The Mind and Body Conversation in Pain

Dr Bronnie Lennox Thompson (clinician, researcher, and person living with Fibromyalgia) recently wrote a thoughtful piece titled Understanding Psychological Factors in Pain Management, which can be found here:

https://healthskills.wordpress.com/2026/02/02/understanding-psychological-factors-in-pain-management/

It resonated with me because it reflects what I see regularly in the clinic.

We know that pain is influenced by physical, psychological and social factors. Sometimes psychological factors can play a significant role in maintaining pain. That does not mean pain is “all in someone’s head.” It also does not mean there are no physical contributors.

Bronnie put it well:

“Pain isn’t psychological” highlights a persistent belief that if psychological factors contribute to pain (even cause pain), the pain is somehow less real.

It’s almost as if there’s a lingering stigma about ‘psychological’ illness. Like it’s not as valid as a broken bone or a cold.

I see this in the clinic. When I gently explore stress, mood or anxiety, people often become defensive. I’ll hear, “My pain isn’t all in my head”, “why are we talking about my mood and not my pain, my pain is my back, it has nothing to do with psychology”.

That reaction tells me something important. There is still a stigma attached to the idea that thoughts, emotions and stress might influence pain.

Pain by definition is an “unpleasant sensory and emotional experience”. And this makes sense, pain sucks, it can be excruciating, of course it is going to bring out thoughts, emotions, moods - it would be strange if it didn’t.

There are many campaigns, such as R U OK?, that have worked hard to de-stigmatise mental health. Most of us know people affected by mental health. But for some reason the stigma still exist in pain management.

If you are dealing with ongoing pain and you notice changes in your mood, your stress levels or your anxiety, that is not a character flaw, weakness, or failure. It is a normal human response.

Seeking support for that is not a weakness. It does not invalidate your pain. It simply means we are addressing all the factors involved.

Your pain may well be driven by ongoing physiological causes, however, addressing the emotional/psychological component can make your recovery more manageable and tolerable. And it leaves no stones unturned.

We also know that some people with persistent pain have made significant improvements, and in some cases even full recoveries, through interventions that address psychological and behavioural factors. That does not mean their pain was “psychological.” It means pain is influenced by many systems, and sometimes addressing one system creates change in another. If that approach could improve your current situation, would it not be worth exploring?

The mind and body are not separate systems. They constantly influence each other.

The more openly we talk about that, the better we can manage pain without shame or defensiveness.

Written by

Samuel Bulten

Exercise Physiologist | Masters in Medicine (Pain Management)

Director, Adapt Movement

Disclaimer

This information is for educational purposes only and is not a substitute for personal medical advice. These blogs are written by Sam Bulten and represent his opinions and insights and are based on his experience and interpretation of the research. As Sam is a human, these opinions and insights are not absolute truths.