FOUNDATION PAIN MANAGEMENT PROGRAMME
Week 2 – Emotional effect of pain
Thoughts, Feelings and Behaviours all interact and influence each other and consequently your symptoms on both good and bad days
It is important to exert as much control as possible to prevent negative cycles of passive coping styles occurring during your bad days
Example of a Negative Cycle
Controlling the Behaviour
In the above cycle, one valid technique would be to adopt a positive behaviour despite symptoms (i.e. still attempt a modified amount of activity). This will provide a physical distraction from symptoms and thoughts. The achievement of adopting this positive behaviour should then be acknowledged in order to create more positive thoughts and consequently emotions
Turning the Negative into a Positive- Controlling the Behaviour
Challenging Strong Negative Automatic Thoughts
We all have many negative automaticthoughts (NATs) or images on a daily basis. However, during times where physical or emotional symptoms are more prevalent (usually at least a 7/10 or higher) more NATs or images occur and individuals pay more attention to them andeven start to believe them. These are known as “hot” thoughts or images. The first step in controlling hot thoughts is to become more aware of them. Awareness will allow you to recognise the potential impact of the NAT and then to challenge its validity- is it actually true?
Some people find it easier to challenge their thoughts, while some to control their behaviours. Both methods are equally valid strategies
External Factors
1.Other People’s Behaviour
The two extremes of behaviour demonstrated by others are being over-protective and under-supportive. Both these extremes can be equally negative
Under-supportive
Deciding whether you disclose your illness to a particular person (family/ friend/ colleague/ manager) is apersonal choice. It is sometimes easier to put on a brave face with people rather than admit how badly you can be affected by your symptoms but who has to suffer the consequences of overdoing things? It is very difficult to be assertive when setting social and work related boundaries around particular activities if the person you are negotiating with has no understanding of the impact when pushing yourself too hard. If you want their attitude towards you to change then it may be worth trying to educate them. Sometimes disclosing your illness to others is prevented because you don’t want to admit it to yourself.
It is also worth acknowledging there will be people within your life that will not understand your illness regardless how much you try and educate them. It may be easier to accept you will not change their opinions. This may help you to cope more positively with any “throw away” negative comments they make
Over-protective
Extreme over-protectiveness is generally the easier behaviour to tackle as it will generally be displayed by someone close to you. Listening to someone who is constantly telling you to rest and avoid activity will have a negative effect upon your mood, self-esteem and physical condition
2. Other External Factors
You will not be able to control factors such as the weather, environment, contracting other illnesses, bereavement, or in some cases external stresses (social/ work). However, you can still try to control how you cope and react to these situations. Try to avoid extreme passive coping strategies during difficult times (prolonged rest periods) and gradually increase your activity levels as the external factor resolves itself
Key Messages
Focus on the factors affecting your symptoms that you can exert control: behaviour and thoughts
Avoid extreme passive coping strategies during difficult times (e.g. staying in bed) and adopt active behaviours despite your symptoms- then acknowledge these positive actions
Challenge the validity of “hot” thoughts/ images
Decide whether there is anything else you can do to influence how others behave towards you (disclose illness, educate, be more assertive). If not, try to control your own behavioural reaction and challenge any hot thoughts that may occur