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Patricia's story – chronic pain

A glance at Patricia’s first behavioural activity diary said it all. “Stayed in bed ‘til 12 noon.” “Sat and watched TV.” “Tired, fell asleep on sofa.” “Nothing – just sat and cried,” are typical entries.

Pat, aged 48 and divorced with three grown-up children, had been in pain for two years and was diagnosed with chronic widespread pain. She had been off sick from work for a year and became depressed as her pain spiralled out of control.

Apart from occasionally picking her granddaughter up from school she had no routine. After the odd “good day”, when she tried to cram in as much as possible, she felt terrible the next day. She got into debt, was lonely and hardly ever went out.

Setting goals

With the help of her therapist she decided on various goals: To meet a friend once a week. To read a book for at least 30 minutes a day. To sort out her debt.

She also had to write a list of routine, pleasurable and necessary things in her life, and she decided that she would try to do small amounts of housework followed by lots of rests. She managed to get up at 11 am, not noon. She set up more routine, started tackling her debt, picked up her granddaughter a more often, and cooked proper meals. Eventually she even started helping in a charity shop one day a week.

Over the weeks, Pat, with the constant help of her therapist, filled in a number of behavioural activation diaries, which slowly revealed that although she was still in pain, with rest and by carefully pacing herself, she was increasingly in control of it, not the other way round.

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