Can you think your way out of pain?

I get asked some version of this question pretty often, and I’ve been chewing over how to answer it without getting too lost in the weeds. 

The answer is: it depends on what you mean by thinking. 

If thinking involves curiosity, and self-reflection, and staying connected to embodied sensations, and a willingness to reckon with whatever emotional valence comes along with your pain, then yes–you can absolutely think your way out of pain. This is a great form of thinking!

But if thinking is just about telling yourself that your sensations and the feelings that come with them aren’t real, then no–I don’t think that’s a path for pain relief, at least not sustainably so.

The notion that you can just change your thinking and top-down your way out of physical discomfort is not a new one, but it’s getting dressed up lately in the garb of neuroscience and plasticity, and personal agency. I think that it can be a trap, because when it doesn’t work people assume the failing is theirs. I’ve seen the fallout in people who’ve been told by well-meaning clinicians and programs that they can fix their thinking and thus fix their pain.

That said, sometimes it really is that simple. I’ve seen it happen, I’ve helped people find their way to this kind of shift. There are instances in which a clear, pragmatic reappraisal of the risk associated with your pain is enough to make it go away. It’s awesome when that happens. For most of us, though, there isn’t a straightforward, cognitive fix for persistent pain.

If you have been trying to change your pain by changing your thinking and it hasn’t worked for you, that doesn’t mean there’s anything wrong with you, or that there isn’t hope for you to get out of pain. Everything works for someone, and nothing works for everyone. You don’t have to white-knuckle this alone.