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 to identify their statements, work out what is unhelpful about them, then replace the statements with new ones. For busy occupational therapists, physiotherapists and others for whom cognitive therapy is an adjunct to their core work of doing, this process can change the focus of therapy away from doing to thinking about doing.
An alternative and pragmatic strategy is to help the person use a positive statement just prior to attempting a difficult task without working with the underlying beliefs that form the automatic thought. Although this doesn’t directly generate reconceptualisation, from a behavioural point of view it provides an interruption to negative automatic thoughts, replaces it with a more positive one, and pairs this more positive statement with an attempt at mastery, thus reducing anxiety. This strategy builds on the idea that brains cannot attend to much more than one thing at a time, and the deliberate use of a positive statement means the brain is attending to the statement more than the associated anxiety.
Practically what do you do?
Ask the person to identify a statement they might use to encourage a child – something like ‘give it a go’, ‘you can do it’, ‘keep going’, ‘it’ll be OK’. You can pair this statement with a relaxing out breath to give it further ooomph!
Then ask the person to attempt the activity they are bothered about, but just before doing so, say the positive coping statement to themselves. After the activity, they can say something like ‘Yay! I gave it a go!’ or ‘well done’ irrespective of the success or failure of the attempt.
To introduce this to the person who may not be convinced of the usefulness of this kind of statement, ask them what they think competitive swimmers say when they are lined up just before a race. Do they look at the competition and say ‘ohhh! they’re big, they’re fast, that water’s going to be cold, don’t know if I can make it’, or do they say ‘I’m going in to win! Let’s get going’.
Try it for yourself – especially if there’s a job you’re putting off!
Date last modified: 1 March 2008