How do you think about your pain?

I don’t know about you but I am currently thinking a lot about pain right now… maybe what inspired this post since it is literally on my mind.

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What we think about the nature of pain, our pain, how it affected our past, our present, and our future… is a very important schema. We often think about it as ‘coping’ but it is far more than that isn’t it? It is our very outlook on things. It is how we perceive our existence. How we conceive of our future. How we believe in a treatment plan. How much effort we put into the little coping strategies we might conceive of or even how actively we look for them.

It can vastly change our moods. By our stress level. By our circumstances. By our beliefs about pain itself. By lack of success in our treatment history. By fear and anxiety for our future. And sometimes just answering these questions can give us a good idea of what we really think and believe about pain and our illness.

I did this very sort of thing when I was younger, about 19 and coping with being on my own coping with the chronic pain of FM… and it revealed to me a great many things about how I  thought about things and helped me adapt in new ways. The method I used was cognitive therapy (Chronic pain and cognitive therapy: taking care of your emotional health) and some people find mindfulness techniques helpful… but similar process really. And I’m trying to do the same thing now that I’m trying to deal with new circumstances and additional chronic pain. It is sort of a reality check that we all need to do once in a while because we all have beliefs about pain and our illness.

Somewhere along the line when the pain gets intense it can distort those beliefs I find… or at least that is what I found recently, and when I was younger as well. When I was younger it was simply because I was a sarcastic, cynical person and when I encountered a higher stress situation and went beyond my limits that personality didn’t work so well on the whole thinking about my illness, whereas as an adult I had fine coping strategies in place but that failed to meet the increase in pain levels while working full time and, yeah, the pain just distorted how I thought about everything… the schema changed.

Like other schemas, a pain schema works automatically


“Much of the time, this can be helpful. For example, you may automatically recognize the set of feelings that signal that a migraine is beginning; you can take your migraine medication right away to prevent the head – ache from beginning. Your pain schema may help you to “just know” how much you can walk before your back starts to hurt too much. Or, your pain schema may help you to provide a simple explanation of your pain condition to others.

How Pain Schemas 


A pain schema can have negative effects. For example, if you hold the GENERAL BELIEF that you can’t exercise because of your pain, you may turn down invitations involving SPECIFIC physical activities that you might be able to do.

Your pain schema may also be outdated or even inaccurate. For example, your schema may contain old and inaccurate information about the cause or treatment of your pain. Most importantly, aspects of your pain schema may make coping with pain more difficult. For example, if you have come to believe that having chronic pain means that you are useless, then you will be less likely to try to be useful. If you believe that the only treatment for chronic pain is pain medication, then you will be less likely to try other options, such as physical therapy, meditation or pacing yourself. If your schema suggests that other people can’t understand your pain, you may isolate yourself and stop giving people the chance to get to know you.”



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