Pain is a universal aspect of human experience and, for many individuals, a frequent daily occurrence. According to the definition provided by the International Association for the Study of Pain (I.A.S.P.), “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (I.A.S.P., Subcommittee on Taxonomy, 1975). This definition highlights the psychological and emotional characteristics of pain. Often, the experience of pain is accompanied by feelings of fear and depression.

Pain is a conscious experience involving multiple systems designed to protect us from threat (the fight or flight response). People often express fear instead of pain. But how exactly does pain work… in the mind?

The human body possesses a complex sensory system that signals the brain about changes occurring within the body. The brain typically responds without conscious awareness. A part of this sensory system is the “danger alarm system,” a highly intelligent mechanism designed to alert the brain when we are in danger. It informs the brain about which area of the body is at risk, the intensity of the threat, and its nature. We should be truly grateful for the function of this system. One of the advantages of the human mind is its ability to anticipate the future. Using memory and reasoning, we can avoid danger before it occurs. Pain is thus perceived by the brain as a threat.

It is also important to consider the various models of pain and how they influence its management:

  • Biomedical model: Focuses on causal and pathophysiological explanations.

  • Psychogenic model: Views pain as a physical manifestation of psychological difficulties.

  • Biopsychosocial model: Integrates mechanical and physiological processes with psychological and social variables that can influence the pain experience.

These models—particularly the psychogenic and biopsychosocial—emphasize the link between pain and the “psyche,” showing how emotional and social factors (mood, beliefs about pain) can affect, aggravate, or even generate the pain experience, or hinder its management. By adopting a holistic approach to the physiological, emotional, and psychological fluctuations that pain causes, it can be more effectively managed.

Chronic pain, by definition, lasts more than six months and impacts a person’s ability to manage daily life. It often becomes a distressing experience marked by feelings of anxiety, fear, discomfort, and sadness. Medical and pharmaceutical treatment alone is frequently insufficient. The chronic pain patient faces critical challenges beyond the physical symptoms—negative beliefs about their condition (e.g., “I’ll never get better”) and thoughts (e.g., “I’m a burden to my family,” “I can’t function,” “I’m incapable now”) are common. These can lead to heightened anxiety or depression. This is precisely where counseling and psychological support become essential.

Acceptance of pain is often the first and most crucial step in its management. It is vital for individuals living with chronic pain to be educated about their condition. Negative emotions decrease the body’s natural opioids and increase sensitivity to pain. It is essential that individuals learn to listen to their bodies, interpret the signals they receive, and follow the rhythms their body dictates.

Through counseling, patients gain skills for self-management of chronic pain, stress reduction (e.g., relaxation techniques), and time management. They are empowered to address daily challenges that trigger stress and depression, regain a sense of control, and restore joy in life. It is essential that they continue to enjoy a functional daily life and attain a better quality of life—even if this newly defined life includes a new “companion”: pain.