Ten Ways Compassion Focused Approaches Can Help With Chronic Pain

Dr Rebecca Chasey
Clinical Psychologist
Sustain Psychology

Are you battling chronic pain? Maybe you notice tension through your body, feeling on edge, as if pitted against an unseen enemy. Perhaps your mood has grown volatile, causing you to lash out and self-criticize, grieving the life that was, and wrestling with guilt and frustration. While you try to press on despite it all, this only aggravates the situation. It’s no surprise you feel exhausted. Perhaps you’ve tried self-management approaches to managing pain such as pacing and goal setting, but find these only become a further battlefield…

compassion focused therapy for pain


Does this sound familiar? If so, you’re not alone. In fact, chronic pain affects one in five people in the UK, with many also struggling with anxiety and mood problems.

Chronic pain can feel overwhelming, but thankfully, there is hope for respite: If you are one of the many who strive to overcome your pain, combining self-compassion with proven pain management techniques may help you regain balance in mind and body.

Can Harshly Pushing Yourself On Make Things Worse?

compassion for pain

Surely pushing yourself on must be a good thing – right? Unfortunately, while there might be times when it makes sense, doing this out of habit can unintentionally worsen pain. While some people with pain find themselves fearful and avoidant of doing things that might cause pain, researchers have found that another group of people are instead prone to repeatedly ‘overdoing it’, finding themselves in a ‘boom-bust’ pattern of behaviour. 

This group of people, whom Dr Malpus, Dr Armitage and colleagues have termed ‘strivers’, may press on to meet the demands they set for themselves, becoming self-critical or comparing themselves negatively with others. Feeling guilty about letting others down, struggling to set healthy boundaries or feeling bad about prioritising your needs can all make a difficult experience worse. If you’re one of the many who grapple with an inner critic, putting you down and chiding yourself on, you know all too well how this may add to your trials. It can feel hard to change and knowing that you are your own worst enemy may only add to self-blame. This is where learning self-compassionate approaches could be a game changer…


Can Compassion Focused Approaches Help People in Chronic Pain

Research shows that Compassion Focused Therapy (CFT) and Compassionate Mind Training (CMT), grounded in the pioneering work of Professor Paul Gilbert, could bring invaluable approaches to lessen the suffering of persistent pain. Like a secret sauce, when blended into other pain management techniques, CFT approaches have been shown to improve self-compassion, anxiety, and mood, bring greater self-kindness, reduced pain, plus an ability to engage in valued activities in a more sustainable way.   

Understanding Chronic Pain

One of the challenges in understanding chronic pain, is that many have felt disbelieved when they talk about pain, feeling they are being told their pain is ‘all in the mind’.  So, before I go on, let me say – I believe you – and I know your pain is very real, but it’s complicated too…

To understand how compassion might help, we need to understand that pain is a warning signal, an alarm system crafted through evolution to signal threat of harm and to safeguard us from danger.  Modern science tells us that the experience of pain is a complex process. Chronic (or’ persistent’) pain, which goes on for more than three months, is now thought to set in as our nervous system becomes more perceptive to signs of peril and goes into protective overdrive. It’s a bit like having an alarm that has got stuck in ‘on’ mode. It’s been shown that learning about pain can make it easier to manage and can even reduce its intensity.

How Pain & Emotions Are Linked

The tricky thing is that pain, and emotions are inextricably linked. Chemical and hormonal changes in the body when we are distressed serve to amplify pain. Maybe you’ve noticed that pain is worst when you feel stressed, anxious, frustrated, or low? Of course, there are many ways that being in pain also leads to these difficult emotions: It’s no wonder that it can feel like a vicious cycle.

Compassion Soothes Our Pain

We only have to think of a child who has cut their knee being comforted by a kindly adult, or a woman in labour having her hand held by a loving partner, to know that compassion helps to soothe short term, or ‘acute’ pain. 

When we receive the compassion of someone else it helps to ‘dial down’ our pain, by reducing distress and helping the nervous system understand that the threat is lessened. Learning to be compassionate towards ourselves can similarly help.

compassion focused therapy for cancer

How CFT Helps Us Understand How Life With Chronic Pain Gets Us Stuck in Unhelpful Patterns

Many of my clients have told me how helpful they have found the CFT approach in helping them to making sense of their emotions and habits. Professor Gilbert’s model explains that we have three systems of emotions:

  1. One of these is focused on responding to threats with responses geared to protect us and get us out of danger. So, what happens to this ‘THREAT SYSTEM’ when you’re in pain? – With its bias to detecting all things potentially harmful it gets hugely amped up…. the threat of not achieving, of losing relationships, income, status, identity…for example. Sometimes this in turn activates the second system…
  2. the DRIVE system: While this system is usually one that’s about achieving things (with all the feel-good emotions and dopamine rushes that go with this), powered by feelings of anxiety, frustration or anger, it can lead to you strive onward, to pull on everything you have to avoid the losses & feelings of failure that pain can bring. Going full throttle to get away from the difficult stuff in life is just something your system is hardwired to do as it tries to protect you. It might be that criticising yourself becomes part of your way of trying to avoid harm too, urging you ever onward. The trouble is that our brains read this inner urging as another threat, amping up the pain and the striving even more until we are exhausted and depleted.
  3. The third system of emotions is the SOOTHING/CONNECTION system, concerned with rest, recouperation, feelings of safeness and connection. While this usually calms down the threat system, if you’re living with pain, this may well be diminished.

Remember, none of this is your fault, it’s just how we are wired. What’s more, insight about what is happening makes it possible to start to change things for the better…

10 Ways Compassion Focused Therapy for Pain Can Help When You Are Struggling with Chronic Pain

  1. CFT encourages you to let go of self-blame – nobody chooses to have these complex brains, bodies and nervous systems that get in such a tangle of pain and distress – it’s simply how we are ‘designed’.
  2. Understanding the science of pain can really help and may even reduce pain, allowing you to be alongside what is happening with more acceptance, saying, ‘we got this’.
  3. By learning to cultivate a compassionate inner dialogue and ‘compassionate self’, you may learn to respond to your experience with kindness instead of self-reproach. Speaking to yourself with a supportive attitude, embracing qualities of understanding, acceptance, strength and caring can help in learning to manage that critical voice.
  4. Think of this like developing a coach who really wants the best for you. They’ll encourage you on when you need it and help you to rein in if required.
  5. Making sense of what’s happening in your 3 emotional systems, helps to make sense of how our threat system can fuel patterns of striving. With this insight you can build greater self-awareness and self-control and make wiser decisions about how to approach things.
  6. Gaining mastery over your threat system is possible with practice. Start by trying out calming techniques such as soothing rhythmic breathing exercises– to help restore balance in your nervous system. With practice, you’ll more easily slip into a peaceful mindset.
  7. You can also tone down your threat system in other ways–remembering a time you received compassion, linking in with friendly others, pets, and the natural world may also lend a deep sense of calm stability.
  8. Just knowing you are not alone with what you are going through and linking in with other people with similar struggles can really help.
  9. Learning compassionate approaches may help you feel less embattled with your body and pain as you find a new, less distressing way of being alongside these.
  10. With compassion on your side, you’ll be better placed to use other pain management strategies: Approaching exercise and activity from a place of collected calm, rather than forcing yourself through, may help you move towards the pursuits that matter to you.

It takes huge courage, strength, and resilience to face each day alongside chronic pain. Bringing compassion to this challenge can unlock a path to less suffering along the way.

Rebecca offers CFT approaches to managing chronic pain and long-term conditions through her practice Sustain Psychology

If you’re interested to learn more about what compassion is, some of the difficulties that come with it, and how to practice becoming more compassionate with yourself and others, subscribe to our mailing list where you’ll get updates on our latest blogs.

You can also develop your compassionate mind through our self-help booksaudioscourses and self-compassion app

And if you’d like to work with one of our experienced CFT therapists, you can find more info here