The following information on one type of cognitive behavioral restructuring was adapted from the Addiction-Free Pain Management® Recovery Guide© and is used with permission—The TFUAR concept is part of the Gorski-CENAPS® Model. Below are some basic principles that can help you to better understand how the TFUAR (thinking, feelings, urges, actions, and reactions of and to others) process works. Understanding this process can help you to develop more effective chronic pain management. The premise is:

1. Thoughts cause Feelings. Whenever we think about something we automatically react by having a feeling or an emotion.
2. 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.
3. 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.
4. 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.

To learn more about effective chronic pain management check out my article The Right to Quality Chronic Pain Management that you can download for free on our Ariticles page.

If you would like to be skill trained in a treatment model that uses in part cognitive behavioral restructuring tools we have two Addiction-Free Pain Management®Trainings scheduled this Spring — one in Sacramento California in May and the one at Valley Forge Medical Center and Hospital in Noristown PA in June. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for either training. To get this discount you must call my partner Ellen at (916) 575-9961 and ask her for the discount. Also, for these and other upcoming trainings you can check out our Calendar page.