Thoughts are part of the pain problem.
Your mind is always running, producing thoughts to try to be helpful and solve problems. But, this never-ending flow of thoughts is not always helpful.
For example, if your mind is always working to solve the “problem” of pain, you can get stuck and spend a lot of time and energy fighting with the pain. Trying to think your way out of pain usually doesn’t lead to a solution or an end to the pain. Instead, it leads to drained energy, emotional pain and stress, and missing out on the things that are most important to you.
Other cognitive traps:
- Believing thoughts reflect reality. For example, if you believe the thought “this pain will just keep getting worse” is real, that belief can be very distressing and lead you to behave in ways that make your pain worse (a self-fulfilling prophecy!). Your thoughts are not reality!
- Believing you are your thoughts. It is easy to become linked or “fused” to your thoughts – to believe that you are made up of all the thoughts your mind generates. You are not your thoughts!
- Acting on your thoughts. Your mind is good at coming up with rules and plans to solve a problem like pain. But, just because your mind generates a thought does not mean you need to act on it. Consider the thought “If I stay home from the graduation party, my back pain will be better tonight”. Just because your brain has generated a thought to help you avoid pain, doesn’t mean that acting on it is consistent with your values. You need to reconsider your thoughts and act with intention rather than impulse. You can choose to act according to your values; you do not need to act on your automatic thoughts!
Cognitive Defusion: Watching thoughts come and go without getting attached
Cognitive defusion is a strategy you can use to help get some distance from your thoughts and see them more objectively – how they might be helping you to live out your values, or how they might be keeping you from living out your values.
You can think of defusion like “de-fusing” or unsticking yourself from your thoughts. There are many strategies for doing this; they are all aimed at helping you to let your thoughts just be what they are – words running through your mind.
Our minds are very powerful, so it takes some practice to relate to our thoughts differently. Practicing defusion strategies (like those in the exercise for this step) can help you to stop fighting with thoughts about pain, so that you can have a little more mental space to make intentional choices about the life you’d like to be living.
- IMPORTANT: cognitive defusion is different from trying to think positively. The goal is not to replace an unhelpful thought with a more “positive” one. This would still keep the fight with our thoughts alive. You want to accept that these thoughts are here, but not attach to them. They do not control you. Remember: You are not your thoughts!
Next Steps
- See: Watch the video
- Cartoon: Watch the animation
- Initiate: Do the exercise!
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Complete exerciseCognitive defusion
Step 1: Listen to the audio recordings. Each recording demonstrates a different cognitive defusion strategy.
Audio Transcript
Start by identifying a thought you have about pain or a thought you have when you are experiencing pain: for example, ‘this pain is never going to get better’. Let yourself engage with this thought as it is now. Repeat it to yourself in your head and out loud. Notice you how feel in this moment. Now, repeat this thought with the lead, “I’m having the thought that this pain is never going to get better.” To further de-fuse from this thought, take another step back and repeat with the lead, “I notice I’m having the thought that this pain is never going to get better” Now, do you notice a mental shift? It may be subtle. Take a moment to reflect on this different way of experiencing this thought. This will take some practice and repetition. Try practicing this exercise with the different thoughts you notice about pain or that are causing you distress when you are in pain.
Audio Transcript
Start by identifying a thought you have about pain or a thought you have when you are experiencing pain: for example, ‘I can’t stand it anymore’. Let yourself engage with this thought as it is now. Repeat it to yourself in your head and out loud. Notice you how feel in this moment. Now, repeat this thought aloud several times very slowly, [read very slowly] “I can’t stand it anymore.” [read again very slowly] “I can’t stand it anymore.” Keep repeating your thought aloud very slowly until it sounds different to you. Notice the thought as a series of sounds, to which meaning can be attached, or not. Now, do you notice a mental shift? It may be subtle. Take a moment to reflect on this different way of experiencing this thought. This will take some practice and repetition. Try practicing this exercise with the different thoughts you notice about pain or that are causing you distress when you are in pain.
Audio Transcript
Start by identifying a thought you have about pain or a thought you have when you are experiencing pain: for example, ‘I’m afraid the pain will get worse’. Let yourself engage with this thought as it is now. Repeat it to yourself in your head and out loud. Notice you how feel in this moment. Now, repeat this thought aloud several times very fast, [read very quickly] “I’m afraid the pain will get worse.” [read several times very quickly] “I’m afraid the pain will get worse.” Keep repeating your thought aloud very quickly until it begins to lose its meaning. Notice the thought as a series of sounds, to which meaning can be attached, or not. Now, do you notice a mental shift? It may be subtle. Take a moment to reflect on this different way of experiencing this thought. This will take some practice and repetition. Try practicing this exercise with the different thoughts you notice about pain or that are causing you distress when you are in pain.
Audio Transcript
Start by identifying a thought you have about pain or a thought you have when you are experiencing pain: for example, ‘This is terrible’. Let yourself engage with this thought as it is now. Repeat it to yourself in your head and out loud. Notice you how feel in this moment. Now, repeat this thought aloud several times in a silly voice, [read in a silly voice] “This is terrible.” [read a few more times in a silly voice] “This is terrible.” Keep repeating your thought aloud with a funny or strange tone or inflection. As you keep repeating, notice the thought as a series of sounds, to which meaning could be attached, or not. Now, do you notice a mental shift? It may be subtle. Take a moment to reflect on this different way of experiencing this thought. This will take some practice and repetition. Try practicing this exercise with the different thoughts you notice about pain or that are causing you distress when you are in pain.
Step 1: Each day, try to identify the thoughts you are having when you are in pain, or thoughts you have about pain.
Step 2: Once you’ve identified the thought, try out some of the cognitive defusion strategies (I’m having the thought that, very slow, very fast, silly voice) and write down what you noticed.Over time you will find the strategies that best help you to get some distance from your thoughts.
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