Step 6: Understanding Thoughts, Feelings, and Actions as they relate to Pain
The experience of pain is a complex event, involving an interaction between our physical state-nerves, the brain, and body chemicals-and our psychological state–our thoughts, attitudes, and history.
A person who focuses on the details of their pain often imagines that they have every last disease under the sun, stops seeing friends, thinks the future is bleak and will therefore suffer to a greater degree than someone who has more rational thoughts and actions.
Those individuals who keep a positive attitude and preoccupy themselves with things other than their pain tend to suffer less. They can, in effect, close pain gates by possessing positive thoughts and taking on healthy actions. Identifying Distorted Thinking
It is difficult to identify irrational thoughts during times of emotional or physical stress. If you find yourself frequently nervous, tense, depressed, feeling hopeless and angry your thinking is likely distorted. Your perception of pain has probably become unrealistic. For example, if you experience pain from degenerative disc disease, you may be convinced you will end up in a wheelchair. While you may not be imagining the medical problem, you are not putting the facts into proper perspective.
Distorted thinking occurs in many forms, including:
- Filtering: You focus on the negative aspects of a situation, ignoring all of the positives.
- Catastrophizing: You think the worse is going to happen. You picture horrible outcomes.
- Overgeneralization: You come to a conclusion based on one piece of evidence. If something bad happens once, you expect it to happen every time.
- All or None Thinking: Things are black and white with no middle ground. “I had a bad experience trying to ride an exercise bike Monday, therefore all exercise is bad”.
- Magnifying: You make the problem greater than it really is.
- Selective Attention: Focusing on threatening signs, rather than paying attention to positive signs.
- Over interpreting ambiguous signs: Thinking a sign or symptom has awful consequences. For instance, interpreting weakness in the back as a sign of worsening degeneration rather than acknowledging it is from a lack of exercise.
- Personalization: Thinking that everything other people say or do is in reaction to you.
Changing Distorted Thinking
Once you begin to study yourself and your thought patterns, you can change your negative thoughts by using positive alternatives. For example, instead of thinking, “I am not going to be able to work because of my back pain” think “It may be difficult, but I can continue to work. I will have to pace myself, but I can still work”. These types of positive coping statements can help you master your pain and cope with challenges.
On the other hand, being overly enthusiastic may set you up for failure. Statements such as, “Pain doesn’t affect me, I can work just as hard as I ever could” are unrealistic. Confidence plays a large role in managing pain. Don’t set yourself up for failure by denying the effect pain has on your abilities. If you prepare for challenges, you will better position yourself for success. And if success does not come right away, you will not feel so overwhelmed.
Feelings also contribute to your pain experience. It is very common for individuals who suffer from chronic pain to feel depressed or angry. In some cases, depression may have existed before the pain condition began. Regardless of which came first, depression makes the pain experience much worse: it lowers pain tolerance and makes it difficult to cope with pain.
In order to treat depression, you must first recognize it. Common symptoms of depression include:
- Feelings of sadness
- Feelings of hopelessness
- Feelings of guilt
- Feelings of failure or self-blame
- Decreased pleasure in activities you used to enjoy
- Irritability, frustration
- Deceased energy levels
- Difficulty sleeping or excessive sleeping
- Decreased appetite or excessive appetite
- Decreased interest in sex
- Thoughts of suicide
Take action against depression
- Breaking free of depression is not easy. Chronic pain can cause depression, and depression can worsen chronic pain. It is important to recognize this connection and take steps to fight depression at the earliest signs.
- Become aware of and change distorted thinking. Depression always distorts your thinking.
- Talk to a trusted friend, religious leader, or professional counselor. Let them give you feedback on your altered thinking.
- Try to keep up with your daily responsibilities as best as possible, even if you don’t feel like it.
- Exercise: take a walk. Remember, exercising raises natural pain killing substances called endorphins which help close the pain gates.
- Interact with other people, whether it’s meeting a friend for lunch or a walk, joining a chronic pain support group, or taking a class.
- Try to think of all of the things you can be grateful for in your life. Count your blessings!
- See your doctor to consider antidepressant medications.
- Do not treat mental pain with alcohol or non prescription drugs as these interact with prescriptive medications and can cause irreparable harm to your organs.
Many individuals with chronic pain experience problems with anger. Although anger can distract you from your pain, it has many negative consequences. Anger affects your health-increasing blood pressure, worsening digestive problems, triggering headaches, and setting off muscle spasm.
Anger and aggressive behavior harm your relationships. It frequently results in conflict, alienation and isolation.
Anger can trigger a vicious cycle– aggressiveness or hostility may generate an aggressive or hostile reaction directed back at you. This in turn fuels the fire, adding to your own anger and rage.
Controlling anger requires an individual to recognize that his or her thought pattern is irrational. Examples of anger triggering beliefs include:
- You should not, must not treat me this way.
- How terrible for you to have treated me so wrongly.
- You are an awful person for behaving towards me that way.
The first step in anger management is to admit that you are angry.
Second, you must take responsibility for your anger. Angry individuals tend to externalize their anger and blame others for their problems. Try to remember that only we make ourselves angry.
Third, challenge your thought patterns that trigger anger. Does blaming someone else help you get what you want? Is anger going to help take away your pain and suffering? Probably not. Blaming others or feeling like someone owes you, either medical treatment or disability compensation, are road blocks to recovery. The anger from these feelings can fester until it consumes your thoughts, and prevents you from focusing on constructive ideas and actions.
Constructive thoughts and actions to control anger
- Stay calm; I’m not going to let them anger me.
- Take a deep breathe and relax-I’m in control.
- I can stay calm and relaxed.
- Easy does it; getting mad won’t help.
- It’s not worth getting angry about.
- There is no reason to take my stress out on others.
- Recite the serenity prayer.
- Identify and change your distorted thoughts.
- Use humor and laughter.
- Distract yourself with recreational activities or a hobby.
- Learn to accept things you cannot change.
- Use relaxation techniques.
- Talk to a professional counselor.
- Join a pain support group.
- Exercise regularly.
- Listen to music.
- Use prayer.