Pain Acceptance In Fibromyalgia
Is More Successful Than
Cognitive Coping Techniques

Interesting study showing that pain acceptance techniques are more successful than cognitive behavior techniques in term of functioning in fibromyalgia.

“A great deal of research supports the role of pain acceptance in the daily functioning of people with chronic pain. In clinical samples, the acceptance of pain is associated with less pain, distress, disability and with greater psychological wellbeing. Pain acceptance methods are associated with improved emotional, psychosocial and physical functioning and with reduced healthcare use. Coping with pain is directly trying to change pain, and what the person feels and thinks about pain. Acceptance of pain is directing efforts towards functioning and living; acceptance is "coping" with life.”

This is another way of showing that ready made recipes used in cognitive processing therapy are counterproductive. By opposition, techniques using socratic thinking where the patient finds the answer within have much better results. It means that accepting the pain and dealing with one’s limitations and managing with it is much better than role playing with guarding and resting that results in nothing being done. A useful life is made of action. Sure, if fibromyalgia imposes some limitations it is better to deal with what we have rather than stay put which ends up in more frustration. Life before was better? There is no magic wand out of fibromyalgia and it is better to accept it and go forward. Any success is measured in term of goals achieved, not in chewing up what would have been without the disease.

We have always used the Socratic method that calls on the solutions and ways to deal with what we’ve got rather than reciting mantras and this study comforts us in this approach. Whilst we do not advocate overdoing it, we push towards activity with relaxation periods. Not passive relaxation where nothing happens but active relaxation that aims towards more activity.


Rodero B, Casanueva B, Luciano JV, Gili M, Serrano-Blanco A, Garcia-Campayo J. Relationship between behavioural coping strategies and acceptance in patients with fibromyalgia syndrome: Elucidating targets of interventions. BMC Musculoskelet Disord. 2011 Jun 29;12(1):143



Previous research has found that acceptance of pain is more successful than cognitive coping variables for predicting adjustment to pain. This research has a limitation because measures of cognitive coping rely on observations and reports of thoughts or attempts to change thoughts rather than on overt behaviours. The purpose of the present study, therefore, is to compare the influence of acceptance measures and the influence of different behavioural coping strategies on the adjustment to chronic pain.


A sample of 167 individuals diagnosed with fibromyalgia syndrome completed the Chronic Pain Coping Inventory (CPCI) and the Chronic Pain Acceptance Questionnaire (CPAQ).


Correlational analyses indicated that the acceptance variables were more related to distress and functioning than were behavioural coping variables. The average magnitudes of the coefficients for activity engagement and pain willingness (both subscales of pain acceptance) across the measures of distress and functioning were r = 0.42 and 0.25, respectively, meanwhile the average magnitude of the correlation between coping and functioning was r = 0.17. Regression analyses examined the independent, relative contributions of coping and acceptance to adjustment indicators and demonstrated that acceptance accounted for more variance than did coping variables. The variance contributed by acceptance scores ranged from 4.0 to 40%. The variance contributed by the coping variables ranged from 0 to 9%.


This study extends the findings of previous work in enhancing the adoption of acceptance-based interventions for maintaining accurate functioning in fibromyalgia patients.

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