Chronic Pain: Using Healthy Thinking

Overview

Living with pain can be hard, especially if it's long-term (chronic) pain. Chronic pain is pain that lasts for 3 months or longer. It can make you sleep poorly, feel tired and irritable, and have a hard time being active or working. It may strain your relationships with loved ones too. You may feel stressed or get depressed or anxious. And these feelings may make your pain worse, because they can make it harder to manage your pain.

One way you can help manage and cope with your pain is through healthy thinking. A type of therapy called cognitive behavioral therapy (CBT) can help you learn healthy thinking habits.

How can cognitive behavioral therapy help?

Cognitive behavioral therapy, also called CBT, is a way to help you stay well or cope with a problem by changing how you think and behave.

CBT can help you learn to think in a healthy way. It can help you notice negative thoughts and reframe them so they're more helpful.

If you learn how to reframe negative thoughts, you may be more able to care for yourself and handle life's challenges. You will feel better. And you may be more able to avoid or cope with stress, anxiety, and depression.

CBT also teaches you how to notice and change unhelpful behavior. For example, you might learn ways to respond to stress differently by calming your mind and body. Techniques may include meditation, yoga, muscle relaxation, or guided imagery.

Many people work with a therapist or a counselor for CBT. But you also can practice CBT skills on your own.

You can use your CBT skills throughout your life. You may find that more "tune-up" sessions help you stay on track with your new skills.

How can you use healthy thinking to cope with pain?

Changing your thought patterns may not be easy. But our minds can be trained to be stronger and healthier—just like a muscle. A technique called thought reframing can help.

Thought reframing is the process of replacing negative thoughts with more helpful thoughts. It's a skill taught in a type of counseling called cognitive behavioral therapy (CBT). There are also books and apps that can help you learn thought reframing on your own.

With practice, you can get better at choosing healthier thoughts to replace negative thoughts.

• Watch for common types of discouraging thoughts.

  When you know some of the common types, it's easier to spot them when they happen. Here are a few to watch out for.

  • Ignoring the positive: This means that you filter out the good and you focus on the bad. For example, you might focus only on the days when pain was worse this week and forget that you had 1 or 2 days when the pain was more controlled.
  • The "should": Thinking that you or other people "should" or "have to" do something is a sign of this type of thinking. For example, "If my physical therapy is working, then it should cure my pain."
  • Overgeneralizing: This means taking one example and saying it's true for everything. Watch for words such as "never" and "always." For example, "I tried going for a walk last week, and my pain got worse. I'll never be able to walk very far."
  • All-or-nothing thinking: This is also called black-or-white thinking. It means that you think of things as either all good or all bad—with no options in between. For example, "If my doctor can't cure my pain, I'll be on disability for the rest of my life."
• Practice reframing your thoughts.
  • Notice the negative thought. Don't be hard on yourself because you had the thought. Negative thoughts can pop up sometimes before you can stop them. But learning to recognize them can help you shift them.
  • Question the thought. Ask yourself whether it's helpful or true. Your answers can help you find more accurate ways to think about the situation.
  • Replace the thought. Ask yourself "What's something that's true and more helpful?" Use your answer to replace the discouraging thought. Here's an example:
    • You might first think: "If my physical therapy is working, then it should cure my pain."
    • You can replace that thought with: "If I keep doing physical therapy, my pain could get a little better. And if it's a little better, then I might be able to go camping with my family this summer."
• Use a thought diary.

  Write down negative thoughts throughout the day. Then rewrite them to be more encouraging. Over time, choosing more positive thoughts in the moment will get easier.