In this series of articles, Stress Illness: The Complete Guide, you’ll learn everything you need to know about Stress Illness/Psychophysiological Disorder/Mindbody Syndrome. Each article addresses a different aspect, the principles of recovery, physical symptoms, emotional aspects, the cognitive elements, the behaviours of those suffering, and the losses they face, and the remedies and therapies that are gaining research backing as effective treatment choices. The articles build into a useful reference for those wishing to understand more about the complexities of Chronic Pain and Stress Illnesses.
This article is the 5th of the series and will focus on 5 different ways thought processes can affect people who endure Chronic Pain or Stress Illness. It also offers scientifically proven methods to challenge those and improve physical and emotional wellbeing.
As an accredited cognitive psychotherapist, one of the first questions I ask potential clients in an assessment is, ‘What were you thinking at the time?’ or ‘What's going through your mind right now?’. For many people this causes confusion and I receive a blank stare and a shrug of the shoulders in response. Most of us, unless we've been trained to think in this way, have not considered thinking about our thinking, or metacognition, as it is known.
To be competent in metacognition, however, is very helpful. It enables us to understand ourselves better. And it allows understanding of the effect of our thinking on our wellbeing. This article is about how our thinking can interact with our physical symptoms and our emotions, to create an unhelpful atmosphere within ourselves, which can lead to more negative symptoms. Pain, anxiety, frustration, tension, and many other unwanted, unhelpful, persistent issues.
If we can become a little more aware of how we think, not necessarily exactly what we think, we have a chance to employ ways of dealing with our emotional and physical wellbeing ourselves, which is extremely empowering.
Problem: Negative Bias
As the world is full of uncertainty, we have evolved to be cautious in the face of novelty. If we cannot gain certainty that something is safe, then we naturally err on the side of caution and avoid it. This phenomenon has been dubbed the negativity bias. It means we are more likely to notice and learn from negative information, than positive information. We will remember negative events more readily than positive. We will remember times we felt unsafe and threatened to prevent us from risking our lives.
This process has been incredibly successful. Humans have survived millennia. However, in today’s Western chaotic, fast-paced environment there is more novelty daily than we were designed to deal with. There is the ability to experience a huge array of physical, emotional, and cognitive challenges all through our phone, T.V. and computer screens daily. We stand witness to horrific crimes, accidents, natural disasters, and wars on a potentially constant basis. This causes an undercurrent of uncertainty and thus more negative thought processing.
Seeing something as a threat to our survival causes the body to start to prepare to get to safety by means of one of the 5Fs (fight/flight/friend/freeze/faint). These puts added strain on the body, so not only do we start to feel emotionally anxious, upset, and/or frustrated, we also experience tension in the muscles, changes to our breathing, heart rate, temperature, and digestive tract. These can magnify existing pain and conditions.
If we are aware that certain forms of media cause us to worry more then it would be wise to create a plan to limit how often we consume that form of media.
Problem: Mind Your Language
As we never stop thinking it is important to consider how we think about our pain, anxiety, or physical symptoms. For the same reasons as above, if we react to our symptoms as if they are threatening, the body will respond with the 5Fs, and the symptoms will increase.
Therefore, understanding that the body often creates different, sometimes totally new, sensations is useful to bear in mind. Also, we must mind our language the mind doesn’t know the difference between reality and make-believe, so we will see an emotional reaction to some statements as well. For example:
“My back is killing me!”
“I'll never get better.”
“I’d rather die, than have this for one more day!”
Are these thoughts likely to make someone feel safe and calm, or more scared and tense?
Try to be mindful how you speak to yourself – your mind doesn’t have a BS filter.
Problem: Thoughts are not facts!
Some of the most common thoughts people say in their first session are:
“The doctor said it's all in my head”.
“I can't cope”.
“Something bad is going to happen”.
“Nobody understands what I'm going through”.
“I’ll never get better”.
Do you relate to any of those? I wonder, how many are 100% true?
How would you ever know that you will never get better? I know thousands of people that have recovered from things that doctors have said they can't recover from. I know I, myself, I recovered from fibromyalgia, which medical professional’s general believe is incurable. Never, is a long time. So much can happen in that time. And as I said, the cure could be out there, you just may not have been introduced to it yet.
We could challenge each of these thoughts in a similar way. I can't cope. I call BS on that. If you are here, if you are reading this right now, you have coped with 100% of everything that has been thrown at you. You are coping if you are here. And you will cope because you are a survivor. And so it's a thought. Thoughts are not facts! Thoughts are just thoughts. They are electrical impulses in the brain that are there one moment and gone the next.
Checkout your thoughts. Employ a BS filter – ask yourself “Is this fact or opinion?” If it’s just an opinion, you don’t have to accept it.
Problem: Unhelpful Thought Habits
Our brain loves habits because it makes life just so much easier to deal with the uncertainties. We have habits of thinking that fall into various different categories. I’m only going to talk about a few here today.
All or Nothing. - Thinking that you either have to do it all now or none of it now. It's either a good job or a bad job. It can’t be an OK job. You might think you’re a good person, or a bad person.
Is the world really this clear cut?
Should, Ought, Must - Using critical words with yourself like should, must, ought can cause guilt and feel like we've failed before we've even tried something. “I should do this today”. “I must get this all done”. “Other people should not do that.” It can make our lives feel very restricted and rule driven. And often those rules are not hard and fast rules. They are rules that we have absorbed from somewhere, they are not written rules.
They're not rules that need to be kept. So, you can change them.
Personalisation. - This is where we take the blame ourselves for things even when it wasn't, we just automatically do it. This often comes when we learned to take responsibility early in life.
The ‘Fact or Opinion’ question can help here too.
Generalising. We can say everything is always bad. “I'm always in pain” “It’s never going to get better”. Words like everything, always, nothing, ever, and never create a picture that looks bigger and usually gloomier than the actual situation. It can be really quite damaging to our mood, anxiety, and physical health. Drawing a conclusion very broad conclusion, sometimes from a small or single event, or at least not the whole, can often be incomplete and misleading.
So, checking it out with ‘Fact or Opinion’ is an option again. If it's an opinion, you get a choice. Take the choice. Make that choice your wellbeing.
Problem: Thought Suppression
If we are in pain, a common thing that we do is try to suppress our thoughts. We try not to think about the pain. We try not to think about what we are worried about, or how we feel. We often push things away. We avoid lots of things.
It often happens when we are stressed about something. Or if we've got something that's happened in the past that we don't want to think about. We may try to avoid thinking about that accident that caused the injury that led to the pain. Or we try not to think about how we might feel at that event because the pain or anxiety might be bad.
Has trying not to think about something ever worked for you? When you try not to think about chocolate when on a diet, what happens?
There was a great research study done in 1987 (Wegner, D. M., Schneider, D. J., Carter, S. R., & White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5–13. https://doi.org/10.1037/0022-35184.108.40.206) they proved that if we try not to think of something, something called the rebound effect occurs. Essentially this means that if you try not to think about something, you're gonna end up thinking about it more. So, thought suppression does not work.
We must allow ourselves to think about things, but in a different way. How to do this is learned in therapy.
This article has looked at five ways our thoughts can impact our physical and emotional wellbeing. It has also offered potential solutions for each of these to improve life with pain and uncomfortable persistent sensations or symptoms. Understanding our own thinking patterns, understanding what to do with our own thinking can be empowering. Knowing whether to indulge in our thinking, challenge it, or to shelve it can be a turning point in our recovery journey.
If you resonate with this and would like to learn more, I offer complimentary consultations, booked via my website.
Next time I'll be discussing the many behaviours that we develop when suffering chronic pain or stress illnesses.