As I said in the previous post, I went to a great talk recently at UniSA on pain coping skills. It was aimed at helping therapists help people with persistent pain problems. There was some great discussion about thoughts – they have a key role in any situation but especially persistent pain.
This was delivered by a psychologist, Associate Professor Christina Bryant, and a physio, Professor Kim Bennell. They talked about psychology and physical methods of helping people cope with pain rather than medication. Not that they were anti-medication, but there are many useful physical and psychological strategies that are important and helpful.
The role of thoughts
As a physio, the role of thoughts and talking about thoughts can be a bit foreign to us. As a group we can be resistant to talking about this kind of thing with clients because we aren’t psychologists (as I keep telling patients as I start talking about these ideas). However, we are in a prime situation to discuss some ‘safer’ aspects of people’s beliefs and how it might impact their situation.
One of the basic tenets of cognitive behavioural therapy is that:
- thoughts create feelings,
- feelings create behaviour and
- behaviour reinforces thoughts.
Another way of putting it is that it isn’t simply that an event causes feelings, it is how you evaluate the situation or in psychology terms, how you ‘appraise’ it.
The example that was given was that of rain – it is raining outside, is that a happy or sad event? It all depends on your perspective. If you are a struggling farmer waiting to plant seed it is going to be completely different to if it is your wedding day. The event is the same. The appraisal is different leading to different feelings.
The words from your health professional can be a strong influence on your thoughts and beliefs about your problem or situation.
What we didn’t fully appreciate was how those words can directly affect pain. If you would like to read more about this (and see some cool illusions to demonstrate the concept), click here to read a fascinating article on how words affect pain.
The ABC model
It has also been described as the ABC model:
antecedent – the situation or trigger
belief – or thoughts, and often this is an automatic thought if has become habitual in persistent pain
consequence – the emotional and behavioural response
Often, the belief part is ignored or forgotten about. For example, ‘that made me feel bad’ or ‘he made me feel bad’ without recognising that there is a step in the middle, that is depends on your evaluation or appraisal of the situation.
An example that I have given my daughter Lily recently, if someone hits you, you can’t hit them back and say that it was completely their fault that you retaliated. They might have done the wrong thing in hitting you, but there is a step in the middle where you make a decision to hit them back.
I guess the short version is that the situation or the trigger doesn’t equal the emotional or behavioural response.
Additional thoughts
There is a similarity between that and pain biology – just because you damage tissues doesn’t equal the experience of pain. There is an evaluation of the situation by your brain that happens unconsciously and almost instantaneously about whether you should experience pain or not.
Injury doesn’t equal pain. Injury PLUS evaluation MAY result in pain.
If you have a problem with ongoing pain of any sort, why not give us a call? Organise a time to have a chat and see if we can help. There is no obligation to have treatment with us. You can ‘check us out’ and see if we sound like the kind of people that you could deal with.
Call anytime on 8356 1000, or organise a time clicking on the online booking button at the top of the page, then go to the preassessment options.
