- •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
Stretches for flexibility
Regular stretches will improve your flexibility so that, for instance, you will be able to get dressed, brush your hair and tie your shoelaces more easily. You could do some stretches as part of your cool-down routine. Choose two or three of them.
To get full benefit from the stretches, you need to:
• Perform one of the above exercises marked with an (S). When your tissues feel tight, hold still in that position. Do not bounce or jerk.
• Hold each stretch for 5 seconds to begin with. Then gradually, over a period of a few weeks, work up to a 15-second hold. Return to the given starting position.
• Stretches only need to be performed once during each exercise session.
• Keep your breathing steady. You should not feel out of breath. If you do, then ease off a little as you are working too hard.
• Stretch on a regular basis. Aim to do 2–3 stretches 3–4 times per day.
Note: The stretches should not be painful. If there is pain then ease off the stretch a little.
WORKING OUT YOUR OWN EXERCISE PROGRAMME
From the list above, choose five strength exercises that you plan to continue – even on a bad day or during a setback. Write them in your notebook.
From the list above, choose three stretches that you plan to continue – even on a bad day or during a setback. Write them in your notebook.
Remember to add in some walking, swimming, dancing or cycling to improve your stamina.
It may help to work with a physiotherapist or fitness coach or personal trainer.
CHAPTER SUMMARY
• Everybody can improve their physical activity and fitness levels, despite pain.
• Improving your activity levels will help you feel good and reduce the impact of pain on your life.
• New aches and pain are normal when you begin increasing your physical activity.
• Little and often is the key. Build up slowly and regularly over a few weeks.
• Build in a mixture of regular daily activities to improve your stamina, strength and flexibility.
• Vary your activities. Make sure that you enjoy them and reward yourself often.
• For more ideas about activity and fitness levels, see the Useful Information section at the back of this book.
10
Understanding problem-solving
This chapter aims to help you understand more about:
• What problem-solving is
• The main steps in problem-solving
• How to put the problem-solving process into practice
What is problem-solving?
Problem-solving is a skill that can help you to cope with many different life problems. These problems may be caused by chronic pain, or by other circumstances. You can use problem-solving to help find the coping strategies that work best for you.
Problem-solving gives you a step-by-step approach to dealing with difficulties. It enables you to face a problem and come up with a plan to try to deal with it. Problem-solving is also a useful way to plan and achieve your goals. This could be anything from organizing limited household finances to getting an awkward glass jar open. Problem-solving can help you to be more confident about overcoming challenges that you face, especially pain. It can put you more in control and help you manage difficulties. It can help you to work out whether something really can be changed or not. If it can’t be changed, problem-solving can help you deal with the unpleasant emotions or thoughts you may have because you cannot change it.