By: Dr Alex Robber
This is what Perry Nicassio calls fibromyalgia an’ enigmatic’ condition. I did not think so, because so many chronic pain conditions seem to be similarly ‘enigmatic’! It is a chronic condition, affects many more women than men, has a multiplicity of effects on people ranging from tiredness, poor sleep, generalized pain, to sensations of pain such as stabbing or needle-like pain that can occur anywhere in the body, often with low mood and function loss.
There are few medications that seem to help and there are many people who never seek treatment for their pain. When patients are searching for treatment, they can face skepticism from some health care providers, desperation from others, and receive a range of therapies that may not appear to do anything to improve the situation.
Outcome of psychological therapies
Did I paint a bad picture? It is only so that the good news still looks good! And the good news is that there has been a clear finding in a recent meta-analysis of psychological treatments that both short-term and longer-term results have improved with this kind of feedback.
OK, the impact sizes were low but kept, and the positive thing about cognitive behavioral therapy (which was found to be the most powerful therapy brand) is that once learned, no one can take it away again, unlike medicines!
Some therapies focus on psychological issues, which doesn’t mean psychiatric fibromyalgia
Any discussion of this topic will be contentious. That’s understandable, particularly given the lingering misconception of fibromyalgia being “just” depression or some other psychological issue in the public and medical community. However, the important thing to understand is that while psychological issues are based on these therapies, that doesn’t mean fibromyalgia is psychological. Here are a few things to remember.
- Fibromyalgia is a neurological illness and involves neurotransmitters (chemical messengers in the brain) that are also involved in some mental illness.
- Stress is a major exacerbating factor in many, if not most, cases of fibromyalgia. It’s suspected as a causal factor and known to make symptoms worse and cause flare-ups.
- Depression and anxiety are common overlapping conditions in fibromyalgia.
- Studies suggest that childhood trauma may alter the body’s physiological stress response, leading to illness later in life.
- Living with a chronic, debilitating illness is difficult and can lead to a lot of negative emotions, and certain types of therapy may help alleviate those emotions. (This is also true of diseases like cancer, which no one thinks is psychological.)
- Psychological treatments aren’t recommended as stand-alone treatments, but as part of a treatment regimen. They’re not intended as replacements for other approaches.
- The brain is changeable. Thoughts have an impact on brain chemistry, so changing thought patterns can affect physiological changes.
Mainstay treatments for fibromyalgia
The key fibromyalgia therapies include daily exercise, which seems to be associated with hydrotherapy, but there is tai chi, Pilates, walking, and anything that gets the entire body moving. People with fibromyalgia often react to getting more information about their condition is strength! And to cognitive therapy recognizing and engaging with unhelpful thoughts to test their helpfulness and accuracy, and then to find new ways of looking at the situation;
Many widely used and researched therapies in this meta-analysis include biofeedback and relaxation training; sleep restriction and other types of sleep control (e.g. sleep hygiene, cognitive therapy); activity regulation such as scheduling, pacing, preparation, and graded activity increases; coping interventions such as constructive behavioral reinforcement and risk management for good behavior.
Emotional Awareness and Expression Therapy
According to the lead researcher Mark A. Lumley, PhD, EAET is an amalgam of methods already common to many therapists. These techniques cover:
- Psychodynamic therapy
- Experiential therapy
- Exposure-based therapy
- Expressive writing
- Rescripting therapy
“We’ve only selected and repackaged concepts or strategies from other, more popular methods, and offered some new ideas to make them more appropriate for pain conditions,” Lumley said in an interview. What that means is, while EAET is a new approach, it is one which therapists can easily duplicate.
EAET’s key aim is to help people overcome unresolved emotional problems. In the sample, 230 fibromyalgia patients had an eight-week treatment plan, one group receiving EAET, another receiving CBT, and the third group receiving counseling on the disorder. At the start of the study the participants were evaluated, upon completion of the treatment, and six months later.
Why Is EAET Needed?
During fibromyalgia, the brain amplifies and even produces pain signals during response to things that should not be causing pain. The pain pathways of the brain “overlap much with pathways that deal with the warnings and risks of risk. If you could alter the directions with respect to a person’s sense of control or fear, minimize anxiety and increase their power by overcoming some of those emotional limitations, it will at the same time reduce the experience of pain. “Lumley said.
He says adaptive anger is a often avoided emotion, even in therapy. Many people in their lives have justifiable resentment toward men, as well as other feelings about relationships. By becoming mindful of those feelings and learning to convey them in healthy ways, he says it can counteract the “helplessness, anxiety and sense of being lost that so many people are feeling.”
Multiple studies support what many of us know from experiencing chronic illness is hard on relationships. Common misunderstandings of fibromyalgia and its confounding existence just add to the problem. Problems with relationships cause stress, and stress revives our symptoms.
P. (2010). Psychological approaches are effective for fibromyalgia: Remaining
issues and challenges Pain, 151 (2), 245-246
Glombiewski, J., Sawyer, A., Gutermann, J., Koenig, K., Rief, W., & Hofmann, S. (2010). Psychological treatments for fibromyalgia: A meta-analysis Pain, 151 (2), 280-295 DOI: 10.1016/j.pain.2010.06.011 ‘PSYCHOLOGICAL THERAPY’ WORKS FOR FIBROMYALGIA! via HealthSkills