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

Thinking about our thinking, part 1: what’s our thinking got to do with it?

Hello, it’s Anna here. We’re going to talk today about our thinking and introduce why that’s relevant for us when we’re doing a pain management programme, and begin to think about how we can influence our thinking.

So this might be your thought just now. What’s out thinking got to do with it? Some of you might already be very aware of your thoughts. You might identify as a worrier, or as somebody who is very negative. But for others of you this way of thinking might be quite different and quite new. You might not notice how our thinking affects our life. And this might feel a new topic and a bit uncomfortable. And that’s ok. Like lots of the Pain Management Programme we just ask that you go with us and see how it feels and how it might be relevant for you as we move forward through the programme. So the reason that we are talking about thinking at a Pain Management Programme is that our thoughts can impact how we cope with pain.

So if I give you an example, when your pain flares up I bet there are a whole load of thoughts that come in quite quickly. “How am I going to cope?”, “Am I getting worse?”, “Does moving make things worse?”. All of these thoughts might pop through your head and actually some of them are going to have quite significant impacts on your behaviour and what you do. And your quality of life and the activities that you do. And something that we’re going to discuss when we meet as a group is how our thoughts can influence our goals. And that’s something that’s really key throughout the programme, and something that we’ll definitely come back to.

This might be a familiar diagram to some of you. It comes from Cognitive Behavioural Therapy, and it might look technical. We tend to call it the hot cross bun, which might make you hungry, it does me.
The idea of it is it just illustrates how these 4 areas are really closely linked. So it talks about our thoughts, physical sensations in our body, our emotions, and our behaviour or what we do are all really closely linked. And the arrows are going in all sorts of different directions, because it’s really saying that all of these things can influence each other. We’re going to focus particularly on that top bubble, thinking about our thoughts, but it’s important that we recognise that this is part of a really frequent cycle.

Imagine that you’re lying in bed in the middle of the night and you hear a clatter downstairs. You wake up with a start and your first thought is “It’s a burglar. There’s somebody in my house”. Now understandably we would expect your body to react. Your heart is racing, you’re sweaty, your senses are heightened, you could hear a pin drop, your eyes are on the lookout for danger. And the emotions that you’re feeling at that time might be panic. Might be anxiety. Might be anger. Now, what might you do in that scenario? You hold your breath, you might hide under the covers, might call the police, might wake up a partner or somebody else in the house, you might go and investigate.

But before you do another thought pops into your mind. And you think “I’ve left the recycling out, and it’s so warm at the moment I left the window ajar. I think that cat from next door has got in again. It’s done it before and it’s knocked the recycling down”. “It’s just the cat”. That’s your next thought.

What happens to you physically when all those things that you were experiencing start to settle. Your heart rate goes down, bit less sweaty, your senses then calm down a bit. And those emotions as well start to reduce. Your panic reduces, your anxiety levels. You might feel a bit of relief as well.

And instead of behaving the way you would have done if it was a burglar, you have a different response now. So you think “oh, I’d better go and tidy up” “better go show the cat out, I don’t want it prowling around the house”. And that’s just a really simple example, but it show us the power of thoughts. The same scenario, the same thing happening, but a different response because there was a different thought.

One of the key messages we want you to get from this part of the programme is that thoughts are not facts. It’s helpful to see our thoughts as our brain’s best guess in the moment, rather than as a fact. Our brain takes a lots of information and it tries to make conclusions. It tries to guess what’s going on. But these guesses can have huge influence over our emotions and over our behaviours. So it’s really important that we pay attention to them and check that they’re as accurate as they can be.

Before your next group session, have a go at completing the hot cross bun on thinking worksheet 1.

Choose a recent situation when you felt a strong emotion such as anger, sadness, or worry and fill in the boxes on the “hot cross bun.” It might be a time someone cut in on you in the motorway and you got angry, it might be a feeling of sadness when a family member snapped at you, or it could be worry when your pain flared up. Any situation at all.

Remember, no one will see these sheets. They are for you to complete for yourself. Completing them now means it will be easier to apply the strategies we will introduce next about how to manage our thinking.

End of video script

Return to preparation for session 4