This content is designed for the participants of the GGC Pain Management Programme.

Thinking about our thinking, part 5: challenging our thoughts

Hello, it’s Anna again. Now that we have identified our troublesome thoughts we are going to focus on how to reduce the power they have over us. During the PMP, we will talk about two different approaches to managing our thoughts. In this video I am going to introduce you to one of these. It comes from CBT or Cognitive-Behavioural Therapy and might be familiar to some of you if you have worked with a psychologist or therapist in the past or if you have read about this approach. The approach taken in CBT is to challenge our troublesome thoughts.

Sometimes we can work out where we went wrong. We can look at our thoughts and recognise that they might not be factual.

A CBT approach helps us to look at the evidence for our thoughts to help us work out where we have gone wrong in our thinking.

Building on the work you did last time, in noticing the triggers for certain thoughts and the emotions and physical sensations that are brought up, this approach helps us to consider if the evidence behind our thoughts would hold up in court.  Is it well reasoned case or are we missing some of the vital evidence in the case?

The first three columns here are the same as the ones you have completed in your worksheet. The situation, the mood or emotion that came up, and the thoughts that came to mind.  In the next column, you write down evidence that supports your thoughts. Keep it factual, rather than based on feelings. This should be quite easy to complete. The next column in normally harder to fill in. Evidence that does not support your thought. We naturally tend to look for evidence that backs up our way of thinking. It is more difficult to look at the flip side of things. In this column, try to write down evidence that does not support your thought, evidence at all that does not support your thought. Evidence to the contrary. The questions there can help you to do this.

What facts do I have that these thoughts are not true?

What would a friend say to me or what would I say to a friend in this situation?

Would I have thought about this differently at a different time in my life?

Once you have spent some time looking some evidence for and against your thought, end my making a statement that takes account of both sides of the evidence and presents a more balanced way of looking at things.

Let’s use an example. We might already have spoken about Steve. Steve is aged 46, married to Jean, 2 children at home aged 19 and 23, and grandson age 4 as well.

He used to work as a labourer on building sites but had to stop due to pain

He is now at home all day, family all out working

Old workmates used to pop in from time to time but have now stopped visiting

Steve’s at the PMP and a situation comes up and he tries to use this approach to help him manage his difficult thoughts.

So the situation was that Steve’s son recognised he was struggling, that he was withdrawn and cut off from people, and thought that signing his dad up to Facebook would help him to reconnect with people. But when he did this Steve saw photos of his old colleagues on a night out.

This made him low, depressed, fed up, and really annoyed.

And he started to fill out this table in his worksheet.

He noticed that the thoughts that came to mind were “They don’t care about me.”     “They don’t invite me because I am just a bore now.”     “I would only spoil their nights out by sitting and moaning about my pain.”

Which was the most troublesome thought for Steve?  It was this one in the middle. “They didn’t invite me because I am a bore”. That’s the one that really got to him.

And then he thought about the evidence that backed up that thought.  They didn’t invite me out. Last time I went, Jim joked that I was a moan. My family don’t even talk to me now as I have nothing to talk about. It was quite easy to fill in that column. Those thoughts came quite quickly.

What was harder as then next, and he had to spend some time thinking about this. But he noticed that one of the guys, John, still texts from time to time, but he kept saying no when they asked him out (maybe they didn’t want to pressure me). He also thought that in the past they’d definitely not seen him as a bore. He used to make them all laugh, and he did the last time they were out. And then lastly he knows that one of the guys, Paul, understands as he has arthritis and has to sit more than he used to.

So in the end he was able to come up with this more balanced approach: Maybe they didn’t invite me as I always say no. I could always mention to Graham and say it looked like a good night and see what he says.

This is just an example. You might be able to relate to this. You might not. The idea that we’re trying to illustrate is just that there might be another side to look at, and with practice we can do this. It helps to have written it down a few times and have practiced it on paper before we are able to practice it in real life.

So your task at this point is to look back at the thought that you put into the table on your worksheet last time or choosing a new situation and thought.

Have a go at finding factual evidence for and against your thought and coming up with a more balanced thought in the table on your worksheet.

End of video script

Return to preparation for session 5