Living with rheumatoid arthritis (RA) pain can feel like the glass is half empty. But negative thinking and expecting worse case scenarios can make your experience of pain worse. You may think, “My fingers are getting swollen. Soon they’ll make it too hard to prepare the meals I love. I should just give up cooking entirely!” This type of thinking is called catastrophising. The individual predicts and obsesses over a negative event or situation. Then, he or she decides that if it does happen, it will lead to the worst possible outcome.
Focusing on pain sensations, ruminating about your pain and feeling helpless make your pain worse, Sometimes pain can become all-consuming and can prevent you from doing the things you enjoy, so in effect you may start living a pain-centred life.
Catastrophising doesn’t just dampen your spirits, having these kinds of thoughts can increase your level of pain, However, if you can distract yourself, engage in relaxation exercises or take your mind off the pain, you can reduce the level of pain you experience.
Catastrophising is also associated with poorer outcomes, according to a 2017 study in Arthritis Care & Research that followed 209 patients with rheumatoid arthritis. The researchers found that people with higher levels of pain catastrophizing were less likely to achieve remission when compared with individuals who did not worry about their pain as much.
It’s also important not to blame yourself if you struggle with these emotions as it can be a natural reaction to your situation. What is important is that you recognise when you may be catastrophising and make efforts to stop this line of thinking for your health and wellbeing.
Sleep and pain are linked. If you get poor sleep you will probably have more pain; and if you are in pain, you are less likely to sleep well.
The combination of higher levels of catastrophising and poor sleep compounds the pain experience, Here are some tips for improving sleep.
Don’t let pain prevent you from doing the things you love. Talk to your doctor about which activities are safe for your arthritis and find creative ways to enjoy them. You may not be able to plant and tend a one-acre garden, but perhaps you can enjoy raised-bed gardening.
Mindfulness is a form of meditation that teaches you to be present in the moment and stop allowing your thoughts to wander. It helps you pay attention to your thoughts and feelings about pain without judging them or making them the only focus.
Start by sitting quietly for 10 minutes a day. Focus on the sensation of your breath. When your mind starts to wander to other thoughts, simply return your attention back to your breath. There are mindfulness apps that can help you make this part of your daily routine.
Pain or comfort; joy or despair. Try not to think in absolutes. All-or-nothing thinking makes pain catastrophising worse. It is understandable to feel down during difficult periods, but remind yourself to be resilient and focus on the good moments, too. Make a mental list of the activities you were able to enjoy or tasks you accomplished.
If you are struggling to keep negative thoughts at bay, get help. See your GP or rheumatologist and they can refer you to a psychologist to help you manage. Goal-oriented treatments, like cognitive behavioural therapy (CBT), can help you develop new coping skills and change patterns of behaviour that lead to negative feelings and thoughts.