How Neutralizing Self-Criticism Can Reduce Pain

I have identified as a perfectionist for years, believing that the self-critical voice in my head gave me some kind of an edge. Being a perfectionist is often rewarded in my work, and even in my hobbies. That kudos I get for a perfect seam in my sewing, or the way I exactingly capture an image in my drawing feeds something in me… and that something is not always healthy. 

Research published in Psychology & Health shows that people living with chronic pain score significantly higher on measures of perfectionism and self-criticism—while scoring markedly lower on self-compassion—than people living pain-free. When our internal monologue is relentlessly critical, the brain interprets those thoughts as a constant state of threat, and it dials up the central nervous system's pain signals. (1)

Are you a self-critical perfectionist? You can do well without tearing yourself apart. Learning to identify and reduce critical self talk can reduce your pain. Here’s a 4-step process for you to quiet that critical noise that leads to pain:

1. Catch yourself being self-critical in real time. Don’t let that negative comment or perfectionist in your head get away with slicing and dicing your performance. Name the thought as self-criticism. Just noticing and recognizing that you are being self-critical is half the battle. Negative thoughts often run on autopilot. Conscious awareness of these thoughts is a prerequisite for neutralizing them.(2, 3)

   
   

2. Consider the critical voice in your head and investigate its origin. Does it sound like your own voice, or remind you of someone who was critical in your past? Ask yourself if this is a trustworthy judge of who you are and what you do.  Were the high standards emphasized by adults in your youth delivered with kindness and encouragement, or were they harsh or even cruel? Too often those high standards morph into a fear of failure and disappointment instead of becoming an incentive to do well.  Consider whether you have work to do in processing trauma and/or negative influences. (4)

   
   

3. Put a stop to rumination on your missteps and mistakes. Recurring  negative thoughts can run on a loop in your brain, but they can be stopped without suppressing them.  

   1. First, label the thought you have caught looping in your mind. . “I am ruminating on how I messed up with my client.”

   2. Actively distract yourself with a specific task like reading aloud, naming objects in the room, or doing simple mathematic equations. The distraction cannot be passive, like just thinking about something else, you need to be actively doing a specific task.

   3. Set a specific time to address the concern you have been ruminating about. For example, plan to correct the error or connect with the individual you think may have been offended thirty minutes from now. Most of the time, you will realize that there isn’t an error needing correction. The scheduled window is simply a time to evaluate whether an action is truly warranted, or if the thought was just perfectionistic "noise" that can be dismissed. By setting this specific time in the future, you have created space for your mind to gain objectivity over your performance. If the thought recurs before the time you’ve established, just acknowledge it and remind yourself that you are committed to addressing it at the allotted time. Once the time to address the issue rolls around, the urgency and need to fix it may have resolved and you will not need to do anything. If there is something that needs to be repaired, do it quickly without analyzing or overthinking. Acknowledge what you want to correct and then move forward with peace and joy. (5)

      
      

4. Shift your attention to something else, your next task or even better, something fun, playful, or restorative. Intentionally shifting your attention and leaning in to something enjoyable helps to teach your brain to look for positive sensations, an important part of Pain Reprocessing Therapy called Positive Affect Induction. When you have lived with long term chronic pain, your brain has become focused on negative sensations. You want to shift that focus to positive sensations. Look for the luscious, delicious, delightful, and pleasurable. Cultivate humor, practice gratitude, and savor sweetness. This doesn’t mean you are oblivious to things that are hard or challenging, but it does mean choosing to dwell on the things that create joy and ease in your life in order to shift the fear, urgency and drive that feed chronic neuroplastic pain. (6, 7, 8)

Learning how to neutralize self-criticism and perfectionism is how you retrain your brain to move from threat to safety. This action, with practice, will turn down the volume on chronic pain.  

1. Ditchburn, G. J., Nicola, M., Correia, H., & Drummond, P. (2025).Perfectionism, self-compassion, and general self-efficacy between those with and without chronic pain. Psychology & Health.

2. Fresco, D. M., Moore, M. T., van Dulmen, M. H. M., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the Experiences Questionnaire: Validation of the Decentering construct. Cognitive Therapy and Research, 31(6), 779–788.

3. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford Press.

4. Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449–468.

5. Borkovec, T. D., Wilkinson, L., Folensbee, R., & Lerman, C. (1983).Stimulus control applications to the treatment of worry. Behaviour Research and Therapy, 21(3), 247–251.

6. Ashar, Y. K., Gordon, A., Schubiner, H., et al. (2022). Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry.  

7. Gordon, A., & Ziv, A. (2021). The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. New York: Avery.

8. Schubiner, H. (with Murphy, K.). (2026). Unlearn Your Pain: The Science of Recovering from Chronic Pain, Fatigue, Anxiety, and Depression. Penguin Life / Penguin Publishing Group.

Lisa Van Allen, PhD is a Pain Psychologist, a CRPS Survivor, and recovering perfectionist.