ABSTRACT
This chapter helps to reduce some concerns by explicitly focusing on evidence for and against the patient's beliefs about chest pain. The aim is to enable the patient to think about chest pain in a way that is less negative and more realistic, helpful and supportive to pain management. The chapter shows how negative thoughts in non-cardiac chest pain (NCCP) are prevalent and are related to social factors, such as the prevalent sociocultural discourse about chest pain and the reactions of other people. Negative thoughts maintain the chest pain cycle because they can fuel anxiety, lead to unhelpful behavioural changes and even directly affect the perception of pain itself. Treatment should have provided plenty of evidence in support of the biopsychosocial model, which is more helpful than seeing chest pain as a cardiac issue, such as evidence provided from the initial assessment. Some patients do not report catastrophic beliefs, yet they remain distressed about chest pain.
