Cognitive Behavior Therapy [CBT] for PHN people
Posted , 7 users are following.
On the "Depression with PHN?" forum, I've talked about CBT as probably the most effective and quickest route to decreasing depression. On this forum, I hope to offer some more detailed guidance toward using CBT. I'm thinking of offering maybe a weekly suggestion for thought and behavior change that will enable people to get better control of the pain and emotions associated with PHN. Anyone interested?
1 like, 54 replies
ruth57682 charlie58834
Posted
Charlie, I would be very interested in that. Sure hope others would b e also. I would think all of us would appreciate that as we are so tired of drugs that don't help.
babs99203 charlie58834
Posted
So would I. But I have to say that my depression varies from day to day and I feel it's related to the Dam Gab (my new name for it). As I'm decreasing, it hits, stays a bit, then poof, disappears. But when I'm in the midst of it, it would be good to be able to come here as a reminder of things to do. On similar note, Ruth, you said that family had suggested you travel a bit to visit them, didn't you? We got back from a 5 day mini-vacation and while the first day was tough (DG and depression) it got better. Now that I'm home I'm feeling much better physically and emotionally. The same thing happened a few months ago after a 3 week vacation. I think the change of pace and location really does help. Think about it. I know they can be a lot of work, but it will pay off.
Artman charlie58834
Posted
Thanks for that Charlie. If CBT is antthing like a modern take in Dale Carnegie's ideas - The Power of Positive Thinking, etc., I am all for it. It could help many people.
?I took it on board in my mid teens and it has been a very postive thing right through my life. Like anyone who has lived into their mid 80s I have been through a few traumas - and survived.
charlie58834 Artman
Posted
Hi Artman,
I'm not sure, but I think The Power of Positive Thinking Is a Norman Vincent Peale phrase. But I think Dale Carnegie had good and possibly similar ideas too.
Anyway, there is some similarity to positive thinking. I advise people to think optimistic thoughts, but only if they are both true and helpful to you. For instance, if you find a negative thought that is worsening your mood, like "This PHN has ruined my life," you could turn it to a positive thought like "It's not that big of a deal, I'll just ignore it." But this thought won't work, because it isn't true. It IS a big deal.
One better thought replacement would be "This PHN is really hard for me, but I WILL find a way to manage it better and I will have a good life." This thought satisfies the test: It is both true and it makes you feel better. Additionally, it guides you toward behavior that will help you. That's the "behavior" part of CBT.
Artman charlie58834
Posted
Many thanks for that Charles.
?Sorry about mix upo in my first posting. It was Dale Carnegie's writing that really changed my life but I also read N Vincent Peal who also had some v. good points to ponder.
?The important point is that a positive mindset can really help in the most difficult circumstances. Your last paragraph really does hold an important key to life.
babs99203 charlie58834
Posted
Charlie that replacement is SO helpful! Often vague suggestions are given about how to do something and the reader is left foundering or worse, like with the first "suggestion" fuming and arguing (which I've been known to do) that it's a stupid suggestion!
I also appreciated your kind wordsin a different post, but it's a struggle. My nature is that I'm a "glass-half-full-half-empty" kind of person. I'm logical, analytical, pragrmatic and tend to be a bit more negative, as I problem solve. BTW, to me, the glass is like Schrodinger's cat, it HAS to be both things!
I've thought of creating a thread about what good has come from PHN and shingles and one of them is that I've been forced to be more positive, as otherwise this is too hard to deal with. I marvel at those who can never say a negative word, always see the bright side and never complain. That ain't me LOL! But staying at my pity party too long doesn't help.
charlie58834
Posted
OK, there is some interest, I'm glad to see. I'll start by sort of defining CBT, cognitive-behavior therapy. The word cognitive refers to "cognitions" which is another word for thoughts. So in CBT we are working on thoughts and behavior.
The basis of cognitive therapy is the idea that thoughts create emotions. This is a foreign idea to many people, especially since our culture has been heavily influenced by Freud's idea that emotions come from "inner conflicts" between different parts of our psyche. In looking at modern psychological research though, there is heavy evidence that it is thoughts that create emotions. Plus, in research comparing different types of psychotherapy [talk therapy], we usually see that CBT is far more effective than other therapies. It tends to work more rapidly also.
So to begin CBT it's necessary to begin to look at our own thoughts and behaviors. When I read people's posts on PHN forums, it's clear that those who are reporting lots of emotional difficulty are thinking the most pessimistic and scary thoughts. Most people think that their situation, their pain from PHN, causes their thoughts, but this is not true. If it were true, all of us with PHN would be having pessimistic and hopeless thoughts, but we aren't. Some of us are not only thinking more hopeful and helpful thoughts, but we're also seeking out and trying new behaviors. Babs' post yesterday is a good example: She talks about taking vacations, going places, and finding out that while it's difficult initially, it pays off. She "feels much better physically and emotionally" not only during most of the trip, but afterward too.
So it's really important to recognize that thoughts create both emotions and behavior! If you know that, now you are ready to move on to the next step, which is altering your emotions and behavior. And isn't that what all of us want, to change emotions from depression/anxiety/anger to more enjoyable ones? To improve the quality of our lives? That's what CBT is all about.
ruth57682 charlie58834
Posted
babs99203 ruth57682
Posted
Despite doing so much better, I still find, Ruth, that I too have to push myself to get out. I went to the library for the first time since October when I got sick, even though I'm a regular user and have been driving again for months. I guess I was taking the easy way out and just reading what I have on hand. This illness does seem to cause more introspection and focus inside, literally and figurately, rather than outside. I may have mentioned that I do ballroom dancing. When I got ill, that was the hardest part--losing that. I had to take a break for 4 months, then injured a knee, THEN injured a foot! When I dance, I laugh, feel like myself and can even ignore the pain.
I was talking to my sister today, who has multiple health issues, but can usually stay upbeat. I told her how much this forum has helped me. Thanks all!
charlie58834 ruth57682
Posted
Ruth,
Great job getting out of the house! And finding another helpful thought when you did.
Babs, you talk about not always being a "glass half full" person. None of us are, me included. But you don't have to be always positive, that's not the goal. You just have to change SOME of the untrue/unhelpful thoughts. Find the ones that defeat you, that are most pessimistic and hopeless. Those are the targets.
So, the example I gave, the thought "This PHN is ruining my life." This is a thought I caught myself thinking in the first years of my PHN. It's what we call a "depressogenic thought." In other words, a thought that causes depression. It's a very common thought among people who have long-term pain. If you keep saying it, or even thinking it, it will become true. But if you change it to a true and helpful thought, it then becomes a strength! That thought for me was "I WILL find a way to manage this pain and make my life good again". From that point on I began to search for creams or other topical meds that would help. And I found some that did help.
So maybe that healthy thought can become our first suggested "thought of the week." "I WILL find a way to manage this pain and make my life good again."
croft4Penny charlie58834
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croft4Penny charlie58834
Posted
charlie58834 croft4Penny
Posted
babs99203 charlie58834
Posted
I thought of you all yesterday. I had a really bad stretch. (I WAS going to say "day", then realized, no, it wasn't a whole day, just 3 hours, thanks Charlie). We have an above ground pool I really enjoy. In WI, there aren't many days week can use it and I've been having trouble swimming without discomfort, but it's been getting better. So yesterday was a beautiful day and I could REALLY swim! So I did...and paid for it. Two hours later, after errands and grocery shopping I realized I was in rough shape. I could barely carry in some lightly packed bags and still had dinner to make. Well that didn't happen, had to go out to eat. I haven't been that uncomfortable (ah heck, in pain) for a while. So much for my swimming for now. I'll go back to easy paddling around.
ruth57682 babs99203
Posted
Sorry you had a bad "3 hours". I hadn't even considered swimming. We so have a pool here with lots of opportunities for exercise. I know the arm movements would be painful but I sure could use the exercise. Maybe just some water walking. I was afraid that would really irritate the skin sensitivity. Like you, I used to love ballroom dancing and that is such great exercise lost my partner 2 years ago and therefore don't dance anymore. Mentally, since touching base with all of you, I have a good couple of days!
charlie58834 babs99203
Posted
Sorry to hear you had a bad day, Babs, but you get points for catching yourself thinking in an exaggerated way about your pain and correcting it. That type of thinking is called "catastrophizing" in CBT terminology, and it's one of the ways people make their mood worse and make themselves feel powerless. "Catching" catastrophizing thoughts and changing them into true and helpful thoughts is the process of CBT.
You rephrased the thought from "I had a really bad day" to "I had a bad 3 hours." Then you did something else helpful: You came up with a plan to adjust your behavior, giving up "really swimming" [which I imagine means swimming some lengths of the pool for a full workout] and deciding to keep it at "paddling around," which you know you can do without too much pain exacerbation. Good job! You changed both your thought and your behavior.
So we can't cure PHN or control the pain 100%, but we can decrease the pain some and maximize our functioning as much as possible. The alternative is to stay inside and sit around focusing on our pain and making our lives low in quality, so what you are doing is really healthy!
charlie58834 ruth57682
Posted
Ruth,
I like your idea of trying a new exercise, water walking. Thinking about what we CAN do rather than what causes pain is a pathway to mental and physical health.
Our thoughts determine our emotions, and our quality of life. It's really important to monitor our thinking and not allow ourselves to focus on the negative more than necessary. And to instead focus on what helps us. For you, maybe that's working toward some type of exercise that is tolerable, and connecting with others who encourage you.