
- •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
Putting the problem-solving process into practise
Here’s a problem-solving guide for you to use with your own problems. Write out all the steps in your notebook.
Problem-solving guide
STEP 1: DEFINE THE PROBLEM
What is the problem or goal?
Talk it through, or make notes for yourself until it is clearer.
Break it down into smaller parts if necessary.
STEP 2: LIST ALL POSSIBLE SOLUTIONS
Remember to include ‘silly’ or ‘bad’ suggestions, and as many ideas as you can.
STEP 3: LIST ADVANTAGES AND DISADVANTAGES
Highlight the pros and cons of each idea.
STEP 4: CHOOSE THE ‘BEST’ SOLUTION
Choose which idea you are going to try first.
Remember to take into account your resources:
• Time
• Money
• Skills
• Circumstances
• How will you carry it out?
• What problems might there be with it?
• How will you overcome them?
• Are there any bits you need to practise first?
STEP 5: REVIEW YOUR PROGRESS
Look at progress so far and revise your solution if necessary.
CHAPTER SUMMARY
• Problem-solving skills will help you deal with life situation difficulties and other problems such as mood difficulties.
• The first and most important step is to define the problems you may have at present.
• Going through the five-step process described above should help you find ways of solving problems.
• Reviewing your progress with the ‘best’ solution can help you learn how to deal with similar problems in the future.
11
Understanding sleep and sleep problems
This chapter aims to help you to understand:
• What sort of sleeping problems can be caused by chronic pain
• What kind of sleep pattern you have at present
• How much sleep you need
• How to use a sleep diary
• How to change unhelpful sleep habits
Problems with sleep usually fall into one of the following categories:
• Difficulty getting off to sleep
• Waking often, with problems dropping off again
• Waking in the early morning and being unable to sleep again
• Feeling tired, groggy and not refreshed on waking
• Sleeping too much or for too long
What sort of sleeping problems can be caused by chronic pain?
For people with chronic pain, there are some extra problems that can interfere with getting a good night’s sleep.
Tick the ones that apply to you:
• It may be difficult to get comfortable or lie still for long.
• Being less active may lead to changes in sleep patterns.
• Some pain medication can make you drowsy during the day.
• Some people find that medications, which helped them to sleep at first, don’t work in the long term.
• Some people feel that it’s not worth sleeping longer because they have a ‘hung-over’ feeling the next day.
• Waking because of pain or nightmares can make you feel tense and makes it harder to get back to sleep.
• Some people get into the habit of napping during the day. This can be a way of finding some relief from the pain. However it can disrupt night-time sleep even more.
• At night, problems can seem worse because time seems to pass more slowly.
• Being worried or feeling low can affect sleeping patterns, whether you are in pain or not.
• Other problems or difficulties?