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Automatic, and Often Negative Thoughts and Pain

Kevin hurts all the time since his accident. After learning how thoughts become automatic, he’s noticing that his pain gets worse with certain ways of thinking. Because this surprises and baffles him, he’s trying to pay attention to the relationship between his thoughts and his pain.

So far he’s identified several instances that result in a pain flare:
– When he dreads an upcoming situation.
– When he gets down on himself—for not doing enough or for handling a situation poorly.
– When he feels like a victim—if someone can’t fix his pain or doesn’t do what they promise.

Dr. Buenaver, a researcher at Johns Hopkins, believes we can reduce our pain when we understand the relationship between thinking, feelings, and behaviors. “It may sound simple, but you can change the way you feel by changing the way you think,” he says.

Many of us with chronic pain hurt the worst when we’re upset or fearful, and Kevin is beginning to connect some of his thought patterns to negative filters. During a recent phone call with his case manager, his fears boiled up and quickly turned into: I can’t go back to work until the doctor releases me…what if I don’t get better?…I’ll lose my job…I won’t be able to pay the mortgage or car payment…I’ll lose everything!…What if my wife decides I’m not worth the trouble?…  His pain skyrocketed in a matter of seconds.

With a smile in his voice, Kevin proudly relates how he stopped that freight train. “The fear blinded me for a minute, and then I realized this was how catastrophizing works. I thought back to what started it—a simple statement by my case worker that I would need a doctor’s release before I could return to work. I slowed down and decided to ask when I could get an appointment so the doctor could sign off on my progress, and my pain level dropped about 3 levels!”

We all have ways of thinking that impede our progress.  Do you recognize any of these and how they make you feel?

Negative mental filter

How it looks:  Filtering every activity/thought through something that bothers me.
Thinking:  My pain was bad today, so learning pain management isn’t helping.  
Feelings:  I feel let down, hopeless, cynical.


How it looks:  Exaggerating the consequences (it’s the worst that could happen).
Thinking:  My spouse is so tired of my pain that he will probably leave me…I will be destitute…I will have to raise the kids alone…I will die alone. 
Feelings:  I feel fearful, worried, tense, anxious.

“Should” statements

How it looks:  Trying to motivate ourselves or directing at others.  
Thinking:  I should have gotten more done today.  Or…  I should have known you’d forget to call me. 
Feelings:  I feel guilty, pressured, disappointed.

Arguing with reality

How it looks:  Focusing on not wanting something to be what it really is.
Thinking:  If I didn’t have pain, I would be happy. 
Feelings:  I feel disappointed, sad, hopeless.


How it looks:  Ruminating excessively on the negative part of a situation or disqualifying the good aspects of something.
Thinking:  Even though I forgot about my pain while the kids were opening their presents, my life is still all about the pain.
Feelings:  I feel cynical, doubtful, hopeless.

If you live with pain, a Coach can help you discover strategies to manage or reduce your pain. Or, Coaching may be the perfect avocation for you to help others. TCC®U trains coaches and prepares students for national certification.

 *Names have been changed.

PainPathways Magazine

PainPathways Magazine

PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.

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