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Pain Thoughts: Identifying and Replacing Thoughts that are Not Helpful

Thinking about how much pain you are in does not help you cope with the pain. As pain increases, thoughts may become more negative; as thoughts become more negative, pain often increases further.

Negative thoughts can lead to:

  • Worsening mood
  • Avoiding activities
  • Isolating/avoiding others

Although pain thoughts can be automatic, with practice you can become more aware when you have them. Then you can replace unhelpful thoughts with ones that are helpful.

Here are some examples of unhelpful pain thoughts and some coping statements that you can use to replace them:

Common Pain Thoughts

Types of Unhelpful Thoughts

Examples of Unhelpful Thoughts

Examples of Helpful Thoughts


Believing something is the worst it could possibly be.

When my pain is bad, I can’t do anything.

Even when my pain is bad, there are still some things I can do.
Should Statements:

Thinking in terms of how things should, must, or ought to be.

My doctor should be able to cure my pain.

There is no cure for chronic pain, but I can use skills to cope with my pain.
All or None Thinking:

Seeing things as “either or” or “right or wrong” instead of in terms of degrees.

I can only be happy if I am pain free.

Even if I am in pain I can still be happy. There is always something that I can do to have a better quality of life.

Viewing one or two bad events as an endless pattern of defeat.

I tried doing exercises for my back pain before and it didn’t help. So, it isn’t going to help now.

Although physical therapy didn’t help much before, maybe this time it will help. I might as well try.
Jumping to Conclusions:

Making negative conclusions of events that are not based on fact.

When I move my back hurts, so it must be bad for me to move.

Hurt does not equal harm.
Emotional Reasoning:

Believing how you feel reflects how things really are.

I feel useless, so I am useless.

Even though I can’t do all the things I used to do, it doesn’t mean I can’t do anything.
Disqualifying the Positive:

Focusing on only the bad and discounting the good.

So what if I am doing more, I am still in pain.

Doing more is important for me to live the life I want to live.