ACT (Acceptance and Commitment Therapy) for Chronic Pain

The Chronic Pain team at Kaiser offered me ACT group therapy, a type of cognitive behavior therapy, and it’s been very helpful. A psychologist did the 10- or 12-week program over Zoom with a small group of 6 of us with severe chronic pain. One dropped out.
The rest of us have gotten so much value out of it that 2 years later we are still meeting once a month with the psychologist and have another private monthly Zoom with just us.

One thing that was quite different was that we were encouraged to share contact info with each other. That has allowed us to support each other with phone calls and texts during particularly rough patches, which is great. We are very different people but have so much in common—isolation, dependency on family, having had to give up on most or all travel—lots to talk about there.

I think for many of us the support has been the main benefit. But for me the cognitive reframing was a huge help. Early on we shared all the things we had tried to “solve” our pain, and although some medicines, procedures, and home remedies like heat, cold, distraction, breathing practices, and meditation definitely help us cope, nothing made it go away.
I realized my whole life had become centered around trying to solve an insolvable problem! They don’t put you in this group if they think your pain is temporary. So facing that truth (Acceptance) is the logical move.

That is too much for most people, I guess. They refuse to give up hope of finding The Solution. In fact they were shocked and refused to believe that giving up hope could be good! But I decided I didn’t want to waste my remaining years on a wild goose chase. Giving up hope set me free.

In the therapy you go on to identify what’s important to you—family, travel, changing habits or attitudes, writing a will, other accomplishments or goals—and decide what’s realistic. Then you pick a goal and break it down into small measurable steps.

You also learn how to pace yourself. (One of the best tips for me was to do less on your good days and more on your bad days. I had been giving up on getting out of the recliner on days my pain was more severe. When I tried it I immediately realized how much better I felt if I got just 15 minutes done towards a goal. One phone call, or balancing an accounts, or organizing a closet (with the help of an able-bodied person) gave me a lift.
Gradually I became a little more productive, and happier. When I talked to friends, I had other things to talk about besides pain, my doctors, and meds.

If you can’t find a way to get ACT treatment there are books and workbooks about it that will help if you’re determined to give it a solid try, but it’s way easier with the support of a therapist and other people with serious chronic pain.