The Psychology of Chronic Pain

Do you struggle with pain that has lasted longer than three months? Maybe the pain started out as acute pain that you thought you would get over if you iced it and gave it rest, but here you are a year later… It’s frustrating, especially if you’ve tried multiple things with no answers and no relief. It can start to feel hopeless.

Let’s begin by talking about what chronic pain is. Obviously, you already know that chronic pain is pain that lasts longer than three months, but did you know that it involves more than just your biology? Pain is biopsychosocial – meaning that it involves biology, psychology, and social factors (Murphy, et al., n.d.). Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (ISAP, 1994). As you can see, pain has an emotional component to it which can increase or decrease the intensity of pain. It includes your thoughts, emotions, and where you direct your attention. What you think and feel affect your pain experience all the time. Stop and think about how you describe your pain. Is it only physical? Or is it emotional too? For example, “It’s this awful shooting pain!”

The worst thing you can do to humans is isolate them. As a part of the mammal species, we survive through social interaction. It’s just how we’ve been created. When you’re isolated, you tell your body that you are in danger; and anytime your body senses danger, your muscles tense and, if you have existing pain, your pain increases.

Things that people think of as negative emotions such as fear, anxiety, dread, and frustration can keep the pain cycle going. Although emotions are neither negative nor positive, different emotions tell us different things about what is happening inside of us. Therefore, it’s important to pay attention to what you feel in your body.

Even though you experience pain physically in your body, it’s created in the brain. You see, when you have a sensation in your body, that sensation sends a message to your brain. Your brain then tries to make its best guesstimate as to whether it needs to create pain to keep you safe. Think about touching a hot stove. The pain you feel tells you to not touch the hot stove so that you don’t hurt yourself. Pain is a way your brain tries to protect you.

When the body thinks you are in danger, it creates or worsens pain, and when the body senses safety, it either doesn’t create pain or it reduces pain. This means that pain can change!

As you work with your doctor and therapist, you can learn strategies that will help you to decrease your pain such as time-based pacing of activities and relaxation strategies that have been shown to work when you practice them regularly. Somatic tracking is another mindfulness exercise that can also have benefits when it comes to pain that has been sensitized which means your brain has become used to making pain, and therefore, it makes it more easily which decreases your activity and increases your stress. You might want to check out the book 8 Steps to Conquer Chronic Pain by Dr. Andrea Furlan. And always work with your doctor on what’s best for you in your situation.

Pain is no fun, and sometimes, there are no answers. But…there are some things you can do to keep you living the life you want to live even if it must be modified.

International Association for the Study of Pain. (1994). Part III: Pain terms: A current list with definitions and notes on usage. (pp209-214) Classification of Chronic Pain, Second Edition. IASP Task Force on Taxonomy Eds H. Merskey & N. Bogduk. IASP Press: Seattle.

Murphy, J.L., McKellar, J.D., Raffa, S.D., Clark, M.E., Kerns, R.D., & Karlin, B.E. Cognitive behavioral therapy for chronic pain among veterans: Therapist manual. Washington, DC: U.S. Department of Veterans Affairs.