What is cognitive behavioral therapy?

The marketers are out in force these days. They want to convince everyone that there is a pill to cure all ills. Oral medications are convenient for the patient. Just swallow and wait for results. They are profitable for the doctors because it takes only a minute to write out a prescription and wheel in the next patient. If you have to talk to the patients, this is fewer patients per day and less profit. It's great for the pharmaceutical industry. Just press the "go" button on the machines in the factory to make the pills and watch the money roll into the bank account. But, as a country, do we really want everyone to be dependent on pills? Surely there must be a better way of delivering treatment to those who need it. Well, in the question lies the answer. The most effective treatments deal with the patient as a human being with a problem instead of a piece of meat to be pacified and sent away with a pill. This is not to say that pills cannot and do not provide effective relief. The drugs used to treat anxiety are safe and effective. But all the major clinical trials show that cognitive behavioral therapy (CBT) produces better results than drugs. So what is CBT?

If you have an anxiety disorder, you should be the focus of attention. You need to move from a negative mindset to a positive outlook on life. Let's take each of the letters in turn:

c = cognitive. Cognition is the process of thinking. It deals with beliefs, opinions and all the other emotions and ideas that run around inside our heads. The problem with anxiety is that you see the future and fear the worst. It's great to have foresight. It helps you avoid danger. But you need a sense of proportion. Not everything is really dangerous, not everything has to be perfect, so you need to learn new priorities. Stop the automatic fear response. Slow down and think about the world more carefully. With a little determination, you can be more focused, avoid anger and frustration, and build a better outlook.

b= behavior. This is what you do and this is your chance to put that new world view into practice. When you have learned the new skills of relaxation, you have to confront the real-world situations where you have felt anxious. No more hiding away. You have to destress, grow calm and find peace as you try to reach your goals.

t = therapy where a guide teaches you coping skills so you can heal and recover from all that negative emotion and find new purpose and optimism. This is not teaching you to be less anxious. It's teaching you to be more self-confident.

Nothing in CBT denies a role for xanax. It's a great drug for the relief of anxiety over the short term. In fact, using xanax helps to calm your mind and make you more responsive to the therapy. As your mind slowly changes around to a positive way of thinking, you can ease off on the drug and allow yourself to start living life afresh. Let your new self-confidence crowd out the old fears and leave your mind calm.

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What is pain management?

In a simple case where you have had an accident and, perhaps, broken a bone, there will be acute pain lasting for a reasonably short period of time. Under normal circumstances, these physical injuries heal and the pain goes away. But, sadly, there are many medical conditions where the pain does not go silently into the night. In cases of chronic pain, you and the doctors advising you have to come up with strategies to help you cope - to make the best of your life under difficult circumstances. Now, the medical profession has recognized that, independently of the underlying cause, pain itself is something to be treated. To do so, there are a range of different techniques, including:

• the use of drugs;


• different kinds of physical therapy, counseling and psychological support;


• acupuncture and forms of treatment slightly outside the bounds of conventional Western medicine; and


• surgery and other forms of procedures to intervene and relieve.

There is a distinction in the type of pain. Some is classified as nociceptive. Here the nervous system is properly identifying the source of the pain as a specific injury or particular point in the body. The symptoms group into radicular and somatic, depending on where the person feels the pain. The pain is said to be neuropathic when the nervous system is not working as it should, i.e. there is no obvious cause for the pain, but the brain insists that there is an injury in a particular place. This type of pain is more difficult to treat because the underlying cause is more difficult to diagnose.

The problem in every case is to decide the best approach. Not everyone reacts to the underlying medical cause in the same way. There are varying degrees of pain and people respond to that pain in slightly different ways. Some are more accepting. Others grow depressed and turn themselves into invalids. So all pain management decisions start with a review of the individual's medical history, asking what has been and can be done to treat the underlying cause, what level of pain intensity the person feels, whether the person has a positive or negative mental attitude, and so on. It is possible that more tests may need to be performed. If targeted surgery or other forms of intervention might relieve the pain, this should be tried first.

While waiting for a specific diagnosis or for the treatments to begin, it is probably appropriate to use one of the standard drugs to control the pain. The best drug is tramadol and it is most commonly prescribed to treat moderate to severe pain across a wide range of cases. You should not self-medicate, i.e. do not go online and buy tramadol without first having a doctor check you out and make sure that it is safe for you to take this drug. You should also not resort to the pill bottle every time you have pain. At an early point, you should have effective treatment either for the underlying cause or for the pain itself and live without using drugs as much or at all.

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