
- •Other titles in the series include:
- •Overcoming chronic pain a self-help manual using Cognitive Behavioral Techniques frances cole, helen macdonald, catherine carus and hazel howden-leach
- •Isbn: 978-1-84119-970-2 eIsbn: 978-1-47210-573-8
- •Table of contents
- •Acknowledgements
- •Foreword
- •Introduction by Peter Cooper Why cognitive behavioral?
- •Introduction
- •Who might benefit from using this book?
- •What does chronic pain mean?
- •What is Cognitive Behavioral Therapy?
- •How can a book help?
- •How can I get the most out of using this book?
- •What do the chapters cover?
- •How do I start using this book?
- •Four case histories
- •Using the person-centred model
- •Maria and the person-centred model
- •How did the model help Maria make changes for the better?
- •How can the person-centred model help you get ready tomake some changes?
- •Getting started
- •Reducing the impact of pain on your daily life
- •How do you or others see these changes occurring?
- •Understanding chronic pain and pain systems
- •Understanding pain
- •Acute and chronic pain
- •What is acute pain?
- •What is chronic pain?
- •Acute and chronic pain systems
- •The acute pain system
- •The chronic pain system
- •Theories of pain The Gate Control Theory of Pain
- •Other theories of pain
- •Frequently asked questions
- •Understanding investigations for pain
- •Blood tests
- •Waiting for tests and results
- •Understanding the roles of healthcare professionals
- •Healthcare professionals
- •What is the role of a physiotherapist?
- •How do physiotherapists work?
- •What is the role of a specialist pain nurse?
- •What is the role of a pain specialist?
- •What is the role of a psychologist?
- •What is the role of a psychiatrist?
- •Talking therapies
- •Cognitive Behavioral Therapy
- •Pain management programmes
- •Understanding medicines and using them better
- •What types of medicines are used to manage chronic pain?
- •How are medicines used? Analgesics
- •Problems with medicines
- •Making better use of medicines
- •Four suggestions for using medications more helpfully
- •Stopping or reducing your medicines
- •Part two Overcoming Chronic Pain
- •Introduction
- •Setting goals
- •What are goals?
- •Informal and formal goals
- •What are smart goals?
- •Setting goals
- •Using a goal ladder
- •Achieving your goals
- •Giving yourself rewards
- •What are rewards?
- •Creating a ‘fun presciption’
- •50 Mg of fun three times a day (at least) For maximum benefit, use imagination!
- •Understanding pacing skills
- •What is pacing?
- •What are the different styles of pacing?
- •What type of pacing style do you use at present?
- •If pain levels are low, do you:
- •If pain levels are high, do you:
- •How to change your pacing style
- •Experimenting
- •Planning
- •Priorities
- •How to deal with barriers to realistic pacing
- •Getting fitter and being more active
- •How being more active can help you manage your pain
- •Trying to get fitter: What does having more pain mean?
- •Why do these types of activity cause aches and pains?
- •Assessing your present activity level
- •Frequently asked questions about increasing physical activity
- •How to get started on a basic exercise programme
- •Strength exercises – do slowly
- •Stretches for flexibility
- •Understanding problem-solving
- •What is problem-solving?
- •The main steps in problem-solving
- •Putting the problem-solving process into practise
- •Problem-solving guide
- •Understanding sleep and sleep problems
- •What sort of sleeping problems can be caused by chronic pain?
- •What kind of sleep pattern do you have at present?
- •How much sleep do you need?
- •How to use a sleep diary
- •How can you change unhelpful sleep habits?
- •Relaxation
- •What is relaxation?
- •How can relaxation help with chronic pain?
- •What can help you relax?
- •How to practise relaxing
- •Time out relaxation
- •What can make it difficult to practise relaxation?
- •Pain, communication and relationships
- •Part 1: communication and sharing concerns How close relationships can be affected by pain
- •How to manage difficulties in relationships
- •How to change behavior
- •How to communicate and share your concerns
- •Part 2: chronic pain and sexual relationships
- •How to deal with sexual problems
- •How to make sexual relationships easier
- •Managing depression, anxiety and anger
- •What moods can occur because of pain?
- •Part 1: managing depression
- •Why do people become depressed with chronic pain?
- •How depression affects people’s thinking
- •What factors can contribute to depression?
- •Unhelpful thinking in depression
- •Using anti-depressants
- •Part 2: managing anxiety
- •What is anxiety?
- •What are the effects of anxiety?
- •How does anxiety affect the body?
- •Anxiety and chronic pain
- •Managing anxiety by dealing with unhelpful thinking
- •Overcoming avoidance
- •Changing unhelpful behaviors
- •Part 3: managing anger
- •How anger affects you and your pain
- •How chronic pain and anger are linked
- •How being angry can affect other people
- •How to manage anger better
- •A coping plan
- •Acceptance
- •What is acceptance?
- •How can acceptance help you manage chronic pain?
- •What is attentional control or mindfulness?
- •1. Reasonable (thinking reasonably)
- •2. Emotional (thinking emotionally)
- •3. Wise (being mindful)
- •Mindfulness skills
- •1. Observing
- •2. Being ‘non-judgemental’
- •3. Focusing on one thing now and being in the present
- •4. Doing what works
- •Mindfulness exercises
- •Maintaining progress and managing setbacks
- •How can you maintain progress?
- •Obstacles to progress
- •What is a setback?
- •How can you manage a setback?
- •Looking to the future and managing work
- •How are new ways of life and new roles possible?
- •How can you use a positive data log?
- •Thinking through work, training and other options
- •How can you stay at work or return to work successfully?
- •Useful information
- •Professional organizations
- •Self-help groups and organizations
- •Books and publications
- •Self-help books
- •Tapes and cDs
- •Useful videos
- •Wordlist
What are goals?
Goals are plans of activities or things that you wish to achieve for yourself or with others, despite having chronic pain. Goal setting is a very useful skill to help you live with chronic pain. You can set both short-term and long-term goals – to suit your needs. Goal setting helps you focus on important activities, achieve success and increase your self-confidence.
For example, to become more physically active, you might set yourself the goal of swimming 12 lengths of the local pool twice a week over a two-month period. Or, if you want to mix with people more, you might set a goal of having a family meal out or a day shopping with friends once a month.
Goals are a helpful way of watching and recording your progress. They enable you to see and believe that change is possible in a range of activities, despite the pain. Sometimes, if you are suffering from chronic pain, activities take longer and require more planning. It doesn’t mean they are impossible. Setting goals puts you back in the driving seat and helps you regain control in many different areas of your life.
Informal and formal goals
Setting goals, when you have no pain, is a normal day-to-day activity. You may not even be aware of setting goals. For instance, you may think: ‘I’ll do this today, then I will go there . . . and then I can do that.’
Think about the goals that you frequently and informally set yourself. For example, ‘I’ll go and do some weeding in the garden’ or ‘I’ll just clean the bedroom’ or ‘I’ll paint the kitchen door’ are all goals stated in an informal way.
In chronic pain it can be helpful to set goals in a formal way in order to achieve particular activities or tasks. Planning goals formally may be new to you, and it may take a little practice until you feel confident about setting them regularly.
What are smart goals?
Your goals also need to be SMART, meaning that they should be:
• Specific
• Measurable
• Achievable
• Realistic
• Timed
Using SMART to set your goals will give you a clear view of what you want to achieve by a set time. It will help you plan how you get there. And it will help others to see what you hope to achieve with your goals. All these factors will increase your chances of success.
WHAT DO THESE FACTORS REALLY MEAN?
Specific: Be clear about what you actually want to do. For instance, ‘Be more active’ isn’t that clear. But ‘Walk more’ tells you and others exactly what you want to do.
Measurable: Set a measurable goal. For instance ‘Walking three times (3×) per week for half an hour’ tells you and others when you have reached your goal.
Achievable: This may be tricky. Think about what you are capable of doing now. Then try to picture what you think you can achieve within your time period, for example eight weeks.
Realistic: Be honest and reasonable with yourself. For instance, climbing a 3000-foot mountain in the Lake District may not be realistic, in 3 months’ time. However, it may be a realistic long-term goal for 12 months’ time.
Timed: Decide how much time you are going to give yourself in order to achieve your goal. It may be a few weeks, which would be a short-term goal. Several months or even years would be a long-term goal.