Arthritis itself can be very stressful and demanding on your body. The source of the stress may be pain that no one but you can understand, or it may be having enough energy to get through one day and being totally exhausted and having to stay in bed the next day. Or looking good and feeling like shit or people looking at your rash or that crooked finger, or maybe even the fact that you know you have to depend on others in ways that make you uncomfortable. Perhaps the source of the stress is that you can no longer do the things that define who you are and who you want to be, as well as not being able to do the things that you used to do.

There are distressing thoughts that can arise due to how you perceive, define, and interpret arthritis-related symptoms: “No one cares about my pain. In fact, no one loves me anymore.” “I’m so tired, I’ll never get out of this bed.” And then there’s this one, my favorite, “People should know I don’t feel good, even if I look good.” These types of thoughts or self-talk are called “internal talk” and the types of thoughts listed above are known as negative self-talk. Therapists, called cognitive therapists, who specialize in helping people identify their self-talk and understand the impact, both negative and positive, it can have on their health and well-being. They also help you change that self-talk when doing so would be helpful to you. In many cases, you can work through these important changes on your own and help yourself better cope with all the stress that this disease called Arthritis will bring.

One of the first steps you can take is to recognize negative self-talk and identify the thought patterns behind it. Once you’ve identified the patterns behind this negative self-talk, you can take a look at some practical ways to identify your own patterns, making sure to consider the benefits and risks of making changes, as well as the commitment staff required to be successful.

Psychologist Albert Ellis wrote a book called A new guide to rational living, where he describes the “A, B, C” of thought. Where A is the actual event or situation that takes place, B is our subjective thought or belief about A, and C is the consequence. Ellis argues that C, the consequence, is a result of B, not A. Let’s take the scenario I’m about to give you as an example of what Ellis is talking about.

A: The situation. Both Jack and Joan work full time. Joan usually cooks a full meal for dinner. She looks better than she feels. For several days now she has been quite tired and has noticed more pain in her joints. Jack doesn’t notice anything wrong with Joan and she really doesn’t want to upset him. She has a doctor’s appointment in a week and Jake keeps hoping that she will have her meals prepared and on the table.

B: Joan’s thoughts. Why can’t “Jack get it”? “Can’t you see I’m not feeling well? Why should I ask? Again, maybe he wants and deserves someone who can do more for him and make his life easier. Maybe not. I don’t care so much anymore. Maybe I should let him know how I feel, but he won’t believe me or refuse to help me. So what will I do?

Now we are going to change the internal dialogue, B, and then we will see a different set of consequences, C.

B: Joan’s new thoughts. It is very difficult for my husband to realize how bad I feel because I do a good job of minimizing it. I really don’t worry about it. Right now, he’s so preoccupied with some job changes that they’re stressful, and I’m not going to bother him with my pain and exhaustion. However, if I want to keep functioning at work and at home, this would be the right time. Maybe I should take a chance.

C: The consequence. Joan tells Jack that she’s been experiencing an increase in joint pain lately and that she’s been feeling really exhausted. She suggests that maybe he prepare the food or maybe they can order. Jack’s first reaction was to be angry at the impact of Joan’s arthritis and angry at himself for not realizing what was happening to her. This actually helps Joan and Jack talk about Joan’s arthritis in a whole new light. Jack is very pleased to learn that Joan has an appointment with the rheumatologist. Joan decides that it is time to ask Jack to come with her so that she can better understand and learn more about what she has been going through on a daily basis. Jack says yes.

Self-talk that has negative consequences has also been called “dysfunctional thinking,” “cognitive distortions,” or “automatic thinking.” Psychiatrist David Buns, in his book, Feeling Good: The New Mood Therapy simplified these and other ideas behind cognitive therapy, making them easier to understand for those without a degree in the medical field.

Burns describes 10 common patterns of automatic thinking or cognitive distortions. These are common, everyday ways of responding to situations we all get into from time to time. The onset of arthritis and the ongoing challenges it brings make it easier than ever to respond to these situations. Below you will find summaries of the 10 common Burns patterns:

o All or nothing thinking. You see things only in black and white.
o Excessive generalization. From one negative thing you establish a whole pattern.
or mental filter. You focus on everything in a negative light.
o Disqualification of the positive. You ignore the positive experience.
o Jump to conclusions. Without all the facts, a negative interpretation is formed. This will include “mind reading” (making assumptions about why others act as they do) and “divination” (predicting a negative outcome).
o Magnification (also known as catastrophizing) or minimization. You tend to magnify the negative.
or emotional reasoning. You assume that your emotions reflect reality.
o “Should” statements. He is driven by “shoulds”, “shoulds” and “shoulds”, which makes him feel guilty when he does not act on them.
o Labeling and mislabeling. An extreme form of overgeneralization, in which you use highly emotionally charged language.
or Personalization. You feel that you are the cause of an external event over which you actually had little or no control.

You can see how many of these thought patterns are present and how negative conclusions were drawn by looking at the original scenario A, B, C. As you can see, Joan’s feeling that her husband no longer loves is an example of emotional magnification and reasoning. and also generalization.

The second challenge is to recognize the patterns in your own life. You most likely have a good idea of ​​the types of automatic thoughts you have, but being able to compare those thoughts to your experiences is another important step. You can keep a journal or take a small notebook with you to write down any feelings you have when you are uncomfortable with an arthritis-related situation, then you can jot down a few words about the situation or the thought you had. , and which of the 10 cognitive distortions (or perhaps several of them) represents this thought. This will help you become more familiar with your own thought patterns, and you can then extend this exercise to focus on personal change. In your journal or notebook, add a column that describes what you did as a result of your original thought. Next, add a column for a most likely explanation of the situation (replace your cognitive distortion with a rational reappraisal), and then describe how you feel now and how you could have acted differently.

This is an example of rational reassessment: When your arthritis is severe enough to affect your ability to function at work on a particular day, your first thought is a dysfunctional thought, such as “I’m not good at my job.” This is what is called all-or-nothing thinking, magnification, and jumping to conclusions. The most realistic response would be to tell yourself that he’s just having a bad day at work because of his arthritis and then go home early to get some rest that he probably needs to be rested for the next day. He can make sure that he is generally well respected for the work that he does and that this does not happen every day. His boss knows about his arthritis and has told him that even though he may have to take extra time from time to time, you are one of the most productive employees he has. By reevaluating his thoughts, he feels less anxious and more empowered.

These exercises may feel like you’re practicing a formula, but it’s a strategy that works because it allows you to become aware of the ideas and feelings that will guide your actions and gives you options for actions you didn’t know you had.

Here is a list of things to keep in mind as you work to maintain the change process:

o When you’ve kept a journal for a week or two, it will help you focus on your efforts to change one thought pattern at a time. This way you will feel less overwhelmed.

o When you find that you are constantly having difficulty changing your thoughts, you might consider why you are holding on to your current way of thinking. Are there certain thought patterns that are serving you in some way? What are the advantages of always feeling like you must do something or the fear that something worse might happen if you change a particular recurring thought? Find out what this meant to you in relation to how you are dealing with arthritis.

o When you begin to change your actions, there may be others who respond to you differently. You may think your changes are positive; there will be others who benefited from your negative self-talk. It is important that you communicate to others that you are taking the necessary steps to change the way you think and behave in certain situations. Let them know that you expect everyone involved to benefit in the long run from their commitment to change and personal growth. There will be instances where there will be conflict and you need to be prepared for that.

o If you start to think that your thoughts are getting in the way, to the point that these types of exercises alone aren’t giving you the relief you need, you may want to consider seeking understanding or advice from someone you can trust. It could be a friend, family member, your doctor, or a spiritual advisor. If this type of reality check doesn’t help, you may want to consider seeing a psychotherapist. Your doctor or local mental health association can be a helpful source for a referral. A professional specifically trained in cognitive therapy or cognitive behavioral therapy (CBT) may be another source to help you with this process. There is some evidence that the types of negative self-talk discussed in this article are related to poor medical outcomes in arthritis and that individualized therapy such as CBT is helpful in reducing fatigue and depression. If you think this type of therapy would be helpful for you and would like to connect with trained CBT therapists in your area, contact the Association for the Advancement of Behavioral Therapy (AABT). The AABT does not certify or recommend therapists, but does maintain a large database of therapists.

Being able to understand and use your self-talk can be a helpful tool in coping with arthritis. Recognizing, understanding, and using your thoughts to help you understand your feelings and guide your actions related to arthritis can enable you to deal with the many different situations as they occur, but it can also help you throughout your life in the long run.