Chronic pain and illness can be overwhelming, affecting every aspect of life—mind, body, and spirit. When pain persists for long periods, it tests our endurance and can stir up deep emotions like hopelessness, uncertainty, fear, isolation, frustration, and doubt. At the same time, it can build resilience, strength, self-awareness, and compassion.
Living with ongoing discomfort often pushes us to find strength we didn’t know we had. But when repeated efforts to find relief don’t yield the comfort we long for, it can start to feel like hope and possibility are slipping away. Chronic pain doesn’t just exist in the present moment—it carries memories of pain, symptoms of pain, and the fear of enduring more pain in the future.
One of the ways pain impacts our well-being is through the thoughts we attach to it. The way we think about our pain—especially in moments of distress—can either amplify our suffering or create opportunities for relief. While shifting our thinking won’t magically eliminate pain, even small changes in how we approach our thoughts can make a meaningful difference in how we experience discomfort, both mentally and physically.
How Cognitive Distortions Affect Chronic Pain
Cognitive distortions are thought patterns that may reinforce feelings of distress, fear, and hopelessness. When pain is persistent, these patterns can become ingrained, making it even harder to find moments of ease. Below is a list of common cognitive distortions along with examples of how they might show up in the experience of chronic pain or illness.
All-or-Nothing Thinking – Seeing things in extremes, with no middle ground.
Distorted Thought: “If I can’t do everything I used to, I’m completely useless.”
Impact: Increases feelings of frustration and hopelessness.
Example: You used to run regularly, but now you can only go on short walks. Instead of recognizing the benefit of movement, you feel like you’ve lost all ability.
Overgeneralization – Viewing a negative event as an unending pattern.
Distorted Thought: “I’ll never feel better.”
Impact: Reinforces a sense of hopelessness and despair.
Example: You have a bad pain day and assume you’ll always feel this way, even though you’ve had better days before.
Mental Filter – Dwelling on the negatives while ignoring positives.
Distorted Thought: “My body is completely broken.”
Impact: Increases distress and reduces motivation.
Example: You focus only on what you can’t do anymore, rather than acknowledging what your body is still capable of.
Discounting the Positives – Undermining accomplishments or progress.
Distorted Thought: “I barely got anything done today.”
Impact: Leads to self-judgment and discouragement.
Example: You completed small tasks despite pain or fatigue, but dismiss them as unimportant.
Jumping to Conclusions – Assuming negative outcomes without evidence.
Mind Reading: “They think I’m lazy because I canceled plans again.”
Fortune Telling: “This treatment won’t work for me.”
Impact: Creates unnecessary anxiety and self-doubt.
Example: You assume people judge you for resting, even though no one has said anything negative.
Magnification or Minimization – Exaggerating negatives or downplaying positives.
Distorted Thought: “My pain will only get worse.”
Impact: Increases fear and anxiety.
Example: A flare-up leads you to believe your condition is worsening permanently, even though flare-ups have passed before.
Emotional Reasoning – Assuming feelings are facts.
Distorted Thought: “I feel like a burden, so I must be one.”
Impact: Reinforces shame and isolation.
Example: You feel guilty for asking for help and assume others must see you as a burden.
Should Statements – Rigid self-criticism based on unrealistic expectations.
Distorted Thought: “I should push through the pain.”
Impact: Leads to overexertion and worsening symptoms.
Example: You ignore your body’s signals and feel guilty for resting, even though rest is necessary for healing.
Labeling – Defining oneself based on struggles.
Distorted Thought: “I’m weak.”
Impact: Reinforces negative self-image.
Example: Instead of recognizing your resilience, you judge yourself for needing to modify activities.
Personalization & Blame – Taking excessive responsibility or shifting all blame.
Distorted Thought: “It’s my fault I’m sick.”
Impact: Leads to guilt and self-judgment.
Example: You blame yourself for developing a condition, even though it’s not within your control.
Reframing Thoughts for Relief
Recognizing these distortions is the first step. The next is learning how to gently shift our thoughts in ways that support our nervous system rather than heighten the sense of threat or hopelessness. Below are examples of untwisting distorted thoughts using evidence-based cognitive strategies that can bring more ease and self-compassion.
The Double-Standard Method – Treat yourself as you would a friend.
Distorted Thought: “I’m weak for needing rest.”
Reframed Thought: “I’d tell a friend that listening to their body is wise, not weak.”
Impact: Self-compassion instead of guilt.
The Experimental Technique – Test the validity of your negative thought.
Distorted Thought: “I never feel good.”
Reframed Thought: “I’ll track my symptoms to see if that’s really true.”
Impact: Increased awareness and perspective.
Thinking in Shades of Gray – Avoid all-or-nothing thinking.
Distorted Thought: “If I can’t do it all, I’ve failed.”
Reframed Thought: “Doing something, even if modified, still counts.”
Impact: Encouragement and motivation.
The Survey Method – Check if your thoughts are realistic.
Distorted Thought: “I’m the only one struggling with this.”
Reframed Thought: “I’ll connect with others who live with chronic pain and see if they relate.”
Impact: Reduced isolation and increased support.
Define Terms – Challenge extreme labels.
Distorted Thought: “I’m useless.”
Reframed Thought: “My worth isn’t defined by what I can do physically.”
Impact: Self-acceptance.
The Semantic Method – Replace “should” with softer language.
Distorted Thought: “I should be able to do more.”
Reframed Thought: “I’d like to do more, but my body has limits.”
Impact: Self-compassion.
Re-attribution – Distribute responsibility more fairly.
Distorted Thought: “It’s my fault I can’t keep up.”
Reframed Thought: “My condition limits me, but I am doing my best.”
Impact: Relief and fairness.
Ways to Explore This Work Further
If you'd like support in identifying and shifting cognitive distortions one-on-one, you can book a free 15-minute Discovery Call to explore how we might work together.
For a hands-on experience, check out Overwhelm to Ease: A Fresh Perspective Using CBT & Somatic Resources; my upcoming experiential online workshop on March 27th, where we’ll explore cognitive distortions and practice untwisting thoughts in community. (Visit my Workshop & Events Page for more ways to explore self-care together.)
You can also follow me on Instagram @mindbodyalignmentcounselling for more self-care and wellness techniques.
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