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What is Locus of Control and why does it matter for your chronic pain?

Updated: Jun 18, 2020

Locus of Control (LoC) refers to the amount of control a person believes they have over the outcomes of events in their lives. It was first introduced by Rotter (1954), although he described it as general and in internal terms only.

LoC is usually further broken down into internal/external LoC.

Internal LoC (I-LoC) refers to the belief that you have control and power over the outcome of events in your life. For example, if someone fails an exam and they have high I-LoC they may accept that they did not revise enough prior and therefore the failure is down to their actions (or lack thereof!).

External LoC (E-LoC) refers to the belief that you have no control over the outcome of events in your life. If we use the example above, rather than looking for behavioural reason behind failing the exam, the person is likely to believe they are not very intelligent and that nothing they could have done would have changed the outcome.

Research also breaks down E-LoC into two further groups: chance or the role of luck (C-LoC) and the action of powerful others (P-LoC).

People with chronic pain who have a higher I-LoC tend adjust better to their disorder, experience less pain, lower disability levels, better quality of life (QoL), have adaptive coping strategies and are more likely to return to work.

On the other hand, people who have a higher E-LoC tend to experience more pain, experience more disruption in their lives due to pain, decreased levels of activity and are more likely to abuse medication. If these people show higher levels of C-LoC they are also more likely to display maladaptive coping strategies such as catastrophizing.

How do I know whether my LoC is Internal or External?

If you would like to know whether your LoC is more external or internal, the quiz found at this link can give you a rough guide:

How can I change it?

Now probably the most important bit. How can I change my LoC from external to more internal?

Be aware of what you CAN control

Okay, so you may not be able to control your diagnosis. But you can control your reaction to it. You can feel sorry for yourself, stay in bed, offer excuses for why you can’t do X, Y or Z.

You’re in pain. I’m not taking that away from you. I’m not saying I don’t understand.

But you can choose to stay in bed all day or you can get up, have a shower, go for a walk etc. You can research what you can do to improve your pain. Are you eating healthily? Are you managing your stress levels? Are you as active as you can possibly be?

All of these things are in your control.

You can also identify goals and break them down into small steps. Setting and achieving goals also has the added benefit of increasing your self-esteem as you progress!

Monitor your language and self-talk

If you fail at something, is you’re first thought “I’m such an idiot!” or “If I had been better this never would have happened”? Practice compassion for yourself. We all make mistakes but its how we react and learn from these mistakes that matters. Instead of berating yourself for only managing a small walk, think to yourself that you made it out! Use it as a building block to see how you can improve from there.

We also briefly mentioned catastrophizing earlier in the article. Catastrophizing is when you view a situation as worse than it actually is. For example, thinking “This pain is terrible, I can’t cope” or “This pain will never get better”. When a catastrophizing thought arises, try challenging it. Instead of thinking “This pain will never get better” try thinking “I’m in pain today but the pain was less yesterday and so will probably be less tomorrow.” It can be helpful to keep a diary of your pain, just to reassure you that there are better times.

Seek Support

Life can be difficult. It can be challenging. And it can be disappointing.

Sometimes talking to friends and family can help you see things from a different perspective. They can give you new ideas. They can also help encourage your goals and celebrate with you when you achieve them!

If you suffer from a lot of negative thoughts, catastrophizing or anxiety or depression, you may also benefit from seeking help from a professional who can help you breakdown and work through these issues.

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