Thread: CBT and nausea
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Unread February 16th, 2007, 04:15 PM
James Pretzer James Pretzer is offline
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Join Date: Jun 2004
Posts: 283
Default Re: CBT and nausea

Yes, I don't think much has been written about CBT with nausea. However, much of what has been written about CBT with chronic pain will be relevant. Here are a few thoughts:

The first question is to think through what the goal of CBT is. Are we trying to eliminate the nausea, to do what can be done to reduce the intensity of the nausea, to help the client cope more effectively with the nausea, or to help the client lead as good a life as possible despite the nausea. From the summary you've presented, it doesn't sound as though there is any reason to think that CBT can eliminate the nausea, but it may well be possible to reduce the intensity, help him cope more effectively, and help him live a more satisfying life despite the nausea.

If the client is trying to control the nausea, avoid the nausea, make the nausea go away, etc., this is likely to result in his constantly being vigilant for GI sensations and in his constantly focusing on the nausea when it is present. Unfortunately, being vigilant for sensations and focusing on them will result on more frequent and more intense nausea. If he is able to shift to a mindset of accepting the nausea and coping with it as best he can, this is likely to result in a decrease focus on the nausea and decreased distress.

If stress and anxiety aggravate the nausea, stress management techniques may be useful. These could include rational responses to any cognitions that intensify the stress, relaxation exercises, assertion, and taking a problem-solving approach to dealing with stressful situations.

It probably will be useful to pay attention to his automatic thoughts about the nausea. Cognitions such as "I can't stand it! I can't go on like this!!!" can amplify distress and increase the risk of depression.

I suspect that ACT/Mindfulness interventions would also be useful as well.
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