Have you ever noticed that pain doesn’t just hurt physically? It talks. Sometimes all day long.
Maybe you’ve heard thoughts like, “This is never going to get better.” “I can’t do this.” “I’m getting worse.” Or maybe my personal favorite: “Well, this is a disaster.”
The strange thing is that when those thoughts show up, we treat them like facts. We assume that because we thought it, it must be true. But what if it’s not? What if some of the thoughts making us feel worse aren’t facts at all? What if they’re just interpretations?
Last time, I talked about the Awareness Wheel and how facts, thoughts, emotions, wants, and actions all influence one another. Today I want to zoom in on one specific part of that wheel: our thoughts. You could also call them our interpretations. Because this one part has more power over our pain than most people realize.
Your Brain Is a Meaning-Making Machine
Your brain is constantly trying to make sense of the world. That’s part of its job. Something happens, and your brain immediately starts building a story around it.
You’re in a pain flare, and the story is “I can’t handle this.” You notice a new symptom, and the story becomes “This is just going to keep getting worse.” Your mind is always trying to answer one question: what does this mean?
The trouble is that chronic pain trains the brain to get very good at creating scary stories. Your brain is trying to protect you. It’s scanning for danger, looking for threats, watching for anything that might require action. That’s a good instinct in the short term. But those protective stories often aren’t helping us.
A Thought Is Not a Fact
This might sound small, even trivial, but it’s one of the most important things I learned in my recovery. A thought is not a fact. It’s an interpretation of a fact.
For years I thought things like “I’m getting worse.” “I’ll never get my life back.” “I can’t handle this.” Those thoughts felt completely true. But feeling true and being true are not always the same thing, especially with pain.
Look closer at those thoughts:
“I’ll never get better” is a prediction, not a fact. It’s about the future, and none of us can actually see the future.
“Nothing is helping me” is usually an exaggeration, not a fact. And it often comes from looking for the silver bullet, expecting all the pain to disappear at once. Healing rarely works that way. If you take antibiotics, you might not feel better until day three. After surgery, recovery can take weeks. Real change is often slow and quiet, even when it’s happening.
“I can’t handle this” is usually fear talking, not fact. Think about the number of hard days you’ve already made it through. The evidence of what you can handle is right behind you.
Why This Actually Matters
At this point you might be thinking, “Okay, maybe my thoughts aren’t facts. But does that really change anything?”
It does, because thoughts don’t just stay in your head. They influence your emotions, your nervous system, your behavior, and ultimately your experience of pain.
Here’s how that chain works through the Awareness Wheel:
The fact is that my back hurts today. My thought is “something is terribly wrong.” That thought produces an emotion, probably fear. The fear creates a want, usually safety. And that want drives an action: I avoid movement, cancel my plans, and stay in bed.
So one fact set off an entire chain reaction. The pain itself might not have changed at all, but the experience of the pain absolutely did.
This is part of why pain researchers spend so much time studying thoughts. Thoughts influence how much danger the brain perceives. And when your protective, short-term-thinking brain senses danger, it’s more likely to keep protection turned on, including pain.
This doesn’t mean you’re causing your pain. It means your thoughts can sometimes turn the volume up, or help turn it down. And that’s a place where you have some influence.
The Pattern Called Catastrophizing
One of the most common thought patterns I see in chronic pain, and one I knew well in my own story, is something called catastrophizing. I also like to call it horribilizing.
It’s a big word for a simple idea. Catastrophizing happens when the brain takes a difficult situation and immediately jumps to the worst possible conclusion.
The fact is that my pain feels worse today. My brain interprets that as “I’m getting worse.” The next thought is “nothing’s helping.” Then “I’ll never get better.” Then “my future is ruined.” From one fact, the brain has written an entire disaster movie.
I was very good at this. But if you do it too, you’re not alone. We humans are remarkably talented at writing catastrophes in our heads. And unfortunately, our nervous systems often respond to those stories as though they’re real. Fear grows, stress grows, tension grows, and very often, so does pain.
One Tiny Word That Changes the Story
A tool that helped me a lot is one small, three-letter word: yet.
For years I would think, “I can’t do that.” And my brain would stop there. Period. End of story. But watch what happens when you add one word: “I can’t do that yet.”
Suddenly there’s possibility. There’s room for growth and change. My clients have come to love this word. It’s tiny, but like profound baby steps, some tiny things can completely change the direction of a story. Sometimes a slightly better story is all we need. Slightly less scary is enough.
You Don’t Have to Fight Every Thought
When people hear all this, they sometimes think, “Great, now I have to monitor every single thought I have.” No thank you. That sounds exhausting.
That’s not the goal. Instead, we can notice our thoughts without immediately believing them. A thought shows up, I acknowledge it, and then I ask one question: is this thought helping me?
Not is it positive. Not can I make it disappear. Just, is it helping me? That’s a completely different relationship with your thoughts. It’s curiosity instead of war.
One of the simplest tools I’ve ever used for this is what I call the good friend exercise. If a thought isn’t helping me, I ask, “What would I say to a good friend in this situation?”
Imagine your friend is struggling. Would you tell them, “You’re hopeless. You’re never going to get better. Nothing will ever help you”? Of course not. You’d say something more compassionate and more realistic. Something like, “You’re going to make it. I’ve seen you make progress over time.”
That’s the goal. Not faking positivity. Just balanced, more accurate thinking. We’re not trying to replace every negative thought with a positive one. We’re replacing unhelpful thoughts with more accurate ones. Less horribilizing, less catastrophizing, and a few more sentences that end in “yet.”
A Different Relationship With Your Thoughts
Looking back, many of the hardest parts of my 21-plus years of unmanaged pain weren’t only about physical pain. They were about the stories I was telling myself. Stories full of fear, grim predictions, catastrophizing, and hopelessness.
Once I started questioning those stories, once I started questioning my interpretations, I began doing well again. Not because all my pain went away, but because I stopped letting every fearful thought drive the bus.
So if there’s one thing I hope you take from this, it’s this: thoughts are powerful, but thoughts are not automatically true. The next time a difficult thought appears, pause, take a breath, get curious, and ask yourself three questions. Is this a fact? Is this thought helping me? Would I say this to a good friend?
Those three questions changed the direction of my thoughts. And very often, they changed my pain levels too. They may help change yours, because awareness creates options, and options create hope.
