Chronic Pain: Using Healthy Thinking

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.