Cognitive behavioral therapy (CBT) is a specialized form of psychotherapy, talk therapy, that has a very strong evidence base. Basically, it has been shown to outperform many other types of therapy, and reduce symptoms of distress in people with chronic pain. CBT has worked more effectively than opioids in some patients. In short, it is viewed as a treatment that works. Cognitive behavioral therapy involves a working with a person with chronic pain and teaching them how their thoughts, feelings, and pain-related actions, can work for or against the person with pain. Chronic pain, while felt in the body, is experienced in the brain. Over time chronic pain actually rewires the brain in an unhelpful way, and ends up reinforcing itself over and over, which in turn causes the patient to focus on it more, worry about it more, dread it more, change their behaviors in response to it more. This becomes a vicious cycle that causes a lot of physical and emotional suffering. In CBT a pain patient is taught about the physiology of the pain response, how pain is represented in the brain, and how things like stress, anger, sleep disturbance, and anxiety over pain, all make pain worse. The person is then taught techniques for self-calming, tension reduction, and mental techniques which change thinking patterns, and this all helps to turn down the central nervous systems aggressive response to pain. CBT is considered very effective because research has shown that people who undergo CBT experience considerable relief, and actually have measurable changes in their brain in response to the treatment. Essentially CBT teaches people how to maximize the healing potential of their own brain.