iCBT Program for Chronic Pain

Module 3. Negative Thoughts

Take a moment to recall two times in the past two weeks where you had a negative thought about yourself or a situation. Write them down on a piece of paper.

Negative Thinking

Take a moment to reflect on your two answers. Do you see how they can affect your perception of yourself?

Negative, distorted, or unhelpful thinking can lead to a negative self-perception and isolation patterning. This then becomes a negative cycle.

Your thoughts control how you act every day. For example, the more negative your thoughts are, the more isolated your behaviours will be.

woman is thinking

negative thinking

Unhelpful Thinking

There are 10 main styles of unhelpful thinking. We will go over each one.

The goal is to learn to recognize each type of style in your daily life, thoughts, and emotions.

Once you are able to recognize them, you will be able to change them!

Unhelpful Thinking Styles

All or nothing: Black and white thinking.

negative thinking style diag.1

If I’m not perfect I have failed.

Either I do it right or not at all.

Example: “I had to stay home from work today because of my pain, therefore I am a terrible employee.”

Overgeneralization: Based on a single incident, you come to a general conclusion.

negative thinking style diag.2

Example: “I slipped on ice last winter and my back has been hurting ever since. Now, I know I am going to fall every time I walk outside this winter.”

Mental Filter: Filtering out the positive things you do, and focusing only on the negative.

negative thinking style diag.3

Only paying attention to certain types of evidence.

Noticing our failures but not seeing our successes.

Example: “I walked for 20 minutes today, but before my accident I could walk for 2 hours.”

Disqualifying the Positive:
The good that you do or that happens is discounted for some reason.

Disqualifying the Positive

That doesn’t count

Example: “Even though I was able to walk around the block today, I am still stuck in this misery forever.”

Jumping to Conclusions
There are two key types of jumping to conclusions:

negative thinking style diag.1

  • Mind reading: Assuming we know what other people are thinking.
    Example: “Since I parked in the disabled parking spot but did not bring my wheelchair, everybody is judging me and thinks I am not truly suffering.”
  • Fortune: Predicting the future with no evidence.
    Example: “These cortisone injections will never work for me. Nothing works for me. I am going to be in pain forever.”

Catastrophizing & Minimizing: Believing something is far worse than reality or minimizing successes.

negative thinking style diag.1

Blowing things out of proportion (catastrophizing), or inappropriately shrinking something to make it seem less important (minimizing).

Example: “I am going to be in pain forever. My pain is so bad that nothing will cure me.”

Emotional Reasoning: Assumptions based on our feelings.

negative thinking style diag.1

Assuming that, because we feel a certain way, what we think must be true.

Example: "I feel like such a failure after my last fall. I truly am one."

“Should” or “Must” Statements: Using phrases involving “should”, “ought” or “must”.

negative thinking style diag.1

Using critical words like ‘should’, ‘must’, or ‘ought’ can make us feel guilty, or can make us feel like we have already failed.

If we apply ‘shoulds’ to other people the result is often frustration.

Example: “I must get over this pain. I should not be feeling the way I am.”

Labelling: Assigning labels or categories to ourselves or other people.

negative thinking style diag.1

I’m a loser.
I’m completely useless.

Example: “I’m in pain all day so I’m nothing but a patient. Not even a human anymore…”

Personalization: Blaming yourself, or taking responsibility for something you did not do.

negative thinking style diag.1

Example: “The accident was all my fault. I am responsible for all my misery. I hate myself.”

Conversely, blaming other people for something that was your fault.

Exercise – match the type of unhelpful thinking to its example.

1. Martha said I looked great today, but that doesn’t count because she’s my friend and just being nice!
Select the type of unhelpful thinking:

Disqualifying the Positive

2. I’m not going to see my friend later today because I know it won’t end well.
Select the type of unhelpful thinking:

Jumping to Conclusions

3. I was late to the dinner, which caused the cook to burn the vegetables.
Select the type of unhelpful thinking:


4. I was very impatient with that man in line at the store today. I’m a jerk.
Select the type of unhelpful thinking:


5. I did not perform at 100%, so I failed.
Select the type of unhelpful thinking:

All or Nothing

6. While giving a toast at a wedding one person stands up and walks out. After your toast, many people tell you how wonderful it was but you are angry that one person left.
Select the type of unhelpful thinking:

Mental Filter

7. I feel guilty I didn’t go to the party because I’m not feeling well, therefore I must be a bad person.
Select the type of unhelpful thinking:

Emotional Reasoning

8. On Monday morning, a man yells at you for walking slowly. You then think everyone is angry at you that day.
Select the type of unhelpful thinking:

Over generalizing

9. When late for work today, you say, “I shouldn’t have been so lazy. I should have woken up earlier.”
Select the type of unhelpful thinking:

“Should” or “Must” Statements

10. A high school student failed a math test. Now they think “I will fail out of school, and not graduate and then not be able to find a job!”
Select the type of unhelpful thinking:

Catastrophizing & Minimizing

Homework for Module 3

Please, click here to download a daily mood log. Fill it out twice a day, for 7 days. Be aware of your negative unhelpful thinking, and try to find ways to turn your thoughts into positive ones.

Hint: Use The Double Standard Technique.
When we are negative with ourselves, imagine our best friend saying those exact words about themselves. What would you say to your friend as advice? Now, use that same advice on your own negative thinking!

Exercises for Different Areas of Pain from Wilderman Medical Clinic

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