Making an exception - one way to soften a rule

I’ve mentioned before that one of the main problems with helping people to develop new ways of managing their pain is internal rules - things that we all learned as kids probably! Things like ‘if a job is worth doing, it’s worth doing well’, ‘never leave a job unfinished’..
These are great general rules, but [...]

We’re not trained monkeys!

One time I was carrying out some work for a large organisation that wanted to train a lot of people to do some assessment work. It annoyed me for some reason, and I’ve finally hit on the problem (OK, several years too late, but never mind!). The problem was that instead of teaching principles, [...]

Checking thoughts during activity

Why would we want to work with thoughts?
It’s not always essential to directly address thoughts but many times thoughts become quite unhelpful and prevent the person from engaging in your therapy. It can prevent them from adopting new skills (eg using pacing or even maintaining activity despite pain), or mean that they ‘resist’ therapy [...]

Responding to real but unhelpful beliefs

One of my beefs about cognitive therapy has to be the concept of ‘maladaptive’ or ‘erroneous’ beliefs. For many people experiencing pain, their beliefs are based on experience since developing persistent pain - so we could readily be called out if we suggest that their belief that ‘I always get a flare-up when I [...]

Motivating people to make changes (iii)

The third of a series about using values and empathy to help people make choices
The previous two installments in this series have introduced the concepts of stages of readiness for change, rapport and empathy and appreciating that the people we work with have their own values influencing the choices they make. This paper introduces [...]

Motivating people to make changes (ii)

The second of a series about using values and empathy to help people make choices
The first installment in this series looked at why people might not be doing what we think they ‘should’ and how they might show this. This installment looks at developing rapport and reviews the essential interpersonal skills that are needed.
Rapport [...]

Changing the inner critic - positive statements

How often do we mutter to ourselves ‘ahh! you stupid xxx, that’s going to hurt’, or ‘I don’t want to do that, it’s never going to work’!
In pain management, challenging negative statements is a tool that is often used. This requires a good deal of work on the part of the person with pain [...]