Chronic pain is both physical and psychological, so certain ways of thinking can make it worse, says Ingela Symreng, Psy.D., director of psychology for the department of anesthesiology and pain medicine at the University of California at Davis. “Fear, anxiety and depression around pain may cause more suffering than the actual physical pain condition,” she says. Chronic pain is like a broken alarm system, she explains, designed to trigger a “fight or flight” response. That works great if you touch something hot—it hurts, so you pull your hand away. With chronic pain, however, you can’t get rid of the discomfort, so you’re left with an intense, unrelenting focus on it and a surfeit of adrenalin, which causes anxiety. “You have to retrain your brain to react differently to these signals,” says Dr. Symreng. This is the crux of cognitive behavioral therapy, which can be highly effective in reducing pain, but you can learn these techniques on your own. Here are five common responses to pain that make it worse—and what you can do to change them.