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.08 THE CONQUISTADOR MINDSET: Cognitive Restructuring


(Identifying Perception Problems)

Hopefully you have been paying closer attention to your thoughts about the NPTE®.

Use the activity below to help you identify your perspective “viruses” for the NPTE®. This activity uses the same outline as presented by David Butler and Lorimer Moseley in their Explain Pain Handbook for patients with central sensitization.(1)

They discuss the evidence of danger versus safety in your body. They talk about having “danger in me” (i.e. “looking at an X-ray and hearing a severe diagnosis” or assuming that “pain is forever”). The “danger in me” (DIMs) thoughts enhance the patient’s pain problems and pain perceptions.

Then, they contrast this with “safety in me”, which are the things that help bring patients' perceptions back to a realistic (and truthful!) spot. Examples include “I have accurate and updated knowledge” and “I am getting help from a good health practitioner”. These are the things that give patients hope that they no longer have to be bound by their pain.

Click here to access the example DIMs and SIMs activity for patients with central sensitization. It’s helpful to visualize their DIMs and SIMs activity (scroll down to half the page), because you will write out your own thoughts that either intensify your test anxiety or shrink it.

Now it’s your turn.

Click here to access the "stress and confidence thoughts" activity to help you identify and document your perceptions about the NPTE®.

There are two columns. One column is for your stressful thoughts. The other is for your confident thoughts. Each time you have a thought about the NPTE® this week, mark it in the appropriate column. There is a middle column to provide ideas for you to record your thoughts.

For example, there is a “places you go” category. If you currently work at a therapy clinic, you may walk in each day with the fleeting thought “I wonder if I’ll ever work here as an actual PT or PTA”. Record that thought under the “stressful thoughts” column and note that it occurs as a result of places you go.


  1. Moseley GL, Butler DS. The Explain Pain Handbook Protectometer. Adelaide, Noigroup Publications. 2015.

  2. Therapist Aid. (2012). Cognitive Restructuring (Guide).


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