Persistent Pain

We are all prone at times to unhelpful thinking. It happens more often when we are under lot of stress or are feeling low. These thoughts can make us feel even more stressed. When you can recognise unhelpful thinking, you can start to challenge it and change it. This can reduce stress and help you feel better about things. Here are some ways of looking at unhelpful thinking styles.

1  Catastrophising

You expect things to go wrong, no matter what.
You tend to magnify and inflate events and how awful they will be.
You over-estimate the chances of things going wrong.
Any setback is seen as a never ending pattern of defeat.
For example “I didn’t get hired for the job; I’ll never get any job.”

2  All-or-Nothing Thinking

Things are either ‘good-or-bad’.
You have to be perfect or you are a failure.
There is no middle ground.
You place people or situations in ‘either/or’ groups.
There are no shades of grey.
It does not allow for the complexity of most people and situations.
If you don’t do as well as you thought you would, you see yourself as a total failure rather than seeing that you are just going through a bad patch and you do have lots of good points.

3  Personalising

You blame yourself or take responsibility for anything horrible even if it has little or nothing to do with you.
If something bad happens you think it is your fault straight away.
An example of this is when a parent blames themselves for their child getting a poor school report. “My son is not doing well in school. I must be a bad parent.”

Negative Focus

You focus on the bad things about a situation.
You also forget about anything that was good.
You focus on your weakness and forget your strengths.
When things do go well you think that they ‘don’t count’.
For example “My friend says I look good today. She is only being nice. She doesn’t really mean it.”

Jump to Conclusions

You assume things about people or things that happen without any proof or evidence.
Mind reading: you think you know what someone else is thinking. For example: “He ignored me because he hates me” or “My friend hasn’t phoned for ages, she doesn’t like me anymore”.
Fortune telling: you predict that something will go wrong.
For instance “I just know something awful is going to happen”.
Or when someone is feeling very low they may think that they will never feel better, ever

Living by Fixed Rules

You have very rigid rules about how others and you should behave.
People who break the rules make you angry.
You feel guilty when you break your rules.
You often use the words ‘should’, ‘ought’, ‘must not’ and can’t’.
This leads to guilt and distress.
The more rigid the rules are, the more upset, angry, depressed or guilty you are likely to feel.

Emotional Reasoning

You respond to your gut feeling and emotions.
Your thoughts lead you to believe your feeling without any proof.
For example, your thoughts are: “I feel bad so it must be bad! I feel anxious, so I must be in danger.

Responding to Memories

Current events can trigger upsetting memories.
You can start to recall a similar event from the past that did not go well.
This leads you to feel the same way as you did in the past.
You may feel that you are in danger now.
This can cause distress.
These distressing thoughts are not based on what is really going on.
They are based on the emotions you felt when it went badly.

Some unhelpful examples:

  • Hoping for change: “When will the pain go?” “Really hope they can do something for my pain” “I pray for a cure”
  • Worrying/panicking/catastrophizing: “My pain is 12/10.” “I can’t stand it any longer” “There must be something seriously wrong if it hurts this much”
  • Avoiding people/activities: “I can’t come out as I’m having a bad pain day”
  • Pain in communication / interaction with others: “I’d love to do that, but it all depends on my pain levels”

Some helpful examples:

  • Actively using pain management principles discussed in our programme “ I can come out for a meal, but maybe a quick meal rather than sitting for 2 hours, and maybe we can go for a short walk afterwards?”
  • Reinterpret thoughts/ positive self-statements/mindfulness/diversion “I can do this despite the pain if I take my time and think about it – maybe doing it as small chunks of activity rather than all in one go”
  • Increase activities engagement/pacing/mindfulness/diversion “I accept that there is pain, but know there is much I can do. Dwelling on the pain doesn’t achieve anything”
  • Assertive communication “I’d love to do that, and I will find a way to manage the task.”

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