Both the patient and the family should be taught to view chronic pain as a problem exacerbated by passivity and the expectation that doctors are the only source of relief via medication or surgery. They must understand that the patient can acquire a meaningful measure of control over pain by becoming the doctor's active partner in pain management. During the last 20 years, cognitive-behavioral therapy has found the strongest empirical support for managing aversive experiences, ranging from depression to anxiety to chronic pain. By identifying and altering maladaptive thoughts, people can change the nature of their experience. Such thinking leads to helplessness and despair.
Patients benefit by learning to manage their catastrophic thoughts effectively.
They can be coached both to develop more realistic expectations and to rationally dispute their catastrophic cognitions. Developing realistic expectations is critical. Many chronic pain patients have debilitating physical conditions that prevent them from even under the best of circumstances achieving a level of mobility they once enjoyed. For treatment to succeed, patients need to grieve their loss of bodily integrity and be helped to accept their condition without capitulating to it. Chronic pain patients frequently restrict their physical activity in the belief that activity will inevitably exacerbate their pain.