Automatic Thought Example for Chronic Disease and Chronic Pain

Living with a chronic disease means constantly managing recurring symptoms and adapting to a new, often unwelcome, reality. This requires not just physical, but also psychological and emotional adjustment. In fact, coping with this new condition often becomes even more important than coping with the physical symptoms themselves.

Research shows that automatic thoughts accompanying chronic symptoms play a significant role in shaping how people experience the pain. Thoughts like “This will never go away” or “This pain/illness controls my life” can make the struggle feel even more overwhelming. That’s why recognizing these thoughts and replacing them with more realistic and functional alternatives can make a big difference in managing chronic pain and illness.

In this article, we’ll explore how someone can work through an automatic thought related to chronic pain using cognitive behavioral therapy (CBT) techniques.

Examining the Thought: “I can’t do the things I want to do because of my pain.”

Is This Thought True?

Evidence Supporting This Thought:

• I can’t go on long walks.
• I can’t sit at my desk and work for extended periods.
• I often have to decline invitations.
• I’m unable to do physically demanding tasks.

Evidence Against This Thought:

• I can walk for short periods if I take frequent breaks.
• I can work for very short durations.
• I can handle daily tasks that don’t require intense physical effort, like personal care and cooking.
• I can maintain my mental productivity.

What’s a More Realistic Perspective?

I can do some of the things I want, while others aren’t as easy as they used to be. I try to find alternative ways to do them.

Worst-Case vs. Best-Case Scenario

Worst-case scenario:

My pain never goes away, and I’m unable to do anything I want.

Best-case scenario:

I have no pain at all and can do whatever I want, whenever I want.

The truth is that real life lies somewhere in between. Some days I can do the things I want to do, some days I can’t.

Does This Thought Contain Cognitive Distortions?

🕵️‍♀️Magnification/Minimization: Focusing too much on what I can’t do while dismissing what I can.
⚫ All-or-Nothing Thinking: “If I can’t do something perfectly, I can’t do it at all.”

🔍Selective Attention/Filtering: Paying attention only to my limitations and ignoring my abilities.
🌧️Emotional Reasoning: Assuming that because I feel helpless, I must be helpless.

What Values or Needs Does This Thought Reflect?

• I want to accomplish things.
• I want to work without limitations and perform tasks as I used to.

How Does This Thought Serve Me? I can’t do the things… 

It might help me protect myself when my symptoms worsen.

However, when I fully believe it, I feel frustrated, powerless, and even anxious. I end up avoiding activities altogether, which only pushes me further from what I want, which is actually not helping me.

How Can I Support Myself?

🤍 Self-Compassion

“This isn’t easy.”

🔎 A More Realistic Perspective

• “What I want to do and what I’m capable of doing may not always align.”
• “With pain, I may not be able to do everything exactly as I used to.”
• “Accepting this is difficult.”
• “This is different. I need time to adjust.”

Is There Anything Positive in This Situation?

• I have motivation to do and achieve things. 
• I listen to myself and notice when I need to make changes.

What If I Used My Motivation to Adapt to This Challenging Situation?

• Instead of focusing on what I can’t do, what if I focused on what I can do?
• How could I find ways to do things within my current limitations?
• Could I break tasks into very small steps, do them for short periods, or find alternative ways to do them?
• What if, instead of trying to complete a task perfectly, I focused on just one small part of it?
• What if I acknowledged my small achievements and reminded myself that I’m still moving forward, even if it’s slow?
• How would it feel to know that I’m here to support myself through this process?

Just thinking about this already makes me feel less helpless and more in control.

So, can I give it a try?

The automatic thought explored here was chosen because it is a common one. If you’d like to share a thought or underlying belief that you want to work on, feel free to reach out through the contact page or the comments section below.

See you in the next article.

Best,
Ayşegül

🔗 Here are some more related topics:

How to Challenge Automatic Thoughts in CBT

How to Challenge Maladaptive Assumptions in CBT