It’s been said that many people are their own worst critics. For people with chronic pain, a specific type of internal criticism can actually worsen pain, according to a study published in the Journal of Pain.
The study examined how a psychological phenomenon known as internalized stigma affects a person’s experience of pain. Internalized stigma is essentially when people believe negative social attitudes or stereotypes about chronic pain. The phenomenon can also refer to a person’s own negative thoughts about a condition.
Thoughts such as, “I’m a loser,” or “I’m no good,” aren’t helpful and may actually worsen pain, according to the study.
Social stigma about chronic pain might, for example, question a patient’s work ethic, not believing the extent to which a condition causes suffering. This could lead to inaccurate beliefs that a person is lazy or a wimp if time to rest is needed, or if pain prevents a person from participating in certain tasks or activities.
Chronic pain patients frequently take negative social attitudes about medical conditions to heart, becoming their own worst critics.
Stigma could also involve how a person copes emotionally with chronic pain, with society—or even a family member—erroneously considering someone weak for experiencing bad days, sadness, or anger.
Difficulty completing certain tasks and experiencing uncomfortable emotions is a normal part of dealing with chronic pain. However, social attitudes and norms don’t always make it easy for people who face disability.
Having compassion for yourself while managing chronic pain is critical, and the Journal of Pain research discovered just how important it is. To discover how internalized stigma affects chronic pain patients, researchers gave 92 adults surveys with questions designed to uncover each person’s internal beliefs and how those beliefs influenced their experiences.
Nearly 40% of the study subjects reported internalized stigma. Researchers found those negative beliefs diminished patients’ feelings that they had power over the pain and lowered their self-esteem. Subjects with critical inner voices were also more likely to view their situation as worse than it actually was.
Chronic pain patients’ negative beliefs about medical conditions worsen pain and lower self-esteem, study shows.
Experiencing low self-esteem and negative beliefs can have profound social implications as well as physical consequences, according to Like Minds, Like Mine, a New Zealand-based organization that works to fight mental health stigma. Believing that you’re not worthy or getting too caught up in your limitations may stop you from applying for a job that you’d be good at or pursuing other opportunities.
Low self-esteem and negative self-talk also has a tendency to create a feedback loop, meaning that that these negative thoughts and beliefs keep you from participating in life as fully as possible, which in turn could worsen chronic pain, further reinforcing negative beliefs and limiting life activity even more. This continues in a vicious cycle.
Fortunately, it doesn’t have to be this way.
How can a person change his or her beliefs about chronic pain?
Working to build self-esteem is one way to encourage positive thoughts and eliminate internalized stigma.
The first step to changing internal beliefs is to recognize that they exist. Secondly, it’s important to realize that a person’s thoughts aren’t necessarily true.
Try observing your thoughts without becoming attached to them. You may be surprised at the contents of your self-talk. Once you become aware of it, you can start the work to shift those thoughts.
For example, if you catch yourself saying something like, “Gosh, another bad pain day. I’m just worthless,” gently stop. Consider that bad days are a natural part of living with chronic illness, and that it’s ok to rest. Forgive yourself for not feeling well, suggests Mayo Clinic, while avoiding statements that involve “should” or “must.”
Telling yourself that you “should” feel better or be able to complete specific tasks will only increase negative feelings. Treat yourself gently and with compassion. Then, perhaps think about something positive that happened that day or that week.
Ask yourself if there’s anything you can do to improve your day or make the current situation less upsetting. Above all, let yourself feel exactly what you’re feeling. Resisting uncomfortable feelings only makes them worse.
If you feel sad, be sad. If you feel angry, be angry. Just try not to act on these feelings. Instead, try to observe them and notice your thoughts. Mayo Clinic adds:
“You don’t have to like (uncomfortable feelings), just allow yourself to feel them.”
Noticing self-talk is the first step to ridding yourself of internalized, negative attitudes about chronic pain.
If you’re having trouble noticing negative self-talk before it completely consumes you and causes emotional pain, consider meditation. Meditation, the process of sitting and focusing on the breath, is a profound way of watching the mind without becoming attached to it.
Meditation also helps you develop a relationship with yourself, according to Oprah magazine. The article promises:
“You get to know who you really are, and to accept and embrace every part. You’ll soon find that your doubts, insecurities, or fears are really only superficial, as you begin to connect with a deeper place of trust, dignity, and self-worth.”
If you’re interested in learning how to meditate, here is a guide from New York Insight Meditation Center.
Self-esteem comes from complete self-acceptance that recognizes both positive and negative traits.
Another way of developing self-esteem is developing a healthy sense of perspective about your strengths and limitations. At the core, self-esteem is the ability to accept yourself for who you are. So in addition to recognizing that yes, you have some limitations, recognize all your wonderful qualities, as well. Try making a list of those attributes and looking at it everyday to help internalize those positive things.
You might also work to set realistic goals and avoid comparisons with others because comparison is the thief of joy.
While tools to increase self-esteem are well-established, internalized stigma is still a relatively new area of psychology. This means that researchers are still learning about it, and no real guidelines exist for treatment, according to research published by the American Psychological Association.
Emerging therapies involve group treatment sessions that target negative beliefs and give patients tools to change their negative beliefs, including the ability to think about and change the course of a personal narrative, which are the stories about ourselves that we tell ourselves.
Have you ever worked to change your thoughts?
Image by MartaZ* via Flickr