Cognitive therapy in the psychosomatic setting: a treatment’s proposal for fibromyalgia syndrome

Author/s Benedetta Vicino, Rita Bianca Ardito, Annunziata Romeo, Riccardo Torta, Lorys Castelli
Publishing Year 2016 Issue 2016/38 Language Italian
Pages 15 P. 16-30 File size 119 KB
DOI 10.3280/QPC2016-038002
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Fibromyalgia is a somatic functional syndrome characterized by widespread muscoloskeletal pain, stiffness, sleep distrubances, fatigue; there is often a comorbidity with anxiety and depressive disorders; the course of fibromyalgia is generally chronic. Although the etiology is still unclear, the hypothesis is that several factors may be involved (biological, psychological and socio-cultural factors). Abrief psychotherapeutic intervention should identify and treat the psychological factors that are relevant for the specific patient, with the aim to improve global functioning and quality of life. This paper aims to be a guide for therapists approaching fibromyalgic patients. The proposed psychotherapeutic intervention is composed by three main steps: the first step is dedicated to build up a working alliance; the second one aims at approaching the affective world (auto-observation and affective regulation); the third step aims at promoting an active role of patient, increasing his/her resources. Finally we introduce a clinical case, Anna’s case, a 60 years old woman who has been suffering from chronic pain since the age of 13.

Keywords: Fibromyalgia, psychotherapy, brief intervention, somatic functional syndrome, chronic pain

  1. Allen L.A., Woolfolk R.L. (2006). Affective cognitive behavioral therapy: a new treatment for somatization. Psicologia Conductual, 14: 549-566.
  2. Ardito R.B., Rabellino D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2: 270.
  3. Baumgartner E., Finckh A., Cedraschi C., Vischer T.L. (2002). A six-years prospective study of a cohort of patient with fibromyalgia. Annals of the Rheumatic Diseases, 61: 644-645.
  4. Bara B.G., a cura di (2005). Nuovo manuale di psicoterapia cognitiva. Torino: Bollati Boringhieri.
  5. Bernardy K., Füber N., Köllner V., Häuser W. (2010). Efficacy of cognitive-behavioral therapies in fibromyalgia syndrome – A systematic review and metaanalysis of randomized controlled trial. The Journal of Rheumatology, 37: 1991-2005.
  6. Bernardy K., Klose K., Busch A.J., Choy E.H.S., Häuser W. (2013). Cognitive behavioural therapies for fibromyalgia. Cochrane of Systematic Review, 9.
  7. Casale R. Cazzola M., Arioli G., Gracely R.H., Ceccherelli F., Atzeni F., Stisi S., Cassisi G., Altomonte L., Alciati A., Leardini G., Gorla R., Marsico A., Torta R., Giamberardino M.A., Buskila D., Spath M., Marinangeli F., Bazzichi L., Di Franco M., Biasi G., Salaffi
  8. F., Carignola R., Sarzi-Puttini P. (Italian Fibromyalgia Network) (2008). Non pharmacological treatments in fibromyalgia. Reumatismo, 60: 59-69.
  9. Castelli L., Tesio V., Colonna F., Molinaro S., Leombruni P., Bruzzone M., Fusaro R., Sarzi-Puttini P., Torta R. (2012). Alexithymia and psychological distress in fibromyalgia: prevalence and relation with quality of life. Clinical and Experimental Rheumatology, 30: S70-S77.
  10. Damasio A. (2003). Looking for Spinoza. Orlando: Mariner Book (trad. it.: Alla ricerca di Spinoza. Milano: Adelphi, 2003).
  11. Di Tella M., Castelli L. (2013). Alexithymia and fibromyalgia: clinical evidence. Frontiers in Psychology, 4: 1-5.
  12. Di Tella M., Castelli L., Colonna F., Fusaro E., Torta R., Ardito R.B., Adenzato M. (2015).
  13. Theory of mind and emotional functioning in fibromyalgia syndrome: an investigation of the relationship between social cognition and executive function. PLoS One, 16; 10(1): e0116542.
  14. George C., Kaplan N., Main M. (1985). Adult Attachment Interview. Unpublished manuscript, Department of Psychology, Berkeley: University of California.
  15. Grandi S., Rafanelli C., Fava G. (2011). Manuale di psicosomatica. Roma: Il Pensiero Scientifico.
  16. Guidano V. (1988). La complessità del Sé. Torino: Bollati Boringhieri.
  17. Guidano V. (1992). Il Sé nel suo divenire. Torino: Bollati Boringhieri.
  18. Harris R. (2014). Fare ACT, una guida pratica per professionisti all’Acceptance and Commitment Therapy. Milano: FrancoAngeli.
  19. Henningsen P., Zipfel S., Herzog W. (2007). Management of functional somatic syndrome. The Lancet, 369: 946-955. DOI: 10.1016/S0140-6736(07)60159-
  20. Herman J.L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5: 377-391. DOI: 10.1007/BF0097723
  21. Imbierowicz K., Egle U.T. (2003). Childhood adversities in patients with fibromyalgia and somatoform disorder. European Journal of Pain, 7: 113-119.
  22. Kano M., Fukudo S. (2013). The alexithymic brain: the neural pathways linking alexithymia to physical disorders. BioPsychoSocial Medicine, 7: 1-9. DOI: 10.1186/17-51-0759-7-
  23. Köllner V., Häuser W., Klimczyk K., Kühn-Becker H., Settan M., Weigl M., Bernardy K. (2012). Psychoterapy for patients with fibromyalgia syndrome. Systematic review, metaanalysis
  24. and guidelines. [Psychoterapie von patienten mit fibromyalgiesyndrom. Systematische Übersicht, metaanalyse und leitlinie]. Der Schmerz, 3: 1-5.
  25. Kroenke K., Swindle R. (2000). Cognitive-behavioral therapy for somatization and symptom syndrome: a critical review of controlled clinical trials. Psychotherapy and
  26. Psychosomatics, 69: 205-215. Leavitz F., Katz R.S. (2003). The Dissociative Factor in Symptom Reports of Rheumatic
  27. Patients With and Without Fibromyalgia. Journal of Clinical Psychology in Medical Settings, 10: 259-266.
  28. Leithner-Dziubas K., Blüml V., Naderer A., Tmej A., Fischer-Kern M. (2010). Mentalization and bonding in chronic pelvic pain patients: A pilot study. [Mentalisierungsfähigkeit und Bindung bei Patientinnen mit chronischen Unterbauchschmerzen: eine Pilotstudie].
  29. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 56: 179-190.
  30. Liotti G. (2005). La dimensione interpersonale della coscienza. Roma: Carocci.
  31. Ablin J., Fitzcharles M., Buskila D., Shir Y., Sommer C., Häuser W. (2013). Treatment of fibromyalgia syndrome: recommendation of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies. Evidence-Based Complementary and Alternative Medicine, 1-7. DOI: 10.1155/2013/48527
  32. Liotti G., Farina B. (2011). Sviluppi traumatici: eziopatogenesi, clinica e terapia della dimensione dissociativa. Milano: Raffaello Cortina.
  33. Liotti G., Gilbert P. (2011). Mentalizing, motivation and social mentalities: theoretical consideration and implication for psychotherapy. Psychology and Psychotherapy: Theory, Research and Practice, 84: 9-25. DOI: 10.1348/147608310X52009
  34. Martínez M.P., Sánchez A.I., Miró E., Lami M.J., Prados G., Morales A. (2015).
  35. Relationships Between Physical Symptoms, Emotional Distress, and Pain Appraisal in Fibromyalgia: The Moderator Effect of Alexithymia. The Journal of Psychology: Interdisciplinary and Applied, 149: 115-140. DOI: 10.1080/00223980.2013.84467
  36. Mease P. (2005). Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. Journal of Rheumatology, 32: 6-21.
  37. Naring G.W.B., Van Lankveld W., Geenen R. (2007). Somatoform dissociation and traumatic experiences in patients with rheumatoid arthritis and fibromyalgia. Clinical and Experimental Rheumatology, 25: 872-877.
  38. Porcelli P. (2009). Medicina psicosomatica e psicologia clinica. Milano: Raffaello Cortina.

Benedetta Vicino, Rita Bianca Ardito, Annunziata Romeo, Riccardo Torta, Lorys Castelli, La terapia cognitiva in psicosomatica: una proposta di intervento per la sindrome fibromialgica in "QUADERNI DI PSICOTERAPIA COGNITIVA" 38/2016, pp 16-30, DOI: 10.3280/QPC2016-038002