CBT for Pain - Module 5 Summary

CBT for Pain: Learn To Relax

Think about your relationship with relaxation.

The word “relaxation” might make you think of lying on the sofa watching TV. Or, maybe you imagine resting in a hammock on vacation. These are enjoyable activities, but we’re going to take a different approach to relaxation.

In this module, we’ll talk about relaxation and why it’s important for helping you manage your pain. We’ll also review some relaxation methods to help your pain.

Before we talk about relaxation, let’s go over the opposite - your “fight or flight” response.

The "fight or flight" response (or stress response) is your body’s normal reaction to stressful situations. It’s helpful in life-threatening moments. For example: if a bear is chasing you, your stress response prepares your body. Your heart rate goes up, and you’re more alert. You’re ready to fight, or “take flight” and run.

However, you don’t want to have a stress response when there’s no danger. Chronic pain can cause your stress response to be overactive, and relaxation can calm your stress response.

Relaxation is a skill you can learn. It can help you manage stress, including pain-related stress. When you take time to relax, it can help you cope with tension, stress, and anxiety.

Think back to a time when you feel your stress was well-managed. What was your environment like? What did you do to manage your stress?

When you have chronic pain, you also have chronic physical and emotional stress. These worsen your pain, just as your long-term pain makes you feel stressed.

When you can cope with stress, it helps you manage your pain. With practice, you can learn to use relaxation methods as part of your daily routine. Relaxation techniques reduce the impact of the stress response. This allows you to better manage both your pain and your stress.

There are many effective relaxation techniques to choose from. We recommend breathing exercises, progressive muscle relaxation (PMR), and guided imagery meditation. We also offer live yoga classes and pre-recorded meditation videos/audios. Talk to your coach to learn more about these.

Breathing exercises help lower tension and relieve stress. They soothe your nervous system by engaging your mind. This slows down your heart rate and lowers your blood pressure, which helps you feel calm. Below is a simple breathing exercise you can do anywhere, at any time.

With progressive muscle relaxation (PMR), you tense and then relax single muscle groups throughout your body. This teaches you to let go of the tightness you might be carrying. It also brings awareness to the parts of your body that hold tension.

Guided imagery meditation involves focusing on pleasant or neutral mental images. This process helps you "break the train of everyday thinking." It’s usually done using a recording or video that leads you through the steps.

Barriers To Relaxation

Relaxing might not come easily to you. It’s hard to free the mind and focus on just one thing like your breath or an object. Your pain can make it even harder to focus on anything else. These things that get in the way of your relaxation are barriers. Being aware of your barriers might help you overcome them.

Take a moment to think about what interferes with your ability to relax - what are some of those barriers? Think about work, your family, your daily activities, your mindset, etc.

Working on pain management requires you to be ready and willing to make changes to your lifestyle, thoughts, and habits.

You already know: Chronic pain usually leads to less movement, which causes you to become deconditioned. The pain and decreased activity often leads to negative thoughts and feelings. These factors can lead to avoidance behaviors. All of this usually leads to more stress and disability, and then increased pain.

Think about your readiness to change your habits to improve your pain. On a scale from 1 to 10 (1 = least, 10 = most), how would you rate your willingness to make changes? Talk with your coach if you feel unsure. They can help you decide if you’re ready to change.

Know your Pain and its Triggers

Understanding your pain and its triggers can help you manage it.

Earlier, you read about how thoughts and beliefs about pain can make it harder to cope with your pain. These thoughts and beliefs can worsen your pain and stress, making it harder for you to function day-to-day.

Are you aware of the things that worsen your pain? You can use the techniques in your program to become aware of triggers (like failing to pace yourself) and cope with them more easily (for example, through journaling, deep breathing, etc).

Improving your relationship with relaxation may take some time and practice. The following slides will cover some tips to help you through the process.

Be Patient

The more you practice relaxation, the more you’ll feel the positive effects. And, once it becomes a regular habit, it will be easier to do. Think about your other habits - when you do them often, they become easier. They might be so easy that you don’t even realize you’re doing them.

Find Your Control

It’s hard to feel like you’re in control when your pain is overwhelming. Although you’re learning about tools that can help, only you can decide you’re ready to make changes and take action.

Get Support

While no one can do the work for you, having support helps. Your Goodpath coach can help support and motivate you. Having encouragement from family, friends, and coworkers makes a difference, too.


  • Relaxation is a learned skill. It’s helpful for managing stress, including stress triggered  by pain.

  • Use relaxation techniques when you feel more pain or stress.

  • There are barriers that make it harder to relax, but there are also ways to overcome them.