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Migraines and Headaches: Can Therapy Help?

Migraines and headaches have long been viewed as a purely medical issue. But that’s not necessarily always the case.

While migraine education and research is constantly expanding, there still is no certainty of what medically causes (or cures) migraines.

In fact, even during severe migraine auras, there often are no underlying medical issues detected, and MRIs and CT scans are commonly negative. While medications are prescribed to treat migraines, it is usually done so with the understanding that what the person suffering from the migraine does on their own to understand their headaches may end up being the most effective treatment.

While there are many possible approaches for treating chronic migraines, psychotherapy has generally been low, if even visible, on this menu. However, psychotherapy can actually play a significant role in reducing frequency and severity of migraines and headaches.

While people who experience migraines may have a genetic predisposition, it’s apparent that many of the triggers for migraines originate from elements of our daily lives — including stress, moods, environment, and how we emotionally handle life’s situations, among others.

Chronic migraines and headaches likely are a symptom caused by an underlying issue, many of which may have a psychological basis. This doesn’t mean that sufferers are not, or shouldn’t be, experiencing pain — it merely indicates that psychological factors can be driving the chronic pain process.

Here are some of the possible benefits of psychotherapy to treat migraines and headaches:

1. Trigger identification. A therapist can facilitate a cognitive process toward understanding the environmental elements that can trigger a headache. This includes identifying patterns from anything such as meal content and sleep habits to habitual emotional and coping processes.

2. Trigger elimination. As patterns and possible triggers are identified, a therapist can help facilitate and monitor change toward a healthier environment. This can include cognitive or behavioral techniques that help remove or diminish the impact of the identified trigger.

3. Stress reduction. Stress is known to be a significant trigger for headaches and migraines. Therapy generally is a good place to improve stress management, regardless of the presence of physiological symptoms. The reduction of stress on its own can yield positive results with migraines and headaches.

4. Anger management. Stored anger (possibly from earlier life events), or a tendency toward bouts of anger also can lead to more migraines and headaches. Therapy is an appropriate setting for improving anger management and resolving stored anger.

5. Rumination management. Excessive amounts of rumination and dwelling can result in headaches from emotional stress. Therapy is an ideal setting for processing issues that cause ruminations, as well as improving the mechanism itself that leads to rumination.

6. Relaxation techniques. People who suffer from migraines often have difficulty fully slowing down and relaxing. It’s common for some people not to know or understand the feeling of relaxation, especially if they are commonly surrounded by stress or tension. Many forms of relaxation techniques can be learned in therapy, from basic breathing exercises to meditation, emotive imagery, and others.

7. Processing the migraines. This component is one that deserves emphasis. Merely dealing with chronic migraines or headaches brings up issues of its own that need to be dealt with. For example, if there is anger or resentment about suffering from migraines, these emotions can possibly lead to a triggering cycle of migraines. There also could be emotions of fear, sadness, frustration, and others that result from having to deal with chronic pain.

A migraine struggle also can cause issues with family and intimate relationships — especially if the migraineur feels misunderstood. For example, a woman said that her husband stated that a headache “can’t be that bad where you can’t help with the kids.” Having a space to be able to be heard and discuss management of these issues can be beneficial.

Obviously, it’s important to rule out any underlying medical issues before calling a therapist for migraine-based therapy. And while there are many possible treatments for migraines, no single method can currently claim to have the cure. It is generally suggested that a combination of approaches can be most effective, and with all of the possibilities that can lead to this struggle, therapy can be a worthwhile consideration as part of becoming headache-free.

Migraines and Headaches: Can Therapy Help?

Nathan Feiles, LCSW

Nathan Feiles, LCSW is a psychotherapist in New York City. In his private psychotherapy practice, Nathan works with individuals, couples, and groups, specializing in migraines, relationships, depression, anxiety, fear of flying, stress reduction, life transitions, and phobias. For more information about Nathan Feiles’s work, including a complete list of services, please visit his website at

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APA Reference
Feiles, N. (2018). Migraines and Headaches: Can Therapy Help?. Psych Central. Retrieved on September 29, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 20 Jul 2012)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
Published on Psych All rights reserved.