CBT for Pain - Module 6 Summary

CBT for Pain: Planning Enjoyable Activities

Pain affects you in many ways, including whether or not you can do activities you enjoy.

Remember: when you avoid these activities, it leads to physical deconditioning and negative thoughts and feelings. 

This module focuses on identifying and increasing activities you enjoy. We’ll also talk about barriers to these activities, and how to overcome them.

Have you stopped doing things you enjoy because of your pain? If so, what have you stopped doing? Think about work, your family, your daily activities, your mindset, etc.

The Chronic Pain Cycle

When your body becomes weaker (deconditioned), you may have more pain. You might also avoid more activities. The pain and decreased activity may also lead to negative thoughts and feelings. These can lead to avoidance behaviors. Together, this usually results in more stress and disability, and then more pain. You learned earlier that all of these combined form the Chronic Pain Cycle.

Physical Changes

When you are less active, you feel weak and tired, lose muscle strength, have worsened heart and lung function, and any activity at all generally feels harder.

For example, something as simple as standing up from a chair may feel hard due to decreased muscle strength. Or, you may feel winded on a short walk. Sometimes, you might feel too tired and weak to do anything at all.

Cognitive Changes

When you are less active, you’re more likely to have negative thoughts. 

To review: Negative thoughts and beliefs about pain can make it harder to cope with your pain. These thoughts and beliefs can trigger more pain and stress, which limits your ability to function.

Emotional Changes

When you’re less active, you’re likely to have negative thoughts and feelings. Avoiding activities due to your pain can deepen these thoughts and feelings.

What emotions do you feel when it comes to no longer doing the things you enjoy?

Benefits of Enjoyable Activities

Taking part in enjoyable activities improves your quality of life. This can include:

  • Higher self-esteem

  • Healthy distractions from your pain

  • More social time with others

  • Better concentration

  • A sense of purpose or direction

All of these benefits can create a more positive mood.

Enjoyable Activities Ideas

Take some time to think about your current activities, what activities you miss, as well as any you’d like to try. For inspiration, here are some ideas:

  1. Try going to a different grocery store 

  2. Do some gentle stretching 

  3. Call a family member 

  4. Plant some flowers 

  5. Take a friend to dinner 

  6. Study a new language

  7. Start or continue a hobby, like woodworking, painting, knitting, or playing music 

  8. Plan a weekend get-away 

  9. Get an adult coloring book, markers, and colored pencils 

  10. Upcycle something

Think about any activities you used to do, or any new ones you’d like to try. What activities would you like to do?

Fear of Activity

You might feel hesitant or afraid of being active again. It’s normal to feel this way when you have pain. If you’re not ready to start an activity that brings up these feelings, it’s okay to start smaller. Or, you can imagine yourself doing the activity through a guided imagery practice to expose yourself to those feelings.

Guided Imagery

A guided imagery meditation can help prepare you to be active again. It allows you to mentally experience the activity, and any emotions that may come with it.

Think about the steps of the activity. Imagine:

  • What you’ll see, hear, and smell at the location of the activity

  • The supplies or equipment that may be involved

  • The presence of others

  • The emotions you might feel

All of this “practice” can help increase positive thoughts and feelings and decrease negative ones. So - feel free to find a quiet, comfortable spot to sit or lie down and begin imagining!

Preparation

You looked at different options for enjoyable activities earlier in this module. Now, the goal is to make them part of your weekly schedule.

Tips

  • Remember that pacing involves balancing activity and rest - avoid doing too much at once.

  • Progress takes time - it might be hard at first, but keep going.

  • If you’re having a hard time getting started, use guided imagery meditation to visualize the experience.

Muscle Soreness

As you bring enjoyable activities back into your daily life, be mindful that muscle soreness may happen. Don’t worry - sore muscles are normal when you reintroduce your muscles to movement.

What to do for sore muscles

Before your activity:

  • Warm up (you could take a short walk)

  • Use your Goodpath supplements

  • Use your Goodpath topical pain relief

After your activity:

  • Cool down by continuing to move. For example, if you’re walking, slow your pace before you stop completely

  • Just like before, use Goodpath products for pain relief

  • Relax - do a quiet, gentle activity

Important Points

  • Be mindful and choose realistic activities that are within your ability level

  • Remember to pace yourself

  • If you feel like the activity you chose is not realistic, it’s okay to make changes

  • This is a time to learn about yourself, and activities and movement that work for you

Barriers

We talked about barriers to relaxation earlier. You might have similar barriers for enjoyable activities. Below are some common barriers to activities:

Barrier: The pain is too much. Alternative thought: With time, relaxation can help relieve my pain. Barrier: There are more important things to do. Alternative thought: Balance is important, and finding time for rest is part of that balance.

Think about the barriers you might face. Can you relate to any of these thoughts, feelings, or behaviors?

Your goal for this week is to do at least one enjoyable activity. It’s okay to start small - remember to pace yourself and to not overdo it.

If you need help with motivation or working through any barriers to relaxation, your coach can lend a hand. Let them know about your plans, and they'll help you come up with a plan.

Summary

  • Doing enjoyable activities has many benefits - all will help create a more positive mood

  • You can use meditation to visualize an enjoyable activity if you’re not ready to do it yet

  • As you introduce activities back into your daily life, muscle soreness is normal

  • When adding enjoyable activities: choose realistic ones, pace yourself; and make changes as needed

  • Think about ways to deal with your barriers to scheduling enjoyable activities