This story provides an example of how Cognitive Behavioral Therapy (CBT) helped Ken cut down on prescription pain meds. While the characters and the story are fictitious, the characteristics and circumstances described are typical of people who come for treatment. Ken’s story is presented for illustrative purposes, to help readers understand how CBT can help people cut down on pain meds. Click here to share your own CBT story.
Ken has lived with chronic pain since an accident at work ten years ago. At that time, his physician prescribed opiate-based pain meds, and increased the dosage at every visit, because it was never enough for Ken to cope with the pain he was in. Ken was also depressed about losing his job as a result of the accident, and within the first few years, had used up all of his savings and his compensation payment looking for a treatment that would take away his pain. While trying to get by living on disability payments, his physician told Ken he may be addicted to prescription pain meds. Ken was referred to a pain clinic where he received CBT, physical therapies to help him learn to live with his pain, and consultation with an ABAM physician.
Tracy, Ken's cognitive behavioral therapist, guided Ken in recording the thoughts and feelings he experienced throughout the day, taking special note of the times he took his pain meds, and changes in his pain level. By analyzing the thoughts and feelings Ken had around his pain and use of pain meds, they came to understand that Ken had become addicted to pain meds because of his obsessive focus on every twinge of pain, and lack of attention to positive experiences in his life, and times of reduced pain. Tracy explained that emphasizing the negative impact of pain on his life, a tendency known as magnification, put Ken and his prescribing physician in an impossible position, because it is not possible to become pain-free all of the time, particularly when living with a serious injury. They also realized that Ken’s physical and emotional pain had become entwined -- for example, Ken’s back pain was elevated every time he thought about how much he missed his old job.
Ken’s ABAM physician was able to gradually reduce (or “taper”) his pain meds to a much lower level over the course of a year. During this time, Ken did not experience withdrawal, because the taper was so gradual. And he worked with Tracy to start to notice the good things in his life, such as the freedom that he had to define his own activities, and the time he could spend with his grandchildren. She also helped him develop more reasonable expectations of his pain level and his ability to cope with his pain.
Although Ken is not pain-free, he now rates his pain as fluctuating between about 2 to 5 out of 10, instead of 8 to 10 out of 10 when he started CBT. He is on a much lower dose of pain meds, and he is over his depression.
- Does this sound like your story? What was your experience of cognitive behavioral therapy?
