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Cognitive behavioral therapy can help patients address pelvic pain that is connected to their emotions, stress, anxiety, or other psychological problems. This psychotherapeutic approach to treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is often used in combination with other therapies that target pelvic muscle tension and disorders. Psychological issues can both cause pelvic pain or develop as a result of having chronic pelvic pain.
Tension in the pelvic floor is the root cause of pain for about 50% of men with CP/CPPS. Anxiety and other psychological stressors can trigger this pelvic floor tension. Sometimes having a long-term chronic pain condition can cause stress, anxiety, or depression. For these men, the stress of dealing with the pain of CP/CPPS long-term makes them more vulnerable to depression, stress, and anxiety. Some men begin to feel hopeless or start thinking catastrophically. Catastrophizing is when a person who has anxiety anticipates extreme outcomes or finds it challenging to cope with unfortunate events. Catastrophizing can worsen symptoms of CP/CPPS, making pain and depression worse, and even making pain symptoms last longer. Cognitive behavioral therapy can help patients who find themselves in these situations.
Several studies have linked prostatitis with a history of certain psychological conditions. Prostatitis is unusually common among men who have anxiety and panic disorders. Researchers in Taiwan compared health records of randomly chosen men with those of men who have CP/CPPS. The men who had CP/CPPS were twice as likely to have been previously diagnosed with an anxiety disorder. These findings demonstrate that men with CP/CPPS have higher rates of anxiety than men who do not have CP/CPPS.
How Does Cognitive Behavioral Therapy for Prostatitis Work?
Cognitive behavioral therapy is beneficial because it helps change maladaptive, or harmful, thinking, which can be making symptoms even worse. By working with therapists or computer-based programs, patients are able to break negative patterns and beliefs, replacing them with more realistic and effective thoughts. Doing this can help decrease the emotional stress and self-defeating behaviors that make pelvic tension and prostatitis symptoms, such as pain, much worse.
Cognitive behavioral therapy has positive benefits in helping patients change maladaptive coping skills, emotions, habits, and behaviors into more positive and healthier ways to think and cope.
There are six phases of cognitive behavioral therapy:
- Reconceptualization (the cognitive portion)
- Skills acquisition
- Skills consolidation and application training
- Generalization and maintenance
- Post-treatment assessment follow-up
Cognitive behavioral therapy can be done individually or in a group setting. There are several different techniques for delivering cognitive behavioral therapy, but all the methods share some elements or similarities. Different techniques include:
- minimizing negative or self-defeating thoughts,
- setting goals,
- changing maladaptive beliefs about pain, and
- giving self instructions (imagery, distraction, or motivational self talk).
A typical cognitive behavioral therapy program may have patients meeting with a therapist for an hour-long session every 1 to 3 weeks for 6 to 18 visits. Patients may be assigned homework assignments. Computerized programs can offer a more convenient and less expensive alternative to meeting with a therapist.
Cognitive behavioral therapy has been found effective for treating people with anxiety disorders and certain kinds of chronic pain. It has also been shown to help patients who suffer depression and anxiety because of their chronic pain disorders. Both scenarios are common with chronic prostatitis patients.
Cognitive Behavioral Therapy and Other Treatments
Cognitive behavioral therapy is only one part of a whole-body approach to treating prostatitis. There are a number of other natural and alternative treatments that can help when following a well-rounded holistic approach to diagnosing and treating prostatitis. Many of the causes of chronic prostatitis stem from problems that take place elsewhere in the body and outside of the prostate itself. Some of the more common causes of pelvic tension include stress and emotional health problems, pelvic floor disorders, chronic tension disorders, and inflammation from other places in the body. Sometimes immune disorders or allergies and food intolerances can play a role in CP/CPPS.
The most successful plan for managing CP/CPPS when psychological issues are present is to combine cognitive behavioral therapy other natural and alternative treatments, especially ones that target tension. A treatment program that includes therapies for prostatitis that work well with cognitive behavioral therapy may include:
- pelvic rehabilitation and therapy,
- trigger point release,
- phytotherapy (quercetin and pollen extract),
- stress management,
- dietary changes, and
- relaxing exercises like yoga and tai chi.
A multimodal approach will help you to best target the physical and emotional problems that may be causing your prostatitis symptoms. It helps to have a positive outlook and be patient with your progress, because that positive thinking will help you heal faster.