Rational Emotive Behavior Therapy improves coping

The basic principle of Cognitive Behavioral Therapy is that errors in thinking (also called irrational beliefs) cause us to develop negative emotions that disrupt our ability to maintain good mental health and achieve our goals. These thinking errors can greatly affect our behavior, too. We can make these errors in two ways.

Externalizing is giving power to something or someone other than ourselves. Some unhealthy ways we do this are by putting unrealistic expectations on our doctors, our support system, or treatments.

Externalizing
Blaming others for creating your next attack
Blaming doctors when treatment fails
Expecting caregivers to know what we need

Healthy Alternative
Knowing your triggers and setting healthy boundaries
Having realistic expectations of treatments
Allowing caregivers to express emotions

Internalizing is focusing responsibility on ourselves. This has the potential to be a good coping mechanism or create an unhealthy sense of self-blame.

Internalizing
Blaming self for causing attacks
Thinking one can control all trigger exposure
Blaming self when a treatment doesn’t work
Thinking one is a bad parent b/c of migraine

Healthy Alternative
Acceptance that some triggers are unavoidable
Maintaining good sleep hygiene, hydration, etc.
Taking medicine as prescribed
Exercising good self-care

Rational Emotive Behavior Therapy

One form of CBT is Rational Emotive Behavior Therapy. This therapy is based on the idea that our automatic thoughts reveal our beliefs about events, circumstances, and people shape our emotions and behaviors. Healthy responses are a result of rational beliefs. Unhealthy responses are the result of irrational beliefs. The therapy itself involves challenging a person’s automatic thoughts by comparing them to facts about the situation in question. A thought is deemed rational or irrational based on whether or not the facts support it. Clients are encouraged to challenge their automatic thoughts and to correct irrational ones with facts to counter it.

The ABC Model

Activating event  ⇒  Beliefs  ⇒ Consequence

Emotional/Behavioral Response:

Negative Event(A)  ⇒  rational belief(B)  ⇒  healthy emotion/behavior(C)

Negative Event(A)  ⇒  irrational belief(B)  ⇒ unhealthy emotion/behavior(C)

Irrational beliefs

Everyone has irrational beliefs. It’s how we respond to them that makes the difference in our ability to cope with stressful situations. Here are just a few common ones:

Perfection
I should be perfect at everything.

Catastrophizing
It is a catastrophic disaster when things are not as I want them to be.

Externalizing
I am helpless to create my own happiness.

Unhealthy boundaries
 I need him/her.

Learned helplessness
I am powerless to change because of my past.

Rigid expectations
There has to be a way to fix this.

Think you don’t do this?

EVERYONE does. We just don’t always recognize what we are doing. Here are a few examples.

Perfection
I can’t stop for a migraine. I have to work, and take care of my kids, and cook, and clean, and be a good spouse, and be there for my friends, and, and, and…

Catastrophizing
No one understands what it’s like. I’m all alone. I’m beyond help.

Externalizing
My husband is tired of this, my kids hate me, my friends have deserted me…you’d be depressed, too!

Unhealthy boundaries
I am afraid my boyfriend is going to leave me because of migraine. How will I ever survive without him?

Learned helplessness
It’s always been this way, I can’t change it. Doctors will never help.

Rigid expectations
There has to be a cure for these blasted things!

I’m not pointing these things out to shame or criticize anyone. I’ve been guilty of making thinking errors just like the examples, too. I’m sharing this because there is a way to break out of these irrational thoughts. Doing so improves our ability to cope with the stressors of living with migraine.

No medicine can do what CBT can do. It is unique, offering benefits unavailable through medical treatment. Yes, Migraine is a disorder of the brain. Just because the brain isn’t working right doesn’t mean we can’t do anything about our thoughts, feelings, and behaviors. There’s a great deal of empirical evidence that CBT treatment does positively alter brain function. Before and after PET and fMRI scans prove that CBT is effective at treating a wide variety of neurological conditions, including migraine.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
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