Cognitive-Behavioral Therapy (CBT)
If you're like many people, the way you think is as distressing as any real or imagined event. Cognitive-behavioral therapy (CBT) can help change the way you think and behave in order to minimize stress and anxiety and thereby lessen your symptoms. If your first reaction to a bad flare is to panic, CBT can help you alter those thoughts so that you are not as fretful and so you behave in a way that supports more positive thinking.
CBT combines two kinds of psychotherapy — cognitive therapy and behavior therapy. Cognitive therapy teaches you how certain thought patterns may play a role in worsening your symptoms. For instance, you may be thinking, “Now I'll never be able to play tennis again.” These thoughts can trigger anxiety and depression, which only make your pain worse.
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When you feel pain, try to keep your focus on the present. Avoid thoughts that take you to the future, such as, “How will I possibly get through the meeting tomorrow if I feel like this?” or the past, such as “I knew I shouldn't have gone bike riding yesterday.” Shifting your thoughts to other moments in time can often worsen the pain.
CBT helps weaken the link between troublesome situations and your reactions to them. For instance, if you typically react to a flare with rage, your therapist will work with you to change that reaction to one that is more positive. It also teaches you how to calm your mind and body so you can think more clearly and make better decisions. In some ways, CBT is similar to education, coaching, or tutoring.

