This type of therapy involves attention to the connections between thoughts (cognitions), beliefs, feelings, behavior, and pain. The therapist may assist the patient in developing positive coping thoughts to combat negative thinking and reduce emotional arousal. For example, to counteract negative thoughts such as "Why me? What did I do wrong? How much longer is this going to last?", the headache sufferer might respond with alternative self-talk, such as "I have a biological predisposition toward headache. Thinking about what I did or did not do never got me out of a headache. Deal with that later. For right now, focus on the next five minutes." The addition of cognitive-behavioral therapy to biofeedback may enhance effectiveness.
