Managing Your Catastrophizing Thoughts and Keeping your Mind Online.
If you’re a person that has ongoing pain, you can tell this story far better than I can, but I woke up with back pain today.
I don’t often have pain, and I also have a stupid belief that I don’t really have physical limits. That’s why I decided it was OK to tackle a heavy weights workout yesterday, although I was getting a few signals that my back wasn’t happy with me. This was not my smartest move, and hence getting out of bed this morning was not a graceful performance. It hurt, but I knew I was still ok — and this is not the common experience that people have with a pain episode. Pain is a signal that your brain thinks you’re in danger, and it’s there to make you do something about it. I felt very grateful that I understood my pain, my pain didn’t scare me and I had some tricks to manage it. It still hurts, it will slow me down for a little while but I have 100% confidence it will go away.
There are many situations where pain tells a much different story. Your pain can tell stories of fear, anger, anxiety and helplessness. Pain, and the thoughts related to it can hold you hostage and determine how your life turns out today. Pain that changes how you live, how you enjoy life and the decisions that you have to make about your day take on bigger and more challenging meanings. Without getting your brain under control, it’s easy to spiral down in to catastrophic thinking.
Thought Viruses and Catastrophic Thinking
“How you think about your pain — and the meaning that you give to your pain — will make your pain better or worse” Dr Beth Darnall, “Less Pain, Fewer Pills”
When we start to experience that spiral down with pain — the focus on pain and the anticipation of more pain — we are catastrophizing. We can catastrophize, or expect the worst, in many aspects of life. In pain, the effect of the thoughts makes our feelings and pain experience a whole lot worse.
The nerdy scientific definition of catastrophizing?
“an exaggerated negative mental set brought to bear during an actual or anticipated painful experience” (Sullivan et al., 2001)
What does that really mean? Catastrophizing is the perfect storm of fear of increasing and unbearable pain, inability to shift your attention from the pain, and a feeling of hopelessness to be able to change your pain experience.
Where does your brain go when you have a flare up of pain, or increased pain that seems different to your normal? How we react and manage a pain experience mentally is critical for controlling pain. It determines how likely the pain is to increase and persist, and how well medication can help us. Allowing your brain to be taken over by thoughts of helplessness and anxiety will make any flareup worse, so we need some strategies to manage our mind.
First Aid for Chronic Pain
Acute injuries have some specific tricks and techniques for first aid — stopping the bleeding, managing the swelling, relieving some pain and feeling safe again. The bigger the injury, the more help you need — sometimes you do need an ambulance, and professional help. The pain makes sense, you can see the injury and there is a lot of processes your body is putting in to action to heal you as fast as it can.
Chronic pain is different. We’ve talked about ongoing pain as a learned response and change to the brain to create more pain than is appropriate related to the health of the tissues. Your brain creates pain because it’s trying to protect you from danger, however it’s learnt to find that danger in places that don’t really threaten your tissues. That’s irrelevant because you certainly feel the effects of this protective response. Since we know that the factors that result in a flareup in chronic pain are multifactorial and very personal to you, we often find that a flareup sneaks up, and all of a sudden, your pain levels are through the roof.
What to do next? How do you make sense of the pain increase, and the continuing experience of pain? This is where thought management around catastrophizing becomes critical. It’s now up to you to outsmart your brain rather than spiral down in to the thoughts. Your thoughts will turn the volume of the pain up or down, and having control over your responses is a critical skill for managing pain. How we think affects the biology of our brain, and how well we can release our own pain medication in our brain.
Resources for Managing Catastrophizing Thoughts
Dr Beth Darnall is one of the foremost researchers on pain psychology and catastrophizing, and has produced many excellent resources to help people in pain help themselves. She has two great books available for purchase at http://bethdarnall.com/books/ where you can learn the practical techniques she uses with her patients at Stanford Pain Management Centre.
“Catastrophizing and Coping” #paintalks Tweetchat
Let’s get together on Twitter and talk about our own experiences of catastrophizing, how we talk back to our mind and overcome the downward spiral in a flare up. See you there Thursday 18th August at 7pm EDT using the hashtag #paintalks.
Here’s our questions this month:
1. What thoughts do you have when your pain increases?
2. What happens to you when you can’t control your thoughts about pain?
3. What ways can you talk back to your brain and get out of catastrophizing?
4. What is your biggest challenge when managing your catastrophizing?