gydytoja psichoterapeutė Rūta Petereit, Clinic AGATAS, kognityvinė elgesio terapija


Chronic pain is one of the most common ailments in modern society. It is also one of the main causes of incapacity for work, which has a negative impact not only on the physical and psychological well-being but also on economic performance. Statistics show that more people are suffering from chronic pain in the world than diabetes, heart disease, and cancer combined.

Chronic pain is very complicated. Often, it may not even be localized, as, for example in the cases of stretched ligaments or a burned hand. It may spread, covering a wider area of ​​the body. People very often perceive pain only as a physical ailment and sensation. However, pain is closely related to both biological, psychological and emotional factors. Those who are suffering from chronic pain, especially if it lasts for a long time, start to feel the side effects – anger, despair, sadness, anxiety, insomnia. Therefore, it is not surprising that to achieve long-term positive results, pain must be treated holistically, taking into account physical, emotional and psychological aspects. For this reason, all the world’s most advanced pain treatment clinics use multidisciplinary treatment – various methods of pain management – medical or invasive, surgery, physical therapy, and psychotherapy.


Cognitive Behavioral Therapy (CBT) is a complementary measure for pain treatment. It helps to cope with health problems by gradually changing the thinking and perception of chronic pain and its negative side effects. Learning how to stop negative thoughts in time can help a person to deal with life’s challenges and difficult situations including, physical and psychological pain.

The purpose of this therapy is to learn how to avoid stressful situations or cope with anxiety or depression. It is a way of changing mindsets by focusing on thoughts (cognitive part) and actions (behavioral part). CBT helps to recognize negative feelings and thoughts. Therapy helps to learn how to stop such negative thoughts and replace them with pleasant ones. This helps the person to relax and feel better, calmer. To develop such thinking, a person learns to calm both the mind and the body. There are a variety of methods to do this. The patient together with the psychotherapist tests and selects methods that are the best in the individual case. This can include meditation, yoga, listening to relaxing music, creating a positive image, and so on.


Cognitive Behavioral Therapy helps a person to develop the skills needed to change physical wellbeing with the help of the mind. When we shift our thoughts away from the pain and focus on the positive aspects of life, the physical response of the body to pain and stress changes. Therefore, not surpisingly many psychotherapists often suggest this method to patients who are suffering from chronic pain. It helps to change attitudes and thoughts about the experienced pain. Patients are also encouraged to be as active as possible. In addition to psychological well-being, physical activity is important in the treatment of pain. It helps to divert thoughts from unpleasant sensations. Physical activity doesn’t have to be intense at all. Sometimes a pleasant walk or a light swim is enough.

Usually, people suffering from chronic pain delay getting an appointment with pain specialists. Especially if the pain is nonspecific. In this case, it is rather difficult to name the source of the pain and its specifics. Then without a specialist’s supervision, a person starts taking a variety of painkillers. So, when the patient finally visits a pain specialist, sometimes the treatment cannot be started due to adverse drug reactions. In such cases, cognitive behavioral therapy can be a great help with no medications.


It is important to realize that psychotherapy sessions are a serious commitment. Continuity is essential. One session is not enough. The patient must realize that suffering from pain for a long time has its negative outcomes – physical, psychological and behavioral. Changing all of this is hard work.

During CBT, the doctor asks the patient about the pain he/she is experiencing: 

  • when, how, where the pain occurs;
  • what may aggravate the pain;
  • what negative emotions the patient feels;
  • whether negative behavior may lead to the occurrence of pain or its exacerbation. 

The psychotherapist tries to find out what stressors are causing anxiety, fear, anger, and other negative feelings. Taking all these factors into consideration, the practitioner will work with the patient to develop the most appropriate treatment plan that meets the needs and capabilities of the individual patient. In any case, the plan typically involves changing attitude to pain, developing relaxation techniques, developing new skills to cope with anxiety or depression.

Treatment of chronic pain can often be long-lasting. It may include several different specialists. An integrated approach to this process yields the best and most lasting results.