Dr. Rosemary Fish and her associates state that chronic pain acceptance “involves experiencing ongoing pain without attempts to avoid, reduce or otherwise control it … and engaging in everyday activities of value to the individual in the presence of pain, and disengaging from the struggle to limit contact with pain.”Acceptance is generally described as having two parts: pain willingness and activity engagement.



Pain willingness refers to being willing to live with pain, to re-duce frustrating attempts toward making the pain go away (while continuing those that help), to understanding that pain is part of who you are now.  It is leaving behind the pressing need you likely had at the beginning of your pain problem that drove you to find a diagnosis, a treatment, a cure.


Activity engagement reflects the idea that you are moving on with your life, doing the things that matter as best you can, even though you have pain. It is being willing to do things even though you may hurt while doing them. It is recognizing that you can either stay home and hurt or go out and hurt. Researchers have found that acceptance seems to be generally helpful and has been associated with reduced pain severity, less distress and lower pain interference and disability.

A key factor in acceptance seems to be the state of mind of avoidance versus engagement. When you strive to control, get rid of, manage, find a cure for pain, you have an avoidance mindset. You are struggling and fighting and perhaps putting your life on hold until you can end your pain. Needless to say, this is a very stressful state of affairs that puts most of your focus and your energy on your pain— and it gets in the way of living. The engagement mindset has a very different “feel” to it. You are not pretending that you don’t have pain; rather you are saying to yourself, “Yes, I know I have pain and I wish I didn’t, but I will work to engage my life, my goals and my friends and family anyway.”It is not denying that you have pain. It is choosing to move your focus away from pain—onto living.

You may be skeptical about everything that you just read. You may think your pain is too severe or that you are too disabled or that it isn’t possible to accept living with pain. I agree: these are challenging ideas. I hope you will take sometime to think about them. I think they are worth thinking about. You may find that acceptance actually brings some relief to your suffering and opens doors that you thought were locked. {PP}