Fibromyalgia & Chronic Pain LIFE Winter 2014, Issue 10 | Page 28

Symptom Management Tools over time. In medical conditions, inckuding FM, hundreds of studies show the effects of the relaxation response, which is easily attained through meditation, mindfulness practices and related approaches. 1. 7. Other skills concern how you manage your time and activities, i.e., “time-based pacing,” or gradually increasing activity and monitoring how your body is responding. You can determine what levels of activity are tolerated without causing a flare-up of symptoms to prevent the “pushcrash” cycle. Pacing is also a key concept to determine how much exercise is good for you. Sometimes referred to as “graded exercise,” you use pacing to find the range of exercise tolerance that allows you to slowly build fitness over time. The same principle of pacing applies to all areas of your life including social and work activity. 2. 8. “Scheduling” your daily patterns and activities, i.e., following a comfortable rhythm of activity and rest, can help reduce symptoms. And the scheduling of pleasurable activities will have both mental and physiological effects that promote relaxation and reduce stress, reducing symptom severity. It’s important to improve sleep quality through having regular sleeping hours, bed times, wake times, and bedtime routines that support sleep such as bathing or relaxation exercises and avoiding the neurological stimulation of television. “Cognitive restructuring” in CBT is a way of changing automatic negative or catastrophic thoughts about illness, and replacing them with thoughts that promote a more relaxed and peaceful way of living day to day. DAY TO DAY APPLICATIONS. B elow are nine changes in thinking and behavior that I have found helpful in my work over the past 25 years with people with FM. You may already be implementing some of them and want to add others to the list. 28  Fibromyalgia & Chr