# Thoughts & Beliefs ##### Untangling Pain --- ![](https://youtu.be/HhUUUK1AZGk) --- ## tl;dr **Pain and beliefs** - Thoughts and beliefs can influence pain - Pain catastrophizing and kinesiophobia are linked with increased pain **Pain catastrophizing & kinesiophobia** - Believing something worse is happening increases pain - Fear of movement (kinesiophobia) reinforces danger and increases pain - Gradual movement helps reduce fear and brain sensitivity **Climbing wall analogy** - Get kids to touch the first hold, celebrate, then do one more - Repeat and reinforce safety - Same principle applies with clients afraid of moving **Client application** - Reduce movement to a non-fearful starting point - Gradually build up with tiny steps - Reinforce that movement is safe **Rubber hand & nail stories** - Rubber hand experiment shows beliefs impact pain — watch on YouTube - Construction worker had real pain from a nail that didn’t injure him **Challenge your beliefs** - Ask: Is this belief about my pain true? - Examples: Wheelchair in 10 years, running ruins knees - These are DIMs — they add to the danger signal **Focus on SIMs** - Are your beliefs SIMs or DIMs? - SIMs: I am safe, walking is good, moving helps me **Resources or mentioned** - Rubber hand experiment (YouTube) → rubber arm experiment [Rubber Arm Experiment | MAGIC FOR HUMANS - YouTube](https://youtu.be/xdxlT68ygt8) - Construction worker nail story → nail in boot - pain without injury --- ## Transcript Now one of the things that has come from pain science, and we're looking at thoughts and beliefs now, but one of the things that has come from pain science is the understanding that our thoughts and our beliefs can actually influence pain. And that higher levels of pain catastrophizing and kinesiophobia, which is the fear of moving, they're all associated with increased pain. So what does this mean? Looking at pain catastrophizing, this means that we believe that something worse is happening in our body than it actually is. This isn't necessarily just for drama queens, sometimes, especially when we don't know what pain is and what we don't, when we don't know what's going on, when we don't know this pain science, then we really can believe that something is seriously wrong, and this belief can then increase our pain. When it comes to kinesiophobia, this fear of moving, and if we do move we are going to make things worse, this can in itself make pain worse, because this fear of moving And what may happen if we move, it stops us from moving and it reinforces that there is a danger. And as we know, if our brain perceives a danger and a threat to our body, then it's going to increase the sensitivity. So in this respect, This is where we need to gradually increase those movements and to reduce this kinesiophobia, this fear of moving. One of the ways I have understood this and try to explain to my clients is that years ago, when my children were little, we would go to a climbing wall, which would have handholds and footholds, these brightly coloured holds. And the kids were scared, so what I would do was to get them to just touch the first hold. And when they did, I would celebrate with them. Yay, well done, you did it. See, it wasn't that bad, was it? And then I would get them to do that one again, plus just one more, I would ask them, Do you think you can do that one again? Because you just did it. And then if you can just do that one again, and then maybe touch the red one. And obviously, being kids, they're like, yeah, of course I can do that one. 'cause I've just done it and the red one's not that far away so I can do that one. And so they'd get hold of the next red hold, 'cause it was just one more step. And then again, we would celebrate and I would get them to do those things that they had just done. And just one more. So each time they did this, they were reinforcing this, that safety and that they were gradually increasing what they could do. They were moving out of their comfort zone. They weren't feeling threatened and for any point that they did start to get scared, then we would maybe keep with that same one for a little bit and let them get used to it and keep reinforcing that safety. Or we would maybe try a different hold. So instead of reaching for the red hold, let's go for the blue hold. So this is exactly the same that I do with my clients. When they were afraid of moving, when they were afraid of doing something, this kinesiophobia, then we would reduce it right down until we could find out the thing that they could do that they were not afraid of. And then they would gradually move from there. So step by step, tiny baby steps and keep reinforcing that safety. And again, reinforcing the pain science and that they were not damaging anything by moving. Another way to understand how our thoughts and beliefs influence pain. And actually there's two ways. Firstly, there is the rubber hand experiment, which if you haven't seen this, then please go and Google it. It's brilliant. So it's on YouTube and it's a great way to understand how our thoughts and our beliefs can influence pain. So firstly, go and check that out. Secondly, it's a story about a guy who was a construction worker and he jumped onto a plank and a seven inch nail pierced his boot so that he could see it through the other side. And obviously, he's jumped on this nail, he's going to be in terrible pain and he's rushed to the ER and he's sedated with painkillers because he's in so much pain. But when the doctors actually removed his boots. They actually found that the nail had passed between his toes and that it didn't even touch the skin. And so there was zero damage to his foot and yet he was still in absolute pain. His pain was real, very real, but there was no damage. So just the belief and the thought of what had happened, the thoughts of the danger to him and his body meant that his brain had created this pain response. So what does this mean for you? I think the main thing is thinking about your pain. Is it true? Whatever you think about your pain, is it true? Do you know it is true? Do you know it is true that you can't do something? This could be a whole course in itself, but I think just looking at what your beliefs are around pain, this is the first step, because again, those beliefs could be DIMs, And they could be adding to that pain response. So think about your beliefs with regards to pain and your thoughts around pain, that Oh my God, I'm going to end up in a wheelchair in 10 years time or which again is a genuine belief that one of my clients came to me with. Another belief that I had client have was that they couldn't run because they were damaging their knees and they'd end up needing a knee replacement. Again there's no evidence for this. It's that magic balling. We're thinking we can predict the future. But at the same time, these beliefs were then adding to the DIMs, that feeling that moving was a danger. So again, think about your beliefs, analyze them, try and work out. Are they a DIM? Are they actually, adding to this pain, or are they a SIM? Are your beliefs, helping you to move? A SIM for beliefs and, thoughts around pain are that I am safe, going for this walk is safe for me, moving my body is safe. It is good for me to do this, and it's reinforcing those SIMs as much as you can. --- Next lesson → [[Untangling Pain – Module 2 Lesson 10|next lesson]] %% - [[Thoughts and Beliefs Can Influence Pain]] - [[Pain Catastrophizing means that we believe that something worse is happening in our body than it actually is]] - [[Kinesiophobia is a Fear of Moving]] - [[Climbing Wall Analogy, pain and danger alarm system]] - [[Rubber Hand Experiment and pain]] - [[Construction Worker Nail Story and pain]] - [[Questioning Beliefs About Pain]] - [[Real Client Beliefs around pain]] - [[SIMs vs DIMs and movement]]