“Pain in this life is not avoidable, but the pain we create avoiding pain is avoidable.”
― R.D. Laing

Cognitive Behavior Training (CBT)


How you think about your condition, your symptoms, your goals… your life – all have direct and immediate impact on the quality of your life and the extent to which you suffer or thrive. Cognitive Behavior Training (CBT) is a discipline directed at helping people understand more about how their thoughts, memories and beliefs shape or control their anxieties, their pains, their fears, and with this understanding learn simple methods of reshaping their experience.

CBT is becoming the cornerstone of treatment for many conditions including chronic pain, anxiety, stress, depression, addiction and many other chronic conditions. It is highly recommended as a tool to explore in the management of any condition that may impair quality of life. CBT is not difficult to understand or engage and it often provides immediate and useful insights and techniques that result in a positive outcome, no matter the person or their condition.
For those who wish to explore CBT in a free, self-directed course:

CBT Self-Directed Course


Accurate Clinic offers group CBT sessions every other Wednesday afternoon (participation must be scheduled in advance). Individual training sessions are also available by appointment.



Cognitive Behavioral Training (CBT) and Chronic Pain Management

“Don’t make it worse by thinking it’s more painful than it actually is.”
― John Boyne 


CBT and Chronic Pain

Several studies have shown that CBT can help patients who have chronic pain reduce pain and associated distress, disability, depression, anxiety, and catastrophizing, as well as improve coping, functioning, and sleep.

How our Thoughts, Feelings, and Actions affect Pain

When the pain signal is experienced and processed in the brain certain thoughts, memories and emotions may be activated. So, when a person experiences pain sensation s/he will have some emotional responses to it and will experience certain thoughts and/or images during or immediately following the pain. Similarly, thoughts and emotions that have activated in the brain may also affect the pain signal. In other words, our thoughts, memories, and emotions can influence the experience of pain physiologically.


Our negative, unrealistic thoughts about pain and other life events can have a significant and negative impact on how we perceive pain sensations, how we feel emotionally, and what we do when we are in pain.


When we think negatively, we are more likely to feel emotionally distressed, which can result in:


  1. Muscle tension, making the pain worse
  2. A hyper-aroused state in our nervous system, activating more pain messages in our bodies, leading to more pain.


When we think negatively, we are also more likely to engage in self-defeating behaviors (e.g., inactivity, social isolation, over reliance on medications), which can also affect our pain. Often times, the thoughts and images we have about our pain and life events in the moment are related to underlying beliefs. Most people who have chronic pain have beliefs about their pain (i.e., “the pain has taken over my life”), themselves (“my pain makes me a weak person”), and their bodies (“my body is broken”), their relationships with others (“my doctors don’t care about my pain”, “no one understands what I am going through”) and about their future (“I am doomed to be pain-ridden forever”).


CBT and Chronic Pain Management

CBT addresses the importance of realistic, healthy beliefs, attitudes, and behaviors in reducing emotional and physical suffering associated with pain. CBT is geared toward identifying any emotional, cognitive, behavioral, physiological, and/or environmental (e.g. family, social, cultural, and societal) difficulties that might be influencing the experience of pain. Although it is rare for clients to become pain free, cognitive therapy teaches people how to reduce their pain, how to be less affected by their pain, and enhance their functioning in various life roles.


CBT sessions focus on helping clients learn to cope with their pain and their lives by learning:


  1. to think more realistically about their pain and other life events
  2. to relax more effectively than before (by using deep breathing techniques and relaxation exercises)
  3. to manage their activities given their pain
  4. to communicate in an assertive manner with others including their physicians, family members, and friends about their pain
  5. to solve problems related to pain and other life stresses.


The course of cognitive behavioral therapy typically starts with a focus on pain management and then moves to other concerns or issues. The primary target for changes is client’s negative, unrealistic thoughts, images, and beliefs about their pain, the consequences of having pain, and other life stresses. Cognitive behavioral therapist also help client’s identify behaviors that exacerbate pain and stress and teach clients new coping strategies as well as adaptive, health behaviors.


Information taken from www.academyofct.org


  1. CBT and pain management summary
  2. CBT Self-Directed Course (download)
  3. Neuroplasticity
  4. Contextual-cognitive-behavioral-therapy-for-severely-disabled-chronic-pain-sufferers-effectiveness-and-clinically-significant-change-2007
  5. Does pain hypervigilance further impact the lack of habituation to pain in individuals with chronic pain? A cross-sectional pain ERP study – 2018



  1. “Your Brain on Pain” by Michael Moskowitz MD

Online free self-help & CBT courses:

  1. Mobile phone web page
  2. Main website for additional free Self-Help courses

Emphasis on Education


Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.


For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.


Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.


For more information, please contact Accurate Clinic.



Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.

Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.

Accurate Supplement Prices