Resilience and chronic pain

When you start to work in the field of chronic pain management, it doesn’t take long before your view of the prevalence, and severity, of chronic pain becomes somewhat skewed.  Of all the people who have chronic pain, only a small number actually ask for treatment.  This could be for many reasons – difficulty accessing treatment because of cost or hours of opening, fear of what the problem may indicate, or because the person has ‘given up’ on successful treatment.

On the other hand, there are many people who have chronic pain and don’t ask for treatment – because they are successfully living their life as normally as anyone else.  Some people live extraordinary lives.  People like Fiona Crombie.  Fiona is a 24 year old athlete with arthritis.  She’s not simply an athlete – she’s a competitive Commonwealth Games athlete who found out three years ago that she had arthritis.  For Fiona’s full story, head here for inspiration.

I’m interested in studying people like Fiona – does she use different skills from the ones we help people to learn in pain management? Or does she simply have a different mindset? And how did she learn to do this, when so many of the people we see in treatment haven’t?

Appreciative inquiry is a process used in organisational development where what is working is examined and extended. Instead of focusing on what doesn’t work, it looks to develop a positive vision for what might be. ‘In its broadest focus, it involves systematic discovery of what gives “life” to a living system when it is most alive, most effective, and most constructively capable in economic, ecological, and human terms.’ (A Positive Revolution in Change: Appreciative Inquiry by David L. Cooperrider and Diana Whitney) Appreciative inquiry is another aspect of the field of positive psychology, again where the good and the positive is explored, rather than deficits and difficulties.

For some more helpful lectures on positive psychology, Tal Ben-Shahar takes a series of lectures you can view here.

I wonder what would happen to us as clinicians, if we could begin to study the strengths and resources our clients bring to treatment. If instead of reading article after article on ‘catastrophising’ and ‘fear avoidance’, we could read about ‘flexibility’ and ‘resourcefulness’. That’s why my PhD study is looking at people like Fiona Crombie and others who live a good, fulfilling and even excellent life despite having chronic pain.

This week I’m going to focus on positivity and resourcefulness. There isn’t a lot of information on this in chronic pain, but I hope to draw some links between what is known from the more general psychology literature and what we could try in our work. Want to join me in this journey?

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Oh, and did you see that I’ve been re-accredited by HON for 2009? It’s an international quality reviewer trying to maintain ethical standards for health information on the internet. It means my blog has been reviewed and I meet the standards required for ethical health information. Yay!



  1. Your blogs are amazing – Its so great to have you transmit your wealth of knowledge via the web. I am at the novice stage of my clinical development and really enjoy your posts and reflections. When you feel like no one is out there. I am. Reading and re reading – trying to increase my expertise…………much appreciated.

    1. Thanks so much Lia!! I do enjoy it too, it’s got to be good for my practice to ‘have’ to read the articles and think about them. If you have questions (especially clinical questions) you could use the ‘about’ page info to post them to me and I’ll try and write some ideas about them
      Good on you for working in this area, it’s such a great area to work in.

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