by Rachel A. Annunziato, PhD, and Bradley Jerson
You may have heard about the mind–body connection, or the idea that paying attention to your mental and emotional health can bring you better physical health. For people with arthritis and other conditions that cause chronic pain, this connection is very important. Stress, depression, and feelings of helplessness can lead to increased pain and difficulty coping. Psychotherapy — working with a trained mental-health professional to address the emotional difficulties you’re facing — is one way to attend to your emotional well-being. Studies show that for people with chronic conditions, psychotherapy can help to improve not only mental health but also physical health. Possible advantages of psychotherapy include an improved mood, better coping skills, and a better quality of life overall.
Despite psychotherapy’s potential to help, many people have never tried it, and some are hesitant to do so. You might have preconceived ideas about what it means to get mental-health treatment. Perhaps you consider seeking professional help to be a sign of weakness or think that psychotherapy is only for people who are “crazy.” Neither of these ideas is true. Avoiding psychotherapy out of fear can keep you from enjoying its benefits, and letting any underlying emotional health problems such as anxiety or depression go untreated could keep you from effectively managing your arthritis. Understanding just what psychotherapy is and what it can do for you will help you decide whether it might be right for you.
Psychotherapy can address general well-being or target specific concerns. The overall goal of psychotherapy for people with arthritis and other conditions is to improve their quality of life. If you’ve recently been diagnosed or your symptoms are becoming more severe, speaking with a mental-health professional (also known as a therapist) can help you learn to live with arthritis and find ways to cope. Therapists may use many different techniques to help you identify and alter unhealthy thoughts such as, “Because I have arthritis, I will never have a normal life.” With help, you can learn to accept and deal with the changes arthritis may bring.
Psychotherapy can also help with depression, which is quite common among people with chronic conditions. Depression may cause you not to care for yourself properly or follow your treatment plan, which could result in increased pain. Feeling depressed can also make you less likely to reach out to others. Fortunately, when used to treat depression, psychotherapy can often help you take better care of yourself and recognize when you need to ask people for help. Getting support from friends and family is important.
Psychotherapy may also help to improve how effectively you manage your arthritis by helping you become more confident in your ability to set and reach goals. Health-care professionals often refer to a person’s belief in his or her ability to achieve a health goal as “self-efficacy,” and studies have shown a link between self-efficacy and decreased pain, improved functioning, and reduced fatigue in people with arthritis. Overall, psychotherapy can offer substantial benefits for both your mental and physical health.
One size doesn’t fit all when it comes to psychotherapy. There are many types of psychotherapy, but in this article we focus on cognitive-behavioral therapy (CBT). CBT has been well studied in people with chronic health conditions, and it can help people with a wide range of conditions improve mood and quality of life, relieve anxiety and stress, manage symptoms better, and follow their treatment plan more closely. A course of CBT is often brief, typically lasting 12–16 sessions, and it focuses on improving well-being by addressing problematic thoughts and behaviors and improving specific symptoms. Therapists who practice CBT serve as teachers, educating you about your mood, your arthritis symptoms, and how the two affect each other and teaching you the techniques that will help you most, based on research findings.
At the beginning of each CBT session, the therapist creates an agenda for what you will talk about or practice during the session and encourages you to offer feedback on it. The goal of CBT is to provide you with a set of techniques that you first practice during therapy and then do on your own. Therapists often track your improvement by asking you to complete questionnaires before and during therapy. CBT therapists often take a team approach and encourage family members to get involved as well.
CBT consists of many strategies that can be helpful for people with arthritis. The following are some examples.
Relaxation training. In relaxation training, the therapist teaches breathing exercises, guided imagery (a technique in which you imagine pleasant scenes or activities to help yourself get into a more relaxed state), or mindfulness exercises, which are ways to help you focus on the present without distractions. These techniques have many benefits, including reducing anxiety and pain.
Behavioral activation. This technique helps make sure you’re doing activities that you like and are good for you. Because of pain, you may stop doing things that you enjoy. Using behavioral activation, a therapist can help you get back to these activities.
Last Reviewed on September 29, 2010
Rachel A. Annunziato is an Assistant Professor at Fordham University and the Mount Sinai School of Medicine in New York City and a clinical psychologist specializing in behavioral medicine. Bradley Jerson is a doctoral candidate in clinical psychology at Fordham University.
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