Psychological coping and the management of pain with cognitive restructuring and biofeedback: a case study and variation of cognitive experiential therapy.

Pain is generally recognized as being influenced by multiple psychological factors. Cognitive experiential therapy may use cognitive restructuring with imagery and hypnosis. The restructuring of negative cognitive, affective, behavioral, and physiological states occurs through six stages. This case study illustrates the use of cognitive restructuring and biofeedback with a woman hospitalized for depression and a chronic pain syndrome consisting of tension headache pain. Measures of headache pain (frequency, intensity), skin temperature, and assessment with the Millon Behavioral Health Inventory consisting of broad categories and scales were taken at pretest, posttest and follow-up. The biofeedback treatment alone showed some physiological improvement. Cognitive restructuring and biofeedback resulted in improvements on the Millon, and reduction of headache symptoms at the posttest. Gains on the Millon broad categories of personality coping styles and psychosomatic correlates were maintained at follow-up and chronic headache pain was not reported. Self-report headache frequency and intensity decreased over time with the cognitive restructuring and biofeedback approach.