Excerpted with kind permission from the book Taking Charge of Fibromyalgia – A Self-Management Program for your Fibromyalgia Syndrome by Julie Kelly, MS, RN and Rosalie Devonshire, MSW, LCSW – two health professionals who live successfully with Fibromyalgia. Introduction: Stress Management/Relaxation
Stress is not an external event that produces anxiety or frustration in our bodies; it is our own physical and emotional reaction to external events taking place around us and within us. Studies have shown that there are actual physical changes occurring in our bodies when we are stressed.
Changes which can occur are:
- Muscle tension and pain
- Stomach distress
- Heart irregularities
- Teeth grinding/TMJ
- High blood pressure
- Cold hands/feet
Chronic stress can deplete the body of many chemicals needed for proper functioning, and we can develop various diseases as a result. Research also shows that we can take steps to change the way we respond to stress and create a healing atmosphere for our bodies….The following techniques are useful for reducing the negative effects of stress. With continued practice, these techniques can produce positive changes in how your body and mind react to stress.
Cognitive Behavioral Therapy (CBT)
Self-Talk: What We Say to Ourselves Affects How We Feel
Researchers trying to help people with Fibromyalgia [and Chronic Fatigue Syndrome] have turned to cognitive behavioral therapy as an additional method of alleviating painful symptoms. A therapist using this technique can teach you how to control disturbing emotional reactions by suggesting more effective ways of interpreting and thinking about your experiences. For example, if you make a mistake at work, you might say to yourself, I am the most stupid person in the world! I always make mistakes!
The therapist would point out that you do not always make mistakes and that everyone makes mistakes and feels foolish at one time or another. The behavioral aspect of this therapy asks you to note your mood or feelings when you are thinking these thoughts.
Painful emotions such as guilt, shame, and anxiety can aggravate pain and your Fibromyalgia. We are our thoughts. Negative thinking produces negative behavior. Some research suggests negative thinking causes illness. If negative thinking causes illness, can positive thinking create health?
There are many researchers who believe this is possible. If this idea sounds foolish to you, and you decide it would never benefit your…symptoms, you are probably feeling skeptical and discouraged or maybe even angry. Your pain level may increase as you are having these thoughts. On the other hand, if this sounds like a great idea to you, you may feel an uplift in your mood. If you pay attention to your body at the same time, you may notice a slight decrease in your pain level. Our bodies react immediately to our emotions. If we can control our thoughts, maybe we can control our bodies.
There are trained therapists who teach people how to change distorted or faulty thinking. If you can’t afford psychotherapy, you can read Feeling Good: The New Mood Therapy, by David D. Burns, M.D., or his handbook The Feeling Good Handbook . Some of the basic ideas of cognitive behavioral therapy are provided for you [here].
CBT treatment typically lasts for six to 20 weeks and requires you to keep track of symptoms, thoughts, and emotions. You will be given homework assignments to work on between sessions. Cognitive behavioral therapy is not in-depth psychotherapy. We cannot teach this technique to you in the limited confines of this book, but we want you to have an idea of what it is all about, so you can decide if it is something you should pursue.
Learning To Notice Stress-Inducing Thought Patterns
During treatment, a cognitive therapist will require you to focus on your negative thoughts and to notice when your thoughts follow any of the following patterns:
All or nothing thinking. “I have Fibromyalgia, therefore, I can’t lead a normal life.” Wrong. It would be better to say to yourself, “Many people lead normal lives once they get their Fibromyalgia under control, and I can too.”
Overgeneralization. You see a single negative event as a never-ending pattern of defeat. “My doctor misdiagnosed me; therefore, I can never get better.”
Disqualifying the positive. Rejecting positive experiences as short-lived and possibly not recurring. “My fibromyalgia symptoms were better this weekend when I rested, but it will never happen again.”
Catastrophizing. You exaggerate the importance of things. “I can’t keep my house as clean as I used to. Therefore, I am a failure.” Are you a failure? No, you just cannot do as much as you used to. Ask for help. Learn to live with a messier house!
Should statements. “I should be able to do all that I did before I had Fibromyalgia.” You can’t, and if you try, you will have a flare-up and frustrate yourself. Be kind to yourself. Treat yourself gently.
Personalization. You see yourself as the cause of some negative event for which you were not responsible. “My Fibromyalgia must have started because I was not taking care of myself.”
CBT Attempts to Change Thought Patterns
No one knows why Fibromyalgia starts; you are not its cause. When you experience problems with distorted thinking, your body reacts to your thoughts within milliseconds. Cognitive behavior therapy attempts to change your irrational thought patterns by finding the positive in your negative thinking, stopping self-blame, defusing anger, and reducing feelings of being overwhelmed.
Do you say to yourself I am in pain now and will be forever? Is that true? Aren’t there times when you are free of pain? If you have small amounts of time when you are free from pain, using this technique can increase that time gradually, until you have more time when you are pain-free.
Notice how high your pain level is when you are thinking about your pain, when someone has made you angry, or when you are hurrying to accomplish tasks.
Notice how low your pain level is when you are engaged in pleasant activities.
Researchers know that psychological factors influence the degree of pain we feel. If you develop healthier attitudes, change negative thinking, and learn to be optimistic, your Fibromyalgia symptoms can and will decrease when used in conjunction with the other treatments described in this book [including relaxation techniques, abdominal diaphragmatic breathing, meditation, relaxation tapes, hypnosis, Yoga, biofeedback, and Tai Chi].
It may take many months to benefit from a change in thought patterns, but it is worth trying. You have nothing to lose and everything to gain. This technique can also reduce the risk of becoming depressed.
Another technique that is easy to implement is to use positive affirmations throughout the day. We have provided a list of some for you to try. It is better to say these out loud and repeat them on a consistent basis for the affirmations to work. <pEvery day in every way, I am getting better and better. Repeat that 10 times three or four times a day, every day for a month. See if it helps you. </p
Some people find it helpful to write down positive affirmations on a card to carry in their purse or pocket. Reading the card a few times during the day can keep your positive thoughts on track and prevent negative thinking from creeping into your mind.
Positive Thoughts for Coping with Fibromyalgia
n I am confident of my ability to deal with my health and live a good life.
n Things are getting better.
n I am making progress in helping myself feel better.
n Today I can do what I need to do for my recovery.
n I can treat myself gently and with the special care I would give a close friend.
n I am learning what I need to do to take care of my body.
n I focus on positive actions I can take to advocate for myself.
n I look for the good this day can bring.
n I go with the flow of each new day, accepting what I can learn from it.
n I seek out the positive support I need to live with Fibromyalgia.
n I let go of any muscle tension or problems over which I have no control.
n I live with positive expectancy: each day I expect to feel better and more relaxed.
n I counter each stress with techniques I know will reduce negative stress.
n I can surmount any problem that occurs today with calm, problem-solving skills.
n I can look for the resources I need to manage any problems.
n I maintain slow and easy breathing, bringing fresh oxygen to my muscles and taking away muscle waste products.
n I keep my muscles loose and relaxed throughout the day.
n I take time during the day to relax and breathe to refresh my muscles.
n I creatively manage the problems each new day brings.
n I can do whatever I need to do to take good care of myself.
Changing Negative Self-talk
If you would like to try charting your thoughts on your own, [start a journal to] keep track of your thoughts. Write down your negative thoughts and the feelings associated with them.
You may be amazed at how often your thoughts are destructive or how quickly you can become pessimistic in your thought patterns.
What is important is to become aware of your thoughts, for without awareness of how often your thinking heads downward, your thinking will be impossible to change. Once you notice your thoughts turning negative, determine the emotion that you feel when you are thinking badly about yourself. You may feel worthless, guilty, angry, depressed, sad, or confused.
Once you become aware of a destructive thought, turn it into a more positive statement. Some people find it helpful to imagine a stop sign or a red light in their minds to defuse a negative thought. Other techniques are putting a rubber band on your wrist and snapping it every time a negative thought comes up or paying attention to your breathing to deflect your mind away from negative thoughts.
You may come up with your own techniques over time. Share them with a friend.
* Excerpted with permission from Taking Charge of Fibromyalgia – A Self-Management Program for your Fibromyalgia Syndrome Fifth Edition, by Julie Kelly, MS, RN, and Rosalie Devonshire, MSW, LCSW. Thomas J. Romano, editor. C2005 all rights reserved. Published by Fibromyalgia Educational Systems, Inc.
Disclaimer: This information is intended for education purposes only and is not to replace the services of a trained health professional. The authors and editor do not accept liability in the event of negative consequences incurred as a result of information presented in this handbook.