COGNITIVE DEFUSION IN FIBROMYALGIA

COGNITIVE DEFUSION IN FIBROMYALGIA

Cognitive defusion is a skill or technique primarily used to detach, separate, or get some distance from our thoughts. It is a cognitive distancing process that we elaborate on when choosing a different relationship with the stream of thought that flows through our heads. Stoic philosophers argue for adapting judgment rather than reality. This method of cognitive distancing implies reframing situations more objectively and less emotionally to regulate distress. The above practice reduces the limbic system’s threat response, permitting the rational prefrontal cortex to perceive challenges as temporary and manageable. Cognitive reappraisal techniques for self-distancing ameliorate depression, anxiety, and stress reactivity in challenging situations.

Chronic pain patients are asked to identify thoughts and see them as assumptions rather than objective facts that describe the world. So, those trapped in the context of their cognitive activity should separate themselves from the literal meaning of thoughts and perceive the function of thinking as a continuous process that is placed according to the situations. Defusion is about seeing the thoughts themselves as an outside observer. Watching the thoughts, not watching the world through the thoughts.

When you feel trapped by a thought, notice it: ''Every time I go out for walking, my pains get worse''.

Take a step back from the thought and think to yourself:

“I’m noticing a thought that tells me every time I go out for walking, my pains get worse.”

Take another step back and think to yourself:

''I’m noticing I’m just having a thought that states every time I go out for walking my pains get worse.”

Take an even further step back by thinking to yourself:

“I notice I’m having just another thought that will hurt when I go for walking,” or even further back with “I’m noticing I’m having just another judgment.”

Cognitive defusion and pain acceptance are crucial factors within the frame of acceptance and commitment therapy (ACT) for the well-being of patients with fibromyalgia. Disarming the content of beliefs loosens the shackles of excessive literalism and reveals possible behaviors that allow patients to act according to their chosen values. The main weakness of cognitive ''disarmament'' is its contradiction as a therapy. It aims to subdue the excessive meaning of thoughts, which directly opposes the disputing and checking of cognitive errors based on cognitive psychotherapy. Disputing cognitive events is in broad contrast to defusion because it depends on the literal meaning of thoughts. Fibromyalgia patients who have obsessive-compulsive features show a fragile cognitive system and seem disturbed at the idea of simply observing thoughts, neither agreeing nor disagreeing.