1. Blaming

You make someone or something else responsible for your pain. “My lousy boss is to blame for my job accident.” “My family demands so much from me, I can’t afford the time or money to take care of this pain.” Blaming is a natural outgrowth of being tired, frustrated, and angry. But blaming only makes a situation worse, since you are not taking responsibility for what is happening to you, but rather expecting others to take the responsibility.

Some people go too far in the other direction and focus all the blame entirely on themselves. “It’s all my fault that this happened to me.” If you continually put yourself down in this way, the insidious nature of self-blame can lead to lethargy and depression. This self-defeating stance can also serve as an excuse for inactivity. “Since I’m such a worthless person, getting better is hopeless. So why should I try?”

2. “Should” Statements

Albert Ellis states that “should” statements are one of the cornerstones of irrational thinking. The words should, must, or ought appear regularly in chronic pain negative thinking. Shoulds are usually a put-down, implying that you were stupid, foolish, or weak for not living up to some standard. “I should have thought of good body mechanics before I lifted that box.” “I shouldn’t have been in such a hurry when I slipped on the ice.” “If only I hadn’t been wearing those high heels; I shouldn’t be such a slave to fashion.” “I must keep up with all my responsibilities, pain or no pain.” “I shouldn’t react to pain like this.”

Should statements can sound a lot like blaming. You are admonishing yourself for not being perfect. But shoulds can also apply to others. You create a set of expectations for other people’s performance that you expect will be met. “My spouse should provide consistent support and sympathy when I hurt.”

3. Polarised Thinking

Everything is “black or white,” “good or bad.” There is no grey area in the middle for improvement. Chronic pain sufferers are often tempted to think, “If I’m not better by March, then that’s it either this particular program will work for me or I’m a failure.” Polarised thinking assumes things must go perfectly or else. If you have a pain relapse, then you’re likely to think that the program you’re using is no good or it’s a sure sign of your ineptness.

This thinking can also be directed towards others, particularly medical professionals. “If they can’t cure me, then they are useless.” People attempting a pain management program for the first time can easily fall into this line of thinking by demanding rapid and total recovery instead of expecting a slow process of building pain control. Small steps toward feeling better are meaningless to these people, because progress is acknowledged only when they feel completely well.

This thinking leads to damaging overgeneralisations. You have one relaxation session where you are unable to decrease your pain, and you assume that you’ll never be able to decrease your pain. Overgeneralisations are often couched in terms of absolute statements – cue words are all, every, none, never, always, everybody, and nobody. Absolute statements tend to limit your options and ignore any positive data that supports your efforts to change.

4. Catastrophising

People who engage in this kind of thinking react to life situations by imagining the worst possible outcome and then reacting to their fear-provoking scenario as if it will surely come true. “I know that the only option left open to me is to have surgery. I’m sure I’ll be laid up for months. What if the operation is a failure?” “What if” statements characterise this thinking, and greatly add to anxiety levels. “What if my pain never gets better, and I have to live like an invalid for the rest of my life? What if my spouse leaves me? What if I am unable to work?”

5. Control Fallacies

Some chronic pain sufferers see themselves as “externally controlled” by others, such as those in the medical profession. By assigning a doctor or a clinic total power over their fate, they make themselves helpless victims of their pain and of the system. In effect, they absolve themselves of any responsibility. Others may see themselves as powerless to change a dysfunctional family situation. “My spouse doesn’t think I need to see a counsellor for my pain, so I can’t come to the session.”

On the other hand, people who see themselves as “internally controlled” believe that they have complete responsibility for everything and everyone. “Everyone depends on me. The family will fall apart if I don’t recover quickly from this mess.” These people assume all of the responsibility, rather than allowing other family members to share some of the load. Some pain sufferers suspect they could be completely well – if only they wanted it enough. “Maybe I don’t want to get better, that’s why this has gone on so long.”

6. Emotional Reasoning

This line of thinking assumes that what you feel must be true. If you feel guilty about needing time to heal, then taking the time must be wrong and needing the time must be your fault. If you’re frightened that the pain will never stop, then you believe it will never stop. If you feel grief at the thought that you’ll never run again, then you must be right – you won’t run again. You let your feelings rule your reasoning ability. While it’s usually helpful to get in touch with your feelings, what you feel may be quite unrealistic. The strength of the feeling creates conviction, but later things may seem different as the emotional storm dies down.

7. Filtering

Some people have a tendency to see their pain through tunnel vision, filtering out any potentially positive aspects. These people make things worse than they are by focusing only on the pain and nothing else. Ted could not appreciate his spouse’s genuine efforts at caring and support because he was so wrapped up in his pain. He failed to enjoy any aspect of this nurturing relationship.

The process of filtering can also be very selective. You may choose to remember only those things which support your angry feelings, thus pulling your negative memories out of context and isolating you from positive experiences. What you fear can be magnified to the point that it fills your awareness to the exclusion of everything else. Ruth was so obsessed with the possibility of another back attack, that she filtered out her doctor’s advice on prevention and exercise.

8. Entitlement

Fallacy People often feel that they are “entitled” to a pain-free existence. They believe they shouldn’t have to suffer pain or loss. They feel cheated, that life is being unfair. John felt that it was totally unacceptable that he couldn’t play tennis because of his injury. He felt that his abilities had been “stolen” from him. His sense of entitlement and outrage kept him from considering new sports to replace his old one. People who harbour the entitlement fallacy feel that the luxury of ignoring or taking their bodies for granted is their right. And if they lose some capacity due to chronic pain, they feel that their life has been diminished.

All of these eight styles of thinking are related to each other. In fact, if you have a tendency towards one line of thinking, you will probably catch yourself doing several categories are a helpful way of showing how negative thinking works, don’t be surprised if you have trouble labeling your own thoughts, since the boundaries between styles can blur. It’s also quite possible to bombard yourself with a number of negative thoughts all at once in a lightening-fast mental shorthand. You rapidly heap negative thought upon negative thought until you feel overwhelmed and ready to give up. Be patient with yourself and allow yourself to gradually become familiar with your unique way of negative thinking.

[Author Unknown]