Do you have Repetitive Thought Injuries (RTIs)?

Dr. Andrea Grayson
7 min readJan 16, 2023


What Are Repetitive Thought Injuries and How to Start Unraveling Them

A woman holds her head in her hands with a distressed look on her face.

“Everything matters,” I pronounced the other day, as my partner and I were getting ready for bed. “Yes it does,” he replied, and added: “What is the context you are considering?” In this particular case, I was reflecting on some new soreness in my left knee, and I hadn’t been able to figure out what was causing it. Turns out that I have had a habit that I thought nothing of: getting onto the bed with my left knee up on the mattress, half crawling, before turning myself around to face outwards. It dawned on me that evening that maybe this seemingly benign movement, repeated daily over years, was the source of soreness in my knee.

“Well, two things,” I replied. “The first is that small, relatively innocuous movements that are repeated over time can end up having an impact.” He agreed. “I know what you mean. The monitor at my desk has been a bit off and I’ve had to shift my torso maybe an inch. Now I’m feeling tightness.” Other common examples include carpal tunnel syndrome and tennis elbow.

“That’s exactly what I’m talking about,” I affirmed. “The small motions we don’t notice that end up impacting our posture or performance. It all matters. But,” I continued, “what about those small, seemingly innocuous thoughts we repeat over and over. The ones we entertain every day but don’t notice. They must be shaping and impacting our psychological posture and performance as well.”

Borrowing from the definition of a Repetitive Strain Injury (RSI), a Repetitive Thought Injury (RTI) is a gradual buildup of restriction or damage to the free-flowing creative process of self from repetitive thoughts. Seemingly innocuous, coming from the familiar voice in our heads, the casually repeated negative thoughts and self-limiting beliefs can reduce our mental and emotional flexibility or result in chronic mental or emotional pain over time. Negative or restrictive thoughts create restrictions on what is possible.

The first few times we have such thoughts, it could have been a shortcut way of thinking about something, a simplification that removed a lot of nuance and became a judgement, like That’s ugly, or I’d never do that.

Sometimes RTI’s start as random and automatic thoughts that we don’t even think but just appear. They become RTI’s then we pull them out of the river of thoughts and give them some energy. Then later we remember that thought and think it again. Pretty soon, the thought is familiar enough to be deemed the truth. Then, with truth in hand, we perceive all the evidence of the physical senses through the lens of that thought-belief, both confirming the belief and the physical reality. And yet all the while it is just a thought.

Still another way that RTI’s can start is by carrying over a thought-reaction, say to a person or situation, from a previous experience rather than re-experiencing it anew. For example, I don’t shop in big box stores very much, but find myself doing so on occasion. The first few times I went to Walmart I was pretty overwhelmed. The next time I needed to go to Walmart, I automatically remembered the feeling of being overwhelmed, and started getting into that state again. The thought-reaction automatically went on repeat (until I saw what was happening). We often carry-over thought-feelings about family members, parts of the country, people of other political persuasions, etc. In this way our activated memories keep us from truly being in the present and experiencing something anew.

All of this is largely because the brain loves a habit — it doesn’t care if it’s a good habit or a bad habit, it just loves a habit.

The brain loves habits because every thought, decision and action in our day requires brain energy to process it. In fact, the brain consumes about 20 percent of the body’s energy.[1] By automating responses or going on automatic pilot, the brain is actually conserving energy.

But some of those thought habits, many of which we have cultivated over decades, have shaped us — or even injured us — in ways that are hard to see. It may take a (negative) outward event or result for us to even notice that we have been thinking in a detrimental way.

As another physical example, let’s use brushing one’s teeth. We brush the way we’ve always brushed. For decades. But then one day the dental hygienist says your gums are receding, and it turns out that you’ve been brushing too hard the whole time. The changes to your gums were so gradual, that you didn’t even notice, then Bam!, you’re dealing with a condition.

Repetitive thoughts are hard to notice because they are so familiar, but for sure we are having them. In fact, everything in our lives is a result of our thoughts and beliefs, whether we created them ourselves or inherited them from our families or culture.

The easiest way to discover the thoughts that are creating your reality is to look at everything in your life — physical, emotional, interpersonal, cultural — and ask yourself, “What thought makes this thing possible?”

Just as a physical therapist might examine our shoes or watch how we walk up and down stairs to determine the cause of a repetitive strain in a knee — or in my case, how I get into bed — we need to retrace and examine the thoughts that create our manifested world in order to uncover the RTI’s that created it.

This is no easy task, mind you. Beliefs are hard to see because we take them as the truth and so they go unexamined. I crawled onto the bed a hundred times before my knee started talking back. It took a physical pain to make me realize that maybe I was doing something that was hurting me. I was oblivious until the pain manifested.

Our pains — emotional and physical — are clues to uncovering the limiting thoughts and actions that created them.

Here’s a journaling exercise to help you start becoming more sensitive to the thoughts, beliefs and actions that are creating your manifested reality.

  1. Make a list of 3 things in your life that you enjoy.
  2. Next write down at least one thought-belief you have that makes each of those things possible.
  3. Then, make a list of 3 things in your life that you are not enjoying right now.
  4. Write down at least one thought-belief you have that makes each of those things possible.

For example, one thing in my life that I enjoy is walking outside. A thought-belief behind that enjoyment is that nature is healing; having that belief enhances my experience of being outside, and motivates me to go out there.

For an opposite example, one thing in my life that I’m not enjoying very much is being active on social media (but it is important for engaging people and supporting business exposure). A thought-belief that is hindering me on social media is that I’m an introvert, and it takes a lot of energy and time to keep up the momentum of posting. Okay, that might be true, but if I want a different outcome, say, thousands of engaged followers, I had better start believing something else more conducive to that actually happening.

In both cases, if the experience of enjoyment or non-enjoyment is precipitated by a thought-belief, changing the thought-belief will result in a different experience.

The belief that it takes a lot of energy and time to have a presence on social media is just that — a belief, a thought taken as truth. That belief causes me to feel a certain way (a heaviness or burden), which leads me to act a certain way (putting off posting).

If I want to enjoy social posting, I’ll need to believe something else. Let’s work backwards. Since actions come from feelings, how do I want to feel doing regular social posting? I want to feel generous, in-the-flow, and useful to my followers. Now, what thought-beliefs could lead to those actions? How about:

Social posting is creative and fun. Social posting is a way to connect with people. Social posting is a way to inspire change.

If I repeat those thought-beliefs more than the self-limiting ones, social posting will be oh-so much more enjoyable and frequent. Instead of Repetitive Thought Injuries, I’ll have Repetitive Thought Victories!

Take a good look at the unwanted results you are having, or the pain-points in your life, and try to isolate the thought-beliefs that are creating them. How long have you had those thoughts? Do you have to believe them? What other thoughts could be possible? If you had other thought-beliefs, what might be other outcomes?

Let me know if you uncover any self-limiting beliefs through this exercise.

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Dr. Andrea Grayson is a student and teacher of behavior change, and founder of Create Change Lab, LLC, a place to experiment with change.


Originally published at on May 26, 2023.



Dr. Andrea Grayson

Andrea is a Communications Consultant and Professor in the MPH program at UVM. She is creator of More info at: