ofIt is the goal of cognitive-behavioral therapy to
fibromyalgia as a disorder affecting the brain'sassist the patient in coming to terms with his
response to muscular and neuropathic pain.disorder and making plans to manage it. This is
Hopefully, future studies will lead to newaccomplished through acceptance and teaching the
treatment options.patient positive ways of thinking about his
Currently, treatment options consist of the use ofcondition and multiple ways of treating it.
a multidisciplinary approach. Medication