Change Your Thinking to Help Manage Chronic Pain

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Allen Hume, Ph.D. and Maureen C. Pierce, Ph.D.

Chronic pain has a profound impact on our thoughts and beliefs, and more importantly on ourselves. Folks in pain often talk about their experiences in “absolutes,” using words such as always, never, should and must when facing difficulties. We are also inclined to unrealistic, distorted in our thinking, particularly when we don’t feel good physically or emotionally.

For example, we may "catastrophize," which means assume the worst without good reason. For example, the back may hurt a bit and we assume that we will wind up back in surgery, when in fact the sensation may be temporary. While it is common to think this way at times, it isn’t a helpful way to think about our problems. Individuals with chronic pain may feel very bad when they first get up in the morning due to a restless night of sleep. The person may be tired, stiff, and frustrated. As they think about how they feel they notice thoughts such as “I shouldn’t feel this way” or “I’ll never get any better.” These thoughts in turn affect emotions, increasing feelings of worry, depression and hopelessness.

A common emotional outcome is believing that others will think badly of the person in pain because the person in pain feels bad. There are many ways to address this type of thinking and beliefs, but the best may be cognitive behavioral therapy or CBT. The basic idea of CBT is that one can change how they feel by recognizing and changing their distorted thoughts. Keep in mind that everyone, and we mean everyone, has distortions in thinking at times. The most common tend to be black and white thinking, jumping to conclusions, minimizing success, focusing on the negative, and catastrophizing.

The good news is that by firmly challenging our thoughts, we can change how we feel, both emotionally and physically. Take a look at the resources provided and discuss with your health care provider. You may want to find a psychologist, either individually or in a group setting to work with your thoughts – just be careful – making these changes might improve your outlook and how you feel!

Steps to Get There

  1. Learn to recognize your thought distortions so that you can begin to challenge and change them. There are many websites and books that can help.
  2. Seek support and feedback from others you trust, including family, friends, and providers.
  3. Notice when you use words like should, ought, must, never and always, either in your head or out loud. These words are often signs of thought distortions and can be a signal to examine and confront your thoughts.
  4. Consider seeing a therapist who uses cognitive behavioral therapy (CBT). This is a practical, generally short term therapy focused on teaching you how to change your own thoughts and feelings.