If you’re one of the millions of Americans living with the chronic pain condition fibromyalgia, you know how incredibly frustrating it can be, especially since treatment revolves around antidepressants and drugs for nerve pain that either don’t work continuously or don’t work at all for some people. Add to that the fact that the mainstream medical community until recently considered fibromyalgia a psychological condition—not a physical disease deserving of attention—and it’s no surprise that many people with fibromyalgia are looking for alternative or complementary approaches. These approaches include cognitive behavioral therapy (CBT) and mindfulness meditation, two mind-body techniques that work to change how we experience and cope with pain and, in turn, bring some needed relief.

Very good news: Building on those approaches is a specific meditation approach called attachment-based compassion therapy (ABCT)—and now, a study published in Frontiers in Psychiatry has shown that ABCT can greatly improve symptoms and overall quality of life for fibromyalgia patients. Fibromyalgia is a disease that is not all in your head…but successful treatment might be.


ABCT is rooted in compassion therapy, itself designed to help people better understand the universal nature of suffering and connect emotionally with others (and want to help others who are suffering). Compassion therapy also is helpful for people who feel a deep sense of shame or embarrassment because of their circumstances and for whom self-criticism stands in the way of getting better.

What’s all that got to do with fibromyalgia? The complex emotions described above often plague people with fibromyalgia, who, don’t forget, were told not too long ago, and told repeatedly, that the problem was all in their head. Compassion therapy involves concepts such as forgiveness and gratitude, and one effect is that it helps boost self-esteem, which often takes a hit in people with fibromyalgia. In fact, because compassion therapy fosters positive emotions, variations of it can even help people with anxiety and/or depression.

Another element of ABCT concerns attachment theory. This area of therapy helps patients better understand their relationships—with friends and family and often, in particular, with one’s parents because the parent-child relationship is so important that it’s often the root of other relationships and of a patient’s self-image. The mind does have a powerful effect, for better or worse, on a person’s experience of his/her own body—and the more positively a person can view his life, the more positive that effect is likely to be.

In ABCT for fibromyalgia, you also learn to separate yourself from your pain and accept that while you may have a debilitating condition, “it doesn’t have you,” explained researcher William Van Gordon, PhD, of the Centre for Psychological Research at the University of Derby in the UK. Once pain and other symptoms are siloed, you learn about the concept of compassion and kindness toward others and are encouraged to express these feelings using visualization techniques. The idea is that these exercises, when done regularly, help refocus attention outward and away from your symptoms.

The study: Dr. Van Gordon and colleagues in Spain and Italy wanted to quantify ABCT’s effect on fibromyalgia. Study participants, all women in their early 50s, were separated into two groups—one received ABCT and the other learned deep breathing and other nonmeditation techniques such as progressive muscle relaxation and assigning imagery to feelings. The ABCT group took a two-hour ABCT class once a week for eight weeks and focused on how to be considerate and kind not only toward others but also toward themselves. Everyone in both groups continued to take her regular medications.

The findings: Participants’ progress was gauged with a fibromyalgia-impact questionnaire that measures the severity of symptoms such as pain, stiffness, fatigue, depression and anxiety. Before the trial started, all participants had an average severity score above 60—any number over 59 indicates severe symptoms. Afterward, severity in the non-ABCT group hadn’t changed at all. But severity in the ABCT group had fallen to 44, on average. Also, some participants showed a reduction to below the clinical threshold for anxiety and depression, and even when some symptoms remained, they tended to be less severe. A follow-up assessment showed that the improvements from ABCT lasted for at least three months. And unlike medication, ABCT had no side effects.


You’ll likely need to do a bit of digging to find a therapist trained in ABCT. Ask your doctor for referrals—and if that doesn’t yield a result, you can search for attachment-based-trained therapists at GoodTherapy.org, Psychology Today, the American Psychological Association,and FindAPsychologist.org, a project of the National Register of Health Service Psychologists.

Once you try a program, if it doesn’t seem to fit in with your life and lifestyle, try another…and another if necessary. Approaches to ABCT vary. Practicing ABCT is meant to last a lifetime, so it’s important that it become integrated into your daily routine. And be patient—it takes time to change the way you see yourself and the world. Don’t give up if you don’t notice benefits immediately. Keeping a journal will help you see even small improvements in symptoms.

Continue taking your medications, said Dr. Van Gordon. And check in regularly with your doctor to make sure that you are doing all that you can to minimize the effect of fibromyalgia on your life.