Expert Author Duncan Smith

Symptoms that let people who suffer from migraines know the migraine is coming are called prodromal symptoms. Not all migraineurs are fortunate to experience these but for those that do the warning they get is sufficient for them to plan how they are going to handle the down time they are about to enter. Cognitive behavioral therapy can help a migraineur use those same prodromal symptoms to short circuit the migraine attack.

The aim of cognitive behavioral therapy is for migraineurs to recognise and consciously manipulate their behaviors that play a part in the development of their headache. The patient and therapist together determine how the migraineur behaves when they feel a headache coming on or, for those who do not experience prodromal symptoms, when the pain starts. Together they then attempt to develop alternative behaviors to use in the same situation that will change the migraine.

The therapist and migraineur work together in cognitive behavioral therapy to:

  • Identifying the problem behavior that needs modification. Often this is achieved by keeping a headache diary.
  • Establishing a treatment goal. Aiming for total annihilation of the migraine is probably not very practical in the beginning. Instead steps along the way should be established like learning to relax around possible migraine triggers.
  • Create new patterns of behavior in an effort to effect changes.
  • Monitoring the patients reaction to their new behavior as well as checking for external factors that may be influencing or affecting that behavior.

Some of the more common therapy techniques are listed below:

  • Desensitization
  • Positive Thinking
  • Reframing
  • Role-Playing
  • Self-Talk

Although cognitive behavioral therapy is helpful in its own right, it is particularly useful for patients who are also on preventative drug therapies. A study done in 1989 found the success rate of clinic-based and minimal-therapist contact behavioral therapy had approximately the same success rate. This makes it an affordable alternative remedy for migraineurs.

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