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Therapy for Trauma, Relationships May Improve Fibromyalgia Symptoms

Couple stands for a moment while talking walk outside to enjoy natureA recently developed therapy approach, emotional awareness and expression therapy (EAET), may ease symptoms of fibromyalgia, according to a study published in the journal PAIN.

EAET encourages participants to address feelings linked to trauma and relationship difficulties. People with fibromyalgia, a chronic pain condition, tend to have higher levels of trauma and relationship difficulties than those in the general population.

Psychotherapy for Fibromyalgia

The randomized clinical trial assigned 230 adults with fibromyalgia to one of three groups. One group received cognitive behavioral therapy (CBT), which is currently supported by research as an effective treatment for chronic pain. A second group received EAET therapy. EAET therapy encourages participants to see their pain as the product of alterable brain circuits that can be affected by emotions. It also encourages them to identify and process emotions such as sadness and anger. These two therapy groups were then compared to a control group that received only educational information about fibromyalgia.

Each group met weekly for eight weeks. Researchers assessed participants on a number of pain and emotional measures before, immediately after, and six months following treatment. Compared to participants who received only fibromyalgia education, those who participated in EAET reported better physical functioning, fewer symptoms of depression and anxiety, greater life satisfaction, and fewer difficulties with cognition. About a third (34.8 percent) said they were “very much” or “much” improved, compared to just 15.4 percent who said the same in the educational group. This suggests EAET may offer benefits comparable to CBT.

On some measures, EAET outperformed CBT. More participants in the EAET group (22.5 percent) than in the CBT group (15.4 percent) saw a 50 percent reduction in pain. Following treatment, EAET participants also had fewer fibromyalgia symptoms than those in the other two groups.

Chronic Pain and Mental Health

Pain is both a physiological and a psychological experience. A person’s mental health can affect the way they experience pain, and research has linked poor mental health to an increased risk of pain. For example, a 2016 study found that back pain could worsen mental health. Another 2016 study found that the partners of people with depression are more likely to experience chronic pain.

Although pain does have a psychological component, this does not mean the symptoms are not real. What it does suggest is that people may be able to better cope with pain by changing the way they think about their life and about their pain. These changes in thinking can help pain feel less severe and help life feel more manageable. In short, EAET’s focus on pain sensations as changeable and linked to emotions may help people regain a sense of control after experiencing the loss of control that can accompany fibromyalgia.


Lumley, M. A., Schubiner, H., Lockhart, N. A., Kidwell, K. M., Harte, S. E., Clauw, D. J., & Williams, D. A. (2017). Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia. PAIN, 1. doi:10.1097/j.pain.0000000000001036

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  • Leave a Comment
  • Theo

    October 6th, 2017 at 7:17 AM

    I would be very curious to learn how these two things actually correlate.

  • Claier

    October 12th, 2017 at 8:51 AM

    One issue with fibromyalgia which is not talked about much is how hard it is for others to understand that there is something very real going on with you. They might tale a look at you and think you look healthy when really they have no clear idea of how much pain you are actually in. I suspect that this can cause many difficulties in marital relationships as one partner cannot understand what is going on with the other. So whatever kind of treatment that they could receive, I believe it is always going to be valuable to have a clearer understanding of what it is that your partner lives with. This can help improve their mental health and in turn the physical aspect of it as well.

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