Change the Way You Think About Pain With Cognitive-Behavioral Therapy

Proponents of cognitive-behavioral therapy (CBT) say that it can help pain patients end the downward spiral of negative thinking that worsens pain. People suffering from chronic pain can spend a lot of time thinking negatively about their pain, growing concerned, anxious, or pessimistic. Those thoughts can actually increase pain, so therapists work with patients to reframe some of the negative thoughts surrounding their pain. By identifying and changing negative thought patterns, patients can actually help relieve their pain.

To benefit from this technique, patients should see a therapist trained in using CBT for chronic pain to help create a list of coping thoughts relevant to particular situations they are having difficulty dealing with.

In the chart below, Francis Keefe, PhD, director of the Pain Prevention and Treatment Research Program at Duke University School of Medicine, in Durham, N.C., and colleague Daphne McKee, PhD, have identified some specific examples of the kinds of thoughts people in pain might feel and some possible ways of reframing them. These are not intended to address your situation directly but to give you an idea of how cognitive-behavioral therapy attempts to change the negative thought patterns that can worsen pain.

Chronic Pain Situation	Negative Thought	Coping Thought
Pain flare	"This pain will never end."	"I've had bad flare-ups before and know I can get through this."
Pain flare	"Why me? Am I being punished?"	"There are lots of people who have persistent pain. I am not alone, and I am not being singled out."
Missing a day of work because of pain	"I won't be able to support my family."	"Missing one day does not mean that I can't return to work and be productive."
Moving furniture at work	"I hate asking for help. I should be able to do this on my own."	"I will be better off in the long run if I ask for help with certain tasks. Most people are happy to lend a hand."
Trip to the mall with friends	"If I go out with my friends and I can't keep up, it will spoil it for everyone else."	"If I plan ahead, take some breaks, and let my friends know I am going to do this, I can keep up and still enjoy being with them."
Can't tolerate the drive to a favorite vacation spot	"My pain interferes with everything."	"I may need to change my goals (e.g. go to a different destination) or modify how I do them (e.g. break the drive up with rest breaks). I can still do a lot of things I enjoy."
Unable to do household chores today	"I am worthless."	"There are lots of things I do for my family and others. Housework does not define my worth."
Turned down opportunity to coach little league team	"What kind of parent am I? I can't even play ball with my kids."	"I spend a lot of time with my children in other ways. I can still go to their games and enjoy watching them play."
A visit to see grandchildren	"I can't even lift my grandchild. She probably thinks I don't love her anymore."	"There are many ways to show love. I can sit and ask her to crawl into my lap."