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Adrienne Dellwo

Cognitive Behavioral Therapy for Fibromyalgia & Chronic Fatigue Syndrome

By January 2, 2013

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Cognitive behavioral therapy (CBT) is a frequently recommended treatment for fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS). But should it be? What do we really know about it?

Answers to those questions vary greatly, depending on which condition you're talking about, and which definition of ME/CFS you look at.

CBT is an especially controversial treatment with it comes to ME/CFS, and the controversy lies at the heart of a fundamental disagreement among researchers as to what ME/CFS actually is. You can learn more about what the research says, and which camp says what, here:

When it comes to CBT for FMS, things are much more straight forward. He's what the research says about it:

Have you had CBT? Did it help? Did it hurt? Leave your comments below!


New From the Glossary

January 2, 2013 at 8:28 am
(1) dfwmom says:

CBT is not bad as a metaphorical crutch. It’s not really going to improve your condition, but since you have to live with horrible pain, stiffness and disability, it helps you adjust to that and live with that. It is palliative care.

My objection to CBT is that it is window dressing for medical providers who don’t have a clue how to treat this disease. They wave CBT around proudly as if they’ve accomplished something really special. I am reminded of the old rape joke — ” just lie back and enjoy it”. That’s what CBT is — “close your eyes and relax and pretend it doesn’t hurt”. It is one step away from faith healing.

The medical community needs to stop spending so much money telling us how great CBT is, if we just try harder to *believe*, and start spending money on finding a cure or an effective treatment, and I don’t mean just trying the antidepressant of the month. I mean real basic research.

January 2, 2013 at 8:39 am
(2) dfwmom says:

A quote from the New York Times…
“The Goals of CBT. The primary goals of CBT are to change any unclear or mistaken ideas and self-defeating behaviors.”

If you are not “unclear” about your fibromyalgia, and don’t have “mistaken ideas and self-defeating behaviors”, CBT may not help you very much. This plays into the “blame the patient” mentality. Fibromyalgia patients aren’t really sick, they are just “self-defeating”.

Fibromyalgia is a real physiological condition. If you think you are in pain, then you are probably not mistaken, or unclear on the concept.

Another quote from the New York Times…
“the effects of CBT and other non-medication treatments for fibromyalgia do not always last over the long-term”

CBT as a treatment for fibromyalgia is somewhat helpful, but it is massively over-hyped.

January 2, 2013 at 9:35 am
(3) MissyD says:

I wonder if any of the people who are against CBT have ever tried it. No, I do not think that psychology can cure a physiological illness. However, my experience is that I have not dealt well with being disabled. I don’t accept not being able to do what I could do, nor am I very good at pacing myself. CBT has been of huge value to me in this regard, and guess what! If I am less angry, less stressed, and pacing myself better, I am going to feel better. Yes, I am still tired, Yes I still hurt, But yes, I do feel better, my life is better and I am grateful for that.
I am in total agreement, that just because this makes some people like me feel better, that is no reason to call it “the” effective CFS treatment. However, I get fed up with people throwing stones at it too.
Hopefully, it is recognised as “a” treatment that helps some people feel better. Personally, though, I think people who resist trying it for fear that it supports a mental illness definition are missing an opportunity. “Oh no, that won’t help me, I’m not even going to try it”.
As a next, logical progression of my therapy, I am going to work on Mindfulness Meditation and living. My feeling is that anything that can contribute to my wellness is worth a shot.

January 2, 2013 at 10:46 am
(4) Rachael says:

The problem with CBT for ME/CFS patients is that it is advocated as a treatment for the autoimmune/neuroimmune illness, or a cure by psychiatrists like Professor Simon Wessely. In other illnesses, such as cancer or MS, CBT is used as an adjunct, an optional treatment for patients who are distressed because of their condition. Herein lies the problem. CBT may be beneficial for all of these conditions, but will cure none of them, including ME/CFS.

January 2, 2013 at 1:41 pm
(5) Abot Bensussen says:

I was helped greatly by my years of good therapy. I needed to learn skills to deal with how I handle problems in my mind. and I did learn new techniques to keep me from anxiety.

Being understood is so rare and wonderful, that, alone, is worth the price.. I had to learn to drive a long distance in very scary neighborhoods to get to the dr. and it was a strengthening part of therapy, too. I became more independant and began to understand myself better, which is always helpful.

I recommend this therapy for any one wishing to evolve.

March 28, 2013 at 7:24 am
(6) Springdale Clinic says:

CBT is a form of talking therapy that combines cognitive therapy and behaviour therapy. It focuses on how you think about the things going on in your life your thoughts, images, beliefs and attitudes (your cognitive processes) and how this impacts on the way you behave and deal with emotional problems. It then looks at how you can change any negative patterns of thinking or behavior that may be causing you difficulties. In turn, this can change the way you feel.

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