Living a Meaningful Life With Chronic Pain: What Cognitive-Behavioral Therapy Can (and Can't) Do
If you live with chronic pain, you've probably already heard a lot of well-meaning advice — try this stretch, cut out that food, have you tried this new supplement or peptide? What you may not have heard as much about is the role your mind plays in how pain is experienced. A structured, skills-based approach like Cognitive-Behavioral Therapy for Chronic Pain (CBT-CP) can genuinely change your day-to-day life. And I have seen it in the thousands of patients I have treated over the course of my career.
I want to be upfront about something: CBT-CP is not about being told that your pain is "in your head." It's real. What the research shows is that pain, stress, sleep, mood, and how we think about pain are interrelated, indivisible. When we intervene on that system, people can get real relief.
What the research actually shows
Early in my career, I helped run a study looking at a brief, 6-session CBT-CP group for Veterans with chronic pain, delivered right in primary care. This wasn't a hand-picked group of easy cases — it included people with a wide range of pain conditions, many with co-occurring anxiety or depression, and about half were taking opioid medication for pain.
The results were encouraging. Across six weeks, participants reported meaningful improvements in pain levels, physical functioning, sleep, mood, anxiety, and — maybe most importantly — pain catastrophizing (that spiral of "this is never going to get better" thinking that tends to make pain feel even more unbearable). And notably, people benefited whether or not they were on opioids, suggesting these skills work regardless of what medications someone is already using.
Therapy has evolved — and so has the toolkit
More recently, I worked on a study looking at what happens when you add a mobile app (Pain Coach, developed by the VA's National Center for PTSD) into that same group therapy format, delivered over telehealth. The Pain Coach app is free and available to anyone with a smart phone, not just Veterans. The findings were something I think anyone considering therapy should hear: people who used the app between sessions attended significantly more sessions overall, and using it early in treatment was linked to staying in treatment longer. In plain terms — practicing skills between appointments, even with something as simple as an app, seems to help people stick with the process long enough to feel better.
One detail from that study stood out to me: age didn't predict who used the app. Older adults engaged with the technology just as much as younger participants. So if you've assumed you're "not a technology person,” the data suggests otherwise.
What this means if you're considering therapy
CBT-CP isn't about eliminating pain entirely — for most people living with chronic pain, that's not a realistic goal, and frankly, promising it would be dishonest. I want to be clear: CBT-CP can and does reduce pain symptoms, but it’s also about helping you:
Understand the connection between stress, thoughts, and physical pain
Build a toolkit of relaxation and pacing strategies that fit into a real, busy life
Challenge the thought patterns that quietly make pain feel bigger than it needs to
Improve sleep, which is often one of the first things chronic pain affects
Reconnect with the parts of your life pain has pushed aside
If you've been managing chronic pain largely on your own — or feel like you've "tried everything" medically and are still stuck — individual therapy focused on these skills can be a genuinely different kind of intervention. It won't erase your pain, but it can change your relationship to it, and that's often where the biggest quality-of-life gains happen. If you’re going to be in some level of pain anyways, how do you want to live out the remainder of your life in a satisfactory way? How can you live a meaningful life in the presence of whatever pain is left over?
If this resonates, I'd love to talk with you about what individual therapy for chronic pain could look like for you specifically. Reach out to schedule a consultation.
Dr. Amber Martinson is a licensed clinical health psychologist and is VA-certified in Cognitive Behavioral Therapy for Chronic Pain, Cognitive Behavioral Therapy for Headache, and Primary Care Mental Health Integration. She has authored nearly 50 peer-reviewed research articles in the area of chronic pain and mental health.
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