iCBT Program for Chronic Pain

Module 4. How we THINK is how we FEEL

When we have a negative view about ourselves, we tend to feel that same way. Our feelings are determined by our thoughts.

Remember the 10 unhelpful thinking styles we learned about in the previous module?

Use the chart provided below to write in the negative feelings that will be associated with each unhelpful thought.

feeling happy

Unhelpful Thinking Style Negative Feelings Associated (Examples: Scared, Nervous, Self-defeated, Anxious, Angry, Worried, Jealous, Upset)
All or Nothing
Mental Filter
Jumping to Conclusions
Emotional Reasoning
Disqualifying the Positive
“Should” or “Must” Statements

Everyone will have different feelings associated with their thoughts

The more negative and unhelpful our thoughts are, the worse our feelings will be, and in turn, the worse our pain will feel.

By the end of this program, you will be able to analyze and understand your negative thoughts, in order to change them to positive ones so that you can start feeling better (mentally and physically).

Cognitive Triad

cognitive triad

Cognitive Triad and CBT

According to CBT, people experience negative feelings for three reasons:

1. They have a negative view of themselves;

2. They interpret experiences in a negative and biased way; and

3. They have a negative view of the future, they expect everything to continue the way it is.

What happens when we reverse each negative point to make it positive? The triad would look something like this:

1. They have a positive view of themselves;

2. They interpret experiences in a positive and unbiased (or even positively biased) way;

3. They have a positive view of the future, they expect everything to continue the way it is, even if they are unhappy at the moment.


Below we will give a scenario. Then we will describe the feelings associated with it from a negative and a positive viewpoint.

Scenario: “I have just slipped and fell walking down the stairs. Now my back is in terrible pain and I cannot walk like I used to.”

Negative Person: “Well, I am not surprised I fell. I’ve been expecting it to happen eventually, as I am getting old and weaker now. I am also very unlucky, so bad things usually happen to me. I think that I am going to be falling a lot more often now, not just on the stairs but everywhere. Oh well – that’s just my luck…”

Positive Person: “The stairs to my house are very steep. I was wearing socks and that makes walking a little bit more difficult (and slippery). I am disappointed it happened and now I am in pain, but I need to focus on being more careful next time and preventing another fall. Accidents happen all the time.”

You should now be able to see the difference between positive and negative thoughts regarding the same situation (ex: a fall), and how these thoughts influence our feelings about that moment.

If we start exchanging negative thoughts for positive ones regarding our chronic pain, we can start to physically and mentally feel better. We will focus more on our improvements and look forward to the future. Remember – life is all about perspective.

Homework for Module 4

Click here to download the emotional log.

For this homework, you will identify at least three events in the last week that have been associated with strong feelings for you.
Examples of feelings are: pleasure, happiness, anger, sadness, guilt and anxiety.

Once you have identified these strong feelings, identify the thoughts that may have produced these feelings. Use these thoughts as your source of change.

Everybody is different and YOU need to identify YOUR thoughts in order to identify areas of change for YOU.

Exercises for Different Areas of Pain from Wilderman Medical Clinic

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