Many pain patients get stuck in the gloom of fear, anger, helplessness, and despair, and can’t see the light at the end of the tunnel. These negative ways of thinking rev up the amygdala’s tendency to attach negative emotions to thoughts, further “fogging” the prefrontal cortex so that it’s difficult to think things through clearly. This makes the pain experience even harder to manage. There are several kinds of negative thought processes that can greatly increase your pain. Let’s take a look at some of the most common ones.
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One day, a group of young men were playing an aggressive game of basketball at the gym Determined to snatch the ball as it rebounded off the basket, two of them, Mark and Hank, leapt into the air, smashed into each other, and crashed to the ground hard, on their backs. Both instantly got up and continued to play, but within a few days each was suffering from terrible lower back pain. Over the months that followed, both went through a rehabilitation program
Mark did fairly well and eventually went back to playing basketball with the guys. But Hank did not do so well. Despite undergoing treatment that was nearly identical to Mark’s, Hank was never able to play a full game of basketball again, always had to restrain himself to protect his back, and suffered from frequent pain flare-ups.
There was no obvious reason for the differences between the two men; they were both in good shape, with very similar injuries and treatments. If you looked at X-rays of their spines, you wouldn’t be able to tell which one was in pain and which was not. There was a striking difference, however, in the way each interpreted what was happening to him, from the moment the pain began until today.
If you asked Mark what had caused the problem, he would say, “I smacked into Hank when we went for the rebound, and we both wound up on our butts. Happens all the time.” And if you asked him what his doctor had told him, he would reply, “She said the MRI showed I have a few cracks in two discs in my back. But I figured that was probably just some typical wear and tear from playing sports all my life.”
Hank’s answers, however, were quite different. When asked what happened, he replied, “That jerk Mark deliberately smashed into me! And that’s not the first time someone’s done that to me!” As for his doctor’s explanation of the problem, he said, “She said the MRI showed I had two cracked discs in my back. That sounded really bad and I knew I was in for a lot of hurt. The same thing happened to a friend of mine, and he still uses a cane to get around.”
To Mark, the injury was just part of the game, and the doctor’s assessment was just a bunch of facts. To Hank, the injury was the result of a deliberate attack, and the doctor’s report was a harbinger of disaster. Similar situations, widely different reactions.
Hank was caught up in what we call catastrophic thinking, which means interpreting events in a harmful and threatening way that is often exaggerated. Hank told himself that things were bad and would stay bad—if not worse. Over and over again, he ran the worst-case scenarios through his head, wondering if he would ever get better—doubting he would ever get better.
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