Pr. Stacey CALAHAN

M.A., PhD; Professeur de Psychopathlogie, Université deToulouse 2, Jean-Jaurès, Toulouse, France

Cognitive behavioral therapy (CBT) applies learning and conditioning principles to understanding links between thoughts, emotions, and behaviors. CBT can identify maladaptive behaviors and provide insight into developing more adaptive strategies. Historically, CBT has had a significant influence on behavioral medicine (BM), a sub-specialty that applies CBT treatment strategies to individuals with chronic conditions. These strategies have a high success rate in improving patient outcomes; in recent years CBT and BM research has extensively studied treating chronic pain, both as a specific pathology as well as a co-morbid manifestation of other psychological disorders. Individuals with chronic conditions that cause pain often develop major depression over time and can experience significant levels of anxiety, often expressed in ruminative thought processes. Moreover, as the worldwide population ages, chronic pain will become a more significant element in the lives of most individuals: statistics show that by age 80, 80% of individuals report living with some form of chronic pain. Research has shown that developing good coping strategies is a key element in confronting chronic pain in daily life. These strategies can take the form of psychoeducation, learning new more adaptive behaviors to reduce pain occurrence, understanding the cognitive interpretations and representations of pain, and learning to accept negative emotions. Specific psychological variables have been shown to improve the likelihood of good coping strategies; these include fostering optimism, self-compassion, and acceptation of one’s conditions while at the same time not giving in to resignation. While treating pain with CBT and BM have traditionally been the domain of specialists, the increasing frequency of pain will require most therapists to develop basic skills in helping patients with chronic pain.