Noticing your thoughts

The way you think about something is linked to the way you feel and act. Knowing what your thoughts are about your fatigue and chronic pain is a big step in helping you Be Pain Smart.

Although it seems unhelpful to notice your thoughts because it could remind you of your chronic pain and fatigue, being aware of what you are thinking can help you manage it. The way you feel and think is not caused by an event, situation or things other people do. Rather it is your beliefs and the way you think about these things that shapes the way you feel and act.

What you feel impacts on what you think, which changes what you do, and in turn guides how you feel. This can be either a helpful or unhelpful cycle.

There is an interactive relationship between what you think, what you do and how you feel..

It is hard to be aware of what your thoughts are because they are often quick and habitual. Your brain can tune out to them, but these thoughts can still guide a lot of your feelings and actions.

Over time, the events and experiences you have in life programs your brain to have certain beliefs about how you, other people and the world works. These beliefs or brain programs then frame the way you see your life.

Feelings and actions are often linked to common thoughts, for example:

  • when people feel depressed they commonly think their life is hopeless
  • when people are anxious, they commonly think that they are in danger or see situations as threats
  • when people are angry and yell or lash out at others, they commonly think that the situation is unfair and unjust.

You can change these brain programs by changing the way you think about what has happened.

Thoughts come and go over the course of a day, but certain ones come up a lot. These thoughts tend to be the same for people who have fatigue and in pain.

How can you start to be more aware of the thoughts you are having?

There are a few main ways:

1. Often your feelings can show you – remember key thoughts tend to go with the same feelings

ANXIETYanxiety You often feel nervous, your heart races or you feel shaky, or you feel worried or fearful all the time.

I worry that might pain will get worse and that things will be worse in the future.

You often feel angry, frustrated, or mad.

People are ALWAYS out to get me.

I SHOULD be able to go for a walk without getting more pain.

You often feel sad, down, or hopeless.

I will never be able to do what I used to do. There is no point in doing anything. I am a failure.

I am a failure.

You obsess over things you cannot change or feel overwhelmed a lot of the time.

Things would be better if I could take my back out and replace it with a healthy one.

I am not coping

You always feel tired, have little energy, or feel like everything will take too much effort.

It is too hard to go out. It will only make me more tired, which will make my pain worse.

It is not worth the effort and will make me. more tired.

Read the Noticing your thoughts guide to see the common thoughts that go with your feelings.

2. Often how you act can show you – remember key thoughts tend to go with the same actions




You often avoid or pull out of situations.

If I go out, I will embarrass myself.

If I go out, then it will not go well.

I will wake up tomorrow and my pain will be worse.

You often yell at others or storm away from others.

No-one ever understands what it is like for me.

The deserve what I said to them because they made me so mad.

You are staying home all the time, staying away from family and friends, or not getting things done.

Everyone would be better off without me.

Nothing good ever happens to me.

I am not good at anything.

I am a failure.

You often feel restless, cannot settle down or sit still.

Everything feels overwhelming.

I cannot cope with anything when I have pain.

It is all too much for me.

You do not go out much, and you rest most of the time.

It is not worth the effort - it will only make me more tired.

I will pay tomorrow or feel even more tired if I do something today.

Read the Noticing your thoughts guide to see the common thoughts that go with your actions.

3. Use a thought diary

This is a place where you can record what you thought, felt and how you acted during situations. This can help you to notice what your thoughts are and to learn how to separate them from your feelings and actions. When you can do this, it is then easier to change or challenge the way you think about what has happened, which can then help you to feel and act differently…but first you need to notice what those thoughts are … have a go at using the thought record in Noticing your thoughts guide to help you to start to notice your thoughts.

Pain and fatigue thought swaps

Swapping unhelpful thoughts for helpful ones can help you deal with fatigue and help you meet your goals. Remember your thoughts, feeling and actions are linked, so the way you think about your fatigue and pain is important.

Thoughts are often seen as positive or negative, but it is more useful to think about thoughts as helpful or unhelpful. Helpful thoughts allow you to deal with your problems better and to meet your goals. Unhelpful thoughts make you feel worse and can lead you further away from your goals.

Lots of people with chronic pain get tired easily and have fatigue, which can lead to them doing less over time and often makes pain worse. The fatigue can be because of pain, but it is also a common problem after a brain injury.

When you are tired or lack energy, your thoughts might focus on how hard it is to do anything, how much effort simple things can take, and that it is not worth doing anything. Sometimes it is hard to stop those unhelpful thoughts, it can be easier to swap these for more helpful thoughts. Read the Pain and fatigue thought swap guide and then use the Pain and fatigue thought swap worksheet to try swapping your unhelpful thoughts for more helpful ones and learn to Be Pain Smart.

Use the links below to download the files