CBT cutting down on the sweat in patients with hyperhidrosis

Hyperhidrosis, a condition that causes excessive sweating, is brought on by a combination of the body’s temperature regulating system and emotional factors. The way emotional triggers affect this condition had never been studied in depth.

A recent study at the Mayo Clinic in Minnesota showed that Cognitive Behavioral Therapy (CBT) helps not only with the general anxieties that trigger sweating, but also with social anxiety brought on by hyperhidroses itself and therefore can further reduce the unwanted sweating.

Fibromyalgia – real disease getting real benefit from CBT

People with Fibromyalgia suffer on many levels. They live with a chronic and painful, life-altering, multi-system disease that affects about 2% of the general U.S. population. For many years, they also suffered from widespread skepticism and debate about the disease itself. Was it real? Wasn’t it the same as Chronic Fatigue Syndrome, which the media disparagingly called Yuppie Flu?

Thankfully, the uncertainty officially ended in 1990 when the American College of Rheumatology established criteria for its diagnosis. This was a positive step; however, appropriate treatment would remain unclear.

A good deal of research has emerged since then and a recent review of treatment protocols for Fibromyalgia showed that the best outcomes involved pharmacologic therapies in combination with Cognitive Behavioral Therapy (CBT). Exercise and patient education, part and parcel of a CBT approach, were also important.

Cognitive therapy strategies “help patients understand the effect that thoughts, beliefs, and expectations have on their symptoms.” It was also very important to use the strategies to help patients prioritize time to achieve balance in their daily lives.

When patients get angry in session

Judith S. Beck writes in:

Some therapists are quite concerned about their patients becoming angry at them. Yet when therapists respond sensitively, they can help patients learn important lessons.

The first thing I do when a patient becomes angry is to elicit their automatic thoughts and positively reinforce them, in a genuine way. “I’m so glad you told me that.” And I am glad. If there’s a problem, I want to know about it, so I can fix it.

Next, I conceptualize the problem in order to decide what to do. If I think the patient is correct, I’ll apologize – and in so doing, become a good role model. For example, a patient might be annoyed because he felt I was interrupting him too much. If he had that reaction, he’s right. I overestimated his tolerance for interruptions, so I can – again genuinely – say, “You know, I think you’re right. I did interrupt you too much. I’m sorry.”

If I don’t think I made a mistake, I can still genuinely say, “I’m sorry you’re feeling distressed,” because I truly am sorry if something I’ve said or done (or not said or done) made the patient feel worse. Then I try to figure out how to solve the problem, which might involve helping the patient evaluate his negative ideas about me or suggesting we change what we’re doing in the session.

Demonstrating to patients that interpersonal problems can be solved is sometimes one of the greatest benefits of therapy.