Understanding that irrational thinking and the self-defeating behaviors that result can sabotage effective chronic pain management is crucial to improve the way people manage their pain. The following information was adapted from the Addiction-Free Pain Management® Recovery Guide© by Stephen F. Grinstead—the TFUAR (thinking, feelings, urges, actions, and reactions of and to others) concept listed below is part of the Gorski-CENAPS® Model.  Below are some basic principles that can help you to better understand how the TFUAR process works.  The main premise is:

Thoughts cause Feelings.  Whenever we think about something we automatically react by having a feeling or an emotion. 

Thoughts and Feelings work together to cause Urges.  Your way of thinking causes you to feel certain feelings.  These feelings, in turn, reinforce the way that you are thinking.  These thoughts and feelings work together to create an urge, or impulse, to do something.  An urge is a desire that may be rational or irrational.  Sometimes the irrational urge is to isolate and give into your depression.  At other times you might be tempted to use inappropriate pain medication, including alcohol or other drugs, even though you know that it will hurt you, which is also called craving.  Other times you want to use self-defeating behaviors that at some level you know will not be good for you and could worsen your depression. 

Urges plus decisions cause Actions.  A decision is a choice.  A choice is specific way of thinking that causes you to commit to one way of doing things while refusing to do anything else.  The space between the urge and the action is always filled with a decision.  This decision may be an automatic and unconscious choice that you have learned to make without having to think about it, or this decision can be based upon a conscious choice that result from carefully reflecting upon the situation and the options available for dealing with it.

Actions cause reactions from other people.  Your actions affect other people and cause them to react to you.  It is helpful to think about your behavior like invitations that you give to other people to treat you in certain ways.  Some behaviors invite people to be nice to you and to treat you with respect.  Other behaviors invite people to argue and fight with you or to put you down.  In every social situation you share a part of the responsibility for what happens because you are constantly inviting people to respond to you by the actions you take and how you react to what other people do.  Sometimes these reactions help you manage your pain more effectively, but at other times it leads to increased stress levels that cause you to making poor decisions.

The Four Steps of the Impulse Control Process 

Pause and notice the urge without doing anything about it;

Relax by taking a deep breath, slowly exhaling, and consciously imagining the stress draining from your body; 

Reflect upon what you are experiencing by asking yourself: “What do I have an urge to do?  What has happened when I have done similar things in the past?  What is likely to happen if I do that now?”; and then

Decide what you are going to do about the urge.  Make a conscious choice instead of acting out in an automatic an unconscious way.  When making the choice about what you are going to do remind yourself that you will be responsible for both the action that you choose to take and its consequences).

Remember:  Impulse control lives in the space between the urge and the action. 

Once people know more about this information it can help them be better able to manage their chronic pain condition. To learn about effectively managing the psychological components of chronic pain please read my article The Psychological Components of Pain that you can download for free on our Article page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people in chronic pain and want to learn how to develop a plan for managing their pain and coexisting psychological disorders including depression or addiction effectively please go to our Publications page and check out my book the Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To listen to a recent radio interview I did conducted by Mary Woods for her program One Hour at a Time please Click Here to go to this interview.

To read the November issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.