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These Thoughts May Increase And The Patient May Feel That The More They Have ...

These thoughts may increase and the patient may feel that the more they have these thoughts, the more damage they are doing to themselves. Patients can end up caught in a web of cognitive gymnastics about their chronic pain, which diverts energy from dealing with the pain in constructive ways and maintaining a satisfactory level of functioning.
The cognitions that a patient may develop concerning their chronic pain are the product of complex and intricate synthesis of experiences, cultural forces and even childhood learning. Patients do not interpret their pain only in terms of their immediate situation, but bring a variety of other elements to bear upon the way that they translate their ideas about pain and what it means into their responses to their own pain. If they have had pain in the past, or have had close relationships with individuals who have suffered pain, the express and null curriculum of their experiences will provide them with a set of beliefs about pain, what it means and what can be done about it. Cultural ideas about how to respond to pain will also affect their evaluations about the role of pain in the life of an individual. Spouse responses can also be important factors in interpreting chronic pain. It can also be said that behaviour that demonstrates acceptance of chronic pain stems from the collaboration of past and present circumstances, as well as the emotive and interpersonal influences of the present. The way that the spouse expresses his or her beliefs about pain can either reinforce or contradict the beliefs of the patient. If the patient believes that his condition or experience of chronic pain has made him incapacitated and the spouse behaves solicitously, the patient's beliefs about his incapacitation can be confirmed and may override any other input about the patient's ability to function normally.
The cognitive behavioural approach has built into its tenets the capacity for the patient to learn new coping strategies and introduce new cognitions without an awareness of the reality of his or her situation. This may be particularly pertinent in the area of medication, where any form of relief from pain, whether it is actual of perceived, may be a response to thoughts that the pain is out of control and the patient is unable to carry on without the presence of medication. The cognitive behavioural approach also asserts that these types of cognitions and resulting actions are cemented together and work in partnership to perpetuate one another. If a patient thinks that performing a particular action will lead to further damage and pain, he will avoid that action. Thus, he will not discover any information to the contrary and will continue to believe that the presence of pain means that he should not engage in such an activity.

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